Approximately one third of New Zealanders who are diagnosed with colorectal cancer present as an emergency. This is a major public health concern because people diagnosed with cancer as an emergency typically have suboptimal clinical outcomes compared with those diagnosed through screening or an alternate non-emergency route.

This protocol paper describes the design of a research study that aims to understand the routes to diagnosis for colorectal cancer, the factors that lead to emergency presentation of colorectal cancer, and its delayed presentation in primary and secondary care. Raising nurses’ awareness of the various diagnostic routes for colorectal cancer and the potential negative effect on health outcomes, will assist them to provide effective patient education, such as the importance of acting on ‘red flag’ cancer symptoms. It will also inform nurses of the effective triaging of cancer patients in acute settings.