Introduction: This thesis examines the quality of colorectal care and its association with healthcare costs.

Methods: Quality of colorectal cancer care was assessed based on geography and hospital volume in patients diagnosed with colorectal cancer in Manitoba between 2004-2014. The associations between healthcare costs and longer wait times, higher postoperative morbidity and mortality and palliative care utilization were evaluated.

Results: There were improvements in the quality of colorectal cancer care between 2004-2014, but disparities by geography and hospital volume existed. Increasing healthcare costs were associated with longer wait times, higher rates of morbidity and mortality and underutilization of palliative care.

Conclusion: The quality of colorectal cancer care in Manitoba is improving but highly variable. This variability is an economic burden on the healthcare system and a cause of preventable patient morbidity and mortality. Strategies to improve the quality and reduce the costs of colorectal cancer care in Manitoba are needed.