In this comparative healthcare series health care professionals across the world describe their approach to a specific clinical problem in the context of their local health care services. This month we focus on colorectal cancer. The prognosis for colorectal cancer remains variable across the world. Although colorectal cancer is one of the most common malignancies diagnosed globally typical five year survival is quoted between 45-55%. Those who survive have usually been diagnosed at an early stage and without metastasis when effective surgical treatment is possible. Most cases are diagnosed after the condition becomes symptomatic and not as a result of screening asymptomatic people. In many countries around the world it is a general practitioner (GP) who must decide when to refer a patient to a specialist before that patient is seen at a hospital clinic. The GP therefore plays a central role in the diagnosis and support of colorectal cancer patients in those countries. Australia and the United Kingdom share a commitment to general practice and the role of the GP is pivotal to the delivery of health care to cancer patients and their families. This month Dr. Andrew Knight and Dr. Michael Gordon describe their approach to a symptomatic patient, writing from their experience as medical practitioners in Australia and the United Kingdom respectively. The views expressed below are their own and do not necessarily reflect health policy or practice elsewhere in their countries. However we believe they offer an interesting perspective on their health care systems and commend the article to our readers.