Carcinoma rectum has several risk factors including family history, inflammatory bowel disease, and genetic conditions. The rectum is divided into three portions with different lymphatic drainage patterns and implications for surgery. Staging includes Dukes', Astler-Coller, TNM, and clinical features are important for diagnosis. Treatment depends on stage and may include transanal excision, chemoradiation, surgery such as anterior resection or APR, and adjuvant therapy.