Abstract: Objective To study the current situation of the risk factors of colorectal cancer and the distribution of the TCM physique type in high risk population of colorectal cancer in the community. Methods A survey of residents aged 50-74 years in Puxing community in Shanghai, using questionnaire survey and fecal occult blood test (FOBT) screening, the high-risk population were analyzed to determine the TCM physical identification and follow-up colonoscopy results. Results A total of 4 136 people completed the screening, 1 102 were judged to be high risk population, and the positive rate was 26.64% (95% CI:25.30%-27.99%), The results of FOBT were positive in 1 006 people, accounting for 24.90% (95% CI:23.57%-26.23%). And 228 people were screened for follow-up, and the compliance rate of colonoscopy was 20.69% (228/1102). The detection rate of colonic polyps was 24.56% (56/228), and the detection rate of colorectal cancer was 1.31% (3/228). The results of TCM physical identification showed that the gentle type was in the highest level of 418 people (37.9%), the biased constitution was mainly in phlegm dampness type 319 people (28.9%), qi deficiency type 142 people (12.8%), and Yang deficiency type 106 people (9.6%). Conclusion High risk population of colorectal cancer is in a higher level among middle-and-old-aged people, the results of colonoscopy is mainly polyps, and the TCM physical identification is mainly gentle type. It is suggested that the high-risk population of colorectal cancer in middle and old aged people has higher concealment, so it is necessary to carry out colorectal cancer screening. The biased constitution was mainly in phlegm dampness type, qi deficiency type, and Yang deficiency type. It shows that the middle-and-old-aged people should pay high attention to the early prevention and treatment of colorectal cancer. The TCM intervene can start with strengthening spleen, replenishing qi and warming Yang.