AIM: To evaluate changes in colorectal cancer (CRC) survival over the last 20 years.METHODS: We compared two groups of consecutive CRC patients that were prospectively recruited:GroupⅠincluded 1990 patients diagnosed between 1980 and 1994. GroupⅠincluded 871 patients diagnosed in 2001.RESULTS: The average follow up time was 21 mo (1-229) for GroupⅠand 50 mo (1-73.4) for GroupⅠ.Overall median survival was significantly longer in GroupⅠthan in GroupⅠ(73 mo vs 25 mo, P<0.001) and the difference was significant for all tumor stages. Post surgical mortality was 8% for GroupⅠand 2% for GroupⅠ( P<0.001). Only 17% of Group? patients received chemotherapy compared with 50% of GroupⅠpatients ( P<0.001).CONCLUSION: Survival in colorectal cancer patients has doubled over the past 20 years. This increase seems to be partly due to the generalization in the administration of chemotherapy and to the decrease of post surgical mortality.