Colorectal Cancer, United States—2007–2016

Rates by Sex, Race, and Ethnicity

The incidence and mortality of colorectal cancer varies by sex, race, and ethnicity (Figure 1). Overall, Black males and females have higher incidence and mortality rates than White, American Indian and Alaska Native, and Asian and Pacific Islander males and females. Non-Hispanic males and females have higher incidence and mortality rates then Hispanic males and females.

Figure 1. Colorectal cancer incidence and mortality age-adjusted rates^a by sex, race, and ethnicity, United States, 2016

^aRates are per 100,000 and age-adjusted to the 2000 U.S. standard population.

Healthy People 2020 objectives include reducing the colorectal cancer incidence rate to 40.0 per 100,000 persons and the mortality rate to 14.5 per 100,000 persons. These targets were met among females but not yet among males (Figure 2).

Figure 2. Colorectal cancer incidence and mortality rates^a by sex and Healthy People 2020 targets, United States, 2007–2016

^aRates are per 100,000 and age-adjusted to the 2000 U.S. standard population.

Colorectal cancer mostly affects adults 50 years and older. The peak of colorectal cancer incidence is among 65 to 69 year olds (n=19,481 cases) (Figure 3). Mortality counts increase as age increases up to 69 years and then plateau among 70 to 84 year olds.

Figure 3. Colorectal cancer incidence and mortality counts by 5-year age groups, United States, 2016

*Data are suppressed when there are fewer than 16 cases.

From 2012 to 2016, the rate of colorectal cancer incidence and mortality increased among 20 to 49 year olds and decreased among individuals 65 years and older (Figure 4). Behavioral risk factors, including excess body fat and physical inactivity, may be contributing to the increase in colorectal cancers among younger adults.^1,2

Figure 4. Trends in incidence and mortality rates^a by age groups, United States, 2012–2016

^aRates are per 100,000 and age-adjusted to the 2000 U.S. standard population.

*Annual percent change (APC) was statistically significant from zero (P<0.05)

Conclusion

Colorectal cancer affects men and women of all racial and ethnic groups and is most often found in people 50 years or older. Colorectal cancer screening can detect and remove precancerous polyps, potentially preventing future cancers. Screening can also detect cancers at an earlier stage when a person may be asymptomatic and when treatment is most effective. However, millions of adults age 50 to 75 are not being screened for colorectal cancer as recommended by the U.S. Preventive Services Task Force.

CDC’s Colorectal Cancer Control Program has funded awardees to increase colorectal screening rates. Awardees work with health systems and clinics that serve high-need groups to help them follow recommendations from The Community Guide to use evidence-based interventions, such as reducing non-economic burdens or obstacles that make accessing screening difficult. The National Colorectal Cancer Roundtable, co-founded by CDC, is working with partners to achieve 80% colorectal cancer screening in every community by reducing screening barriers.

Data sources

Data in this brief come from U.S. Cancer Statistics, the official federal cancer statistics.

U.S. Cancer Statistics incidence data are from population-based registries that participate in CDC’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and meet high-quality data for the November 2018 data submission, covering 100% of the U.S. population.

U.S Cancer Statistics death data are from CDC’s National Center for Health Statistics National Vital Statistics System and cover 100% of U.S. population.

Data were analyzed using SEER*Stat (version 8.3.6).

References

¹Siegel RL, Fedewa SA, Anderson WF, Miller KD, Ma J, Rosenberg PS, Jemal A. Colorectal cancer incidence patterns in the United States, 1974–2013. JNCI 2017;109(8).

²Liu PH, Wu K, Ng K, Zauber AG, Nguyen LH, Song M, He X, Fuchs CS, Ogino S, Willett WC, Chan AT, Giovannucci EL, Cao Y. Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncology 2019;5(1):37–44.