Polyamines, by virture of their regulatory role in the cellular synthesis of DNA, RNA, and protein, are potential indicators of malignant growth. In view of this, serum polyamine levels of patients with colorectal carcinoma or benign bowel disease were examined. Of 53 patients with colorectal carcinoma, 35 (66%) showed elevations of 1 or more polyamines. Nine patients with benign bowel disease (villous adenoma, Gardner's syndrome, familial polyposis, and diverticulitis) showed normal serum polyamine levels except 1 patient with a villous adenoma. Patients with colorectal carcinoma were designated stage A, B, C, or D depending on the progression of their disease. All patients classified as D showed elevation of 1 or more polyamines. Serum polyamines became elevated following surgery in patients with colorectal carcinoma as well as those with benign bowel diseases, suggesting a relationship to the surgical procedure. Preliminary longitudinal studies of patients with colorectal carcinoma (B stage) undergoing curable surgical procedures show normal polyamine levels and no evidence of disease at 15 months.