ObjectiveTo analyze the surgical treatment patterns for newly diagnosed colorectal cancer (CRC) patients based on hospital registry data in Sichuan Province (2020–2023). MethodsBased on the hospitalization records of CRC inpatients from all secondary and tertiary hospitals in Sichuan Province (2015–2024), the newly diagnosed CRC patients admitted during 2020–2023 and evaluated rates of primary lesion resection, neostomy, and stoma reversal procedures were identified. Then stratified analyses by gender, age, tumor location, and organ metastasis at diagnosiswere analyzed (One-sided test with α=0.025). ResultsBased on hospitalization records of 118 787 newly diagnosed CRC inpatients in Sichuan Province (2020–2023), the cohort had a mean age of (66.4±12.3) years, with 70 756 s (59.6%) male, 64 646 (54.4%) rectal cancer cases, and 16 418 (13.8%) cases exhibiting synchronous organ metastasis at diagnosis. Within one year post-diagnosis, 84 634 (71.2%) patients underwent primary tumor resection and 26 514 (22.3%) received neostomy procedures, both demonstrating significantly increasing annual trends (resection: χ2trend=72.2, P<0.001; ostomy: χ2trend=70.6, P<0.001) while showing inverse correlations with advancing age (resection: χ2trend=4 096.0, P<0.001; ostomy: χ2trend=56.3, P<0.001). Stratified analyses revealed significantly lower resection rates among females vs. males, rectal vs. colon cancer, and metastatic vs. non-metastatic patients (all P<0.001), whereas ostomy rates were higher in females and rectal cancer patients but lower in metastatic cases (all P<0.001). Among 26 514 ostomy patients, 11 288 (42.6%) underwent stoma reversal after a median (interquartile range) interval of 123 d (95 d, 188 d), with 8 187 reversals (72.5%) within 6 months, 2 700 (23.9%) during 6–12 months, and 401 (3.6%) after 12 months. Reversal rates increased temporally (χ2trend=80.0, P<0.001) but decreased with advancing age (χ2trend=1 072.3, P<0.001). ConclusionIn Sichuan province, rising trends are observed in the hospitalization burdern of newly diagnosed CRC and rates of primary tumor resection and neostomy.