According to the American Cancer Society, colorectal cancer is the third most commonly diagnosed cancer and the third most common cause of cancer-related death in both men and women in the United States. However, it ranks second in cancer-related deaths overall and is the leading cause of cancer death in men younger than age 50.
Findings from a new report by the American Cancer Society show that the proportion of individuals diagnosed with advanced-stage colorectal cancer increased from 52% in the mid-2000s to 60% in 2019. The number of people younger than age 55 diagnosed with colorectal cancer increased from 11% in 1995 to 20% in 2019. There was also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. Racial and ethnic disparities in this cancer continue, with Native Americans, Alaskan Natives, and Black individuals experiencing the highest incidence and mortality rates compared with White patients. These findings were published by Siegel et al in CA: A Cancer Journal for Clinicians.1
In 2023, the American Cancer Society is predicting that approximately 153,020 individuals will be diagnosed with colorectal cancer and that 52,550 will die of the disease, including 19,550 incidences and 3,750 deaths in people younger than age 50.
The researchers used population-based cancer incidence data collected through 2019 by the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program and the Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries, and mortality data through 2020 provided by the CDC’s National Center for Health Statistics. Their analysis provides a comprehensive overview of current statistics on colorectal cancer in the United States, including the estimated numbers of new cases and deaths in 2023 by age, and incidence, survival, and mortality rates and trends by age, race, and ethnicity.
According to the results from the report, the decline in colorectal cancer incidence slowed from 3% to 4% annually during the 2000s to 1% annually during 2011 to 2019, driven partly by an increase in individuals younger than age 55 of 1% to 2% annually since the mid-1990s. Consequently, the proportion of cases among those younger than age 55 increased from 11% in 1995 to 20% in 2019.
The incidence since 2010 increased in those younger than age 65 for regional-stage disease by about 2% to 3% annually and for distant-stage disease by 0.5% to 3% annually, reversing the overall shift to earlier-stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 vs 52% in the mid-2000s and 57% in 1995, before widespread screening. There was also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019.
In addition, the researchers found that colorectal cancer mortality declined by 2% annually from 2011 to 2020 overall but increased by 0.5% to 3% annually in individuals younger than age 50 and in Native Americans younger than age 65. The colorectal cancer incidence rate was 33% higher in men (41.5 per 100,000) than in women (31.2 per 100,000) during 2015 to 2019, likely reflecting differences in risk factor prevalence, including excess body weight, processed meat consumption, and historical smoking.
The incidence of colorectal cancer is highest in people who are Alaskan Native (88.5 per 100,000), Native American (46.0 per 100,000), or Black (41.7 per 100,000) vs White individuals (35.7 per 100,000). Mortality patterns were similar in these patient populations, with rates highest in people who are Alaskan Native (50.5 per 100,000), Native American (17.5 per 100,000), or Black (17.6 per 100,000) vs White individuals (13.1 per 100,000).
Ahmedin Jemal, DVM, PhD
Rebecca L. Siegel, MPH
“Despite continued overall declines, colorectal cancer is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against colorectal cancer could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans,” concluded the study authors.
“We have to address why the rates in young adults continue to trend in the wrong direction,” said Ahmedin Jemal, DVM, PhD, Senior Vice President, Surveillance & Health Equity Science at the American Cancer Society, and senior author of this study, in a statement. “We need to invest more in research to uncover the causes of the rising trends and to discover new treatment for advanced-stage diseases to reduce the morbidity and mortality associated with this disease in this young population, who are raising families and supporting other family members.”
Rebecca L. Siegel, MPH, Senior Scientific Director of Surveillance Research at the American Cancer Society, is the corresponding author of this study.
DISCLOSURE: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
1. Siegel RL, Miller KD, Wagle NS, et al: Cancer statistics, 2023. CA Cancer J Clin. January 12, 2023 (early release online).