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Introduction: Intercellular Adhesion Molecule -1 (ICAM-1) is a transmembrane endothelial (EC) and leukocyte associated glycoprotein that plays a key role in leukocyte migration and activation. ICAM-1 expression is induced by IL-1 and TNF alpha. ICAM-1 participates in immune and inflammatory processes by interacting with leukocyte LFA1 and Mac-1 integrins. Soluble ICAM-1 (sICAM-1) is generated via proteolytic cleavage and is present in the plasma. sICAM-1 delivers chemokinetic signals to lymphocytes and enhances cytokine production and T-cell proliferative responses. sICAM-1 promotes angiogenesis and elevated serum levels have been reported in patients with melanoma, gastric or gallbladder cancer, and liver metastases. Plasma sICAM-1 levels in patients with colorectal cancer (CRC) have not been well studied. The purpose of this study was to compare plasma sICAM-1 levels in patients with CRC and benign colonic disease. Method: Preoperative blood samples were obtained from CRC and benign colon pathology patients undergoing colorectal resection (CR). Clinical, demographic and final pathological data were collected. Plasma sICAM-1 levels were determined via ELISA in duplicate and are reported as mean ± SD. sICAM-1 levels between groups were compared by the t test and the ANOVA test was used to assess the relationship between sICAM-1 levels and T, N or tumor stage in the cancer group. Significance was defined as p<0.05.Results: A total of 130 CRC (74% colon, 26% rectal) and 116 benign disease patients (adenoma 39%, diverticulitis 58%, other 3%) were studied. The sex breakdown was similar but the CRC patients were older (mean age 66 vs 60, p=0.001). The mean preoperative plasma sICAM-1 level was significantly higher in the malignant disease group (271.7±93.5 ng/ml) than the benign pathology group (235.1±68.0; p<0.001). No significant correlation was found between plasma sICAM-1 levels and T, N or final tumor Stage although non-significant elevations were noted with increasing T and final tumor Stage and in node positive patients Conclusion: The mean plasma sICAM-1 level in a group of CRC patients was modestly (15%) but significantly increased when compared to benign pathology patients. ICAM-1 expression is upregulated in cancers due to inflammation-related angiogenesis, tissue remodeling and leukocyte trafficking. Tumor shedding of ICAM-1 may increase plasma sICAM-1 levels. A larger study is needed to determine the clinical relevance, if any, of this change and to definitively determine if plasma levels correlate with T, N and tumor stage