Colorectal cancer, the second leading cause of cancer deaths in the United States, is a molecular disease that is largely lifestyle determined and preventable. While heart disease has been sharply declining, in large part from widespread use of biological measurements that indicate risk ("biomarkers of risk"), such as blood cholesterol, to motivate and guide preventive treatment, colorectal cancer is a disease for which mortality rates have changed little and for which there have been no biomarkers of risk. Based on new knowledge about the molecular basis of colorectal cancer we developed and validated a panel of treatable biomarkers of risk that can be measured in rectal biopsies using automated immunohistochemistry and semi-automated image analysis. The methodology is now being made practical for clinical application through the use of 1) quantum dots, so that all of the biomarkers can be detected simultaneously on the same histologic sections (i.e., multiplexed), and 2) novel, automated image analysis algorithms to measure the quantities and tissue distributions of the biomarkers. Herein we summarize our methods, results, current directions, and progress.