Minimally invasive therapies (trans-anal endoscopic microsurgery (TEM)) for the curative treatment of early rectal cancers, is well-validated. The complication rate is low, and above all, the operative mortality of less than 1% even in the elderly and patients with comorbidities, opposed to 10% at standard surgery. The use of TEM surgery early in the rectum cancers in selected patients will thus be able to reduce the risk of complications and improve the overall long-term survival. Even though the disease-specific survival is reduced due to a less radical procedure. The Danish screening program for colorectal cancer will result in a significant increase in the detection of early cancers.