​Colorectal cancer shifts to more advanced disease, younger people.

Colorectal cancer is swiftly shifting to more advanced disease and younger individuals according to a new American Cancer Society report released March 1. The news came as ACS researchers published a new report on cancer facts and trends in CA: A Cancer Journal for Clinicians, alongside its consumer-friendly companion, Colorectal Cancer Facts & Figures 2023-2025.

Colorectal cancer is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the US (the second leading cause in men and women combined). While incidence of the disease declined rapidly in people aged 50 and older during the 2000s, largely because of increased screening with colonoscopy, this progress has slowed during the past decade, with decreasing trends now confined to people aged 65 and older.

This new report shows several key trends:

• 3 in 5people are now being diagnosed with advanced-stage colorectal cancer.
  • Researchers showed the proportion of individuals in the United States diagnosed with advanced-stage colorectal cancer (CRC) increased from a low of 52% in the mid-2000s to 60% in 2019 despite increased screening. 
• 1 in 5 people diagnosed are younger than 55 years old.
  • Diagnoses of people in this age group doubled from 11% (1 in 10) in 1995 to 20% (1 in 5) in 2019.
  • Declining incidence rates are confined to ages 65 and older since 2011; incidence rates have stabilized in ages 50-64 years and have increased by 2% per year in people younger than 50 years of age, as well as in people ages 50-54 years.
  • CRC death rates have increased since around 2005 by 1% annually in people younger than 50 years and by 0.6% in people ages 50-54.
• Alaskan Native people have the highest incidence and mortality rates. 
  • CRC incidence is highest in people who are Alaska Native (88.5 per 100,000), American Indian (46.0 per 100,000), or Black (41.7 per 100,000; versus 35.7 per 100,000 in Whites); mortality patterns are similar, with rates highest in people who are Alaska Native (50.5 per 100,000), American Indian (17.5 per 100,000), or Black (17.6 per 100,000; versus 13.1 per 100,000 in Whites).
• In 2023, an estimated 153,020 people will be diagnosed with CRC in the US, and 52,550 people will die from the disease.

“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” Rebecca Siegel, ACS senior scientific director, surveillance research, and lead author of the report said in a news release Wednesday, which was also announced in Spanish. “The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened.”

Dr. Ahmedin Jemal, ACS senior vice president, surveillance and health equity science and senior author of the study said, “We have to address why the rates in young adults continue to trend in the wrong direction. 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.” 

ACS’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), advocates for policy solutions that eliminate barriers to colorectal cancer screening, including those that ensure coverage of follow-on colonoscopies after a positive non-invasive test without cost sharing. In November 2022, the Centers for Medicare and Medicaid Services (CMS) finalized its rule for Medicare to cover colonoscopies after non-invasive screening tests and lower the minimum age of screening to 45. To date, 11 states have passed such laws that would eliminate cost-sharing and lower the screening age to 45. ACS CAN will continue to advocate for the implementation of these policies at the state level.

More about Cancer Facts & Figures

• ACS has published Colorectal Cancer Facts & Figures since 2005. It is one of a suite of eight publications that comprise the Cancer Facts & Figures series.
• The audience for Cancer Facts & Figures publications extends not just nationwide, but around the globe. This publication – and all in this suite of materials – equip health professionals, educators, policymakers, patients, and others with essential information.
• Each Cancer Facts & Figures report is published with a companion article in the ACS journal, CA: A Cancer Journal for Clinicians.
• A unique feature of Cancer Facts & Figures is their state-specific data: the publications break down projections by state and at the national level.
• ACS Cancer Facts & Figures publications are downloaded on average about 9,000 per month or about 300 times every single day!
• The next Cancer Facts & Figures publication scheduled for update and release is Cancer Prevention & Early Detection Facts and Figures. 
• An annual report, Cancer Facts & Figures, is updated and published each winter.

What you can do

• Any time a Cancer Facts & Figures publication is released is a good opportunity to refresh your cancer knowledge as an ACS team member or volunteer. Download a copy and learn more about the disease and its current impact. 
• Learn the latest about colorectal cancer guidelines – particularly as March is Colorectal Cancer Awareness Month.
• Regular screening for colorectal cancer can save lives. Most people should begin colorectal cancer screening at age 45. Learn more at cancer.org/getscreened. 
• Stay tuned to ACS2Go for updates on this topic throughout the week as the news media covers this important topic.
• Follow and share this news on social media and amplify messaging from ACS brand channels.