en Nursing Orginal research <strong><em>Background:</em></strong> Colorectal cancer (CRC) is one of the most common and age-related cancers worldwide.<br> <strong><em>Objectives: </em></strong>The present study aimed to determine the recurrence, severity, distress, and clustering of symptoms in the elderly with colorectal cancer in the selected hospitals in Isfahan from 2018 to 2019<span dir="RTL">.</span><br> <strong><em>Methods:</em></strong> This descriptive-analytical study was conducted over a period of six months on 300 patients with colorectal cancer in selected hospitals in Isfahan. Data collection tools were contextual questionnaires and symptom recall scale (MSAS). To determine the correlation matrix between symptoms (clusters), a heuristic analysis factor was used in terms of mean recurrence, severity, and distress of symptoms in research units through PCA heuristic analytical method in SPSS <span dir="RTL">16</span>.<br> <strong><em>Results</em></strong><strong>:</strong> The most common symptoms in terms of recurrence were dry mouth (32.92%) and numbness and frisson (24.55%). The most common symptoms in terms of recurrence were dry mouth (80.33%) and nausea (86%); the most common symptoms in terms of severity were dry mouth (41%) and nausea (29.8%). The most common signs of distress were &quot;I do not look like myself&quot; (6) and dry mouth (35.3%). Finally, five clusters were obtained, including systemic, psychiatric, cardiovascular, mucosal, and gastrointestinal symptoms.<br> <strong><em>Conclusion:</em></strong> The results of the present study showed that psychological symptoms had a higher percentage of recurrence, severity, and distress in CRC patients than physical symptoms<span dir="RTL">.</span> Cluster symptoms, the elderly, colorectal cancer 9 18 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-751-1&slc_lang=en&sid=1 Arghavan Esmaeili arghavan.esmaeili@gmail.com 10031947532846007301 10031947532846007301 No MSc Student, faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Parvaneh Khorasani khorasanip@nm.mui.ac.ir 10031947532846007302 10031947532846007302 No PhD in nursing, Nursing and Midwifery Care Research Center, Department of Community Health Gerontological Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Masoud Bahrami bahrami@nm.mui.ac.ir 10031947532846007303 10031947532846007303 No PhD in nursing, Professor of Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Habibollah Hosseini h_hoseini@nm.mui.ac.ir 10031947532846007304 10031947532846007304 Yes Master in nursing, Nursing and Midwifery Care Research Center, Health Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran