Colorectal Cancer Rates Rise Again in 2023
Incidence reversed a decades-long decline, with rising rates across adults aged 18 to 49 and into the late 60s.
Updated on Nov. 5, 2026 in Cancer
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Colorectal cancer incidence in the United States reversed its steady decline in 2023, according to an analysis of National Cancer Institute surveillance data. The age-adjusted rate rose to 38.3 per 100,000 in 2023 from 36.7 per 100,000 in 2022.
Why it matters
The rise is concentrated among younger adults, a shift that complicates the long-standing picture of falling colorectal cancer rates in the United States. The study authors attributed the increase in the 45-49 age group in part to improved screening and adherence to guidance recommending average-risk screening begin at age 45.
The age-adjusted incidence rate fell from 55.2 per 100,000 in 2000 to 36.7 per 100,000 in 2022 before rising to 38.3 per 100,000 in 2023. Annual percentage change for ages 45-49 climbed to 12.76% over 2019-2023, compared with 0.94% over 2000-2019, though the cause of the increase is not established.
The players
National Cancer Institute
The federal agency within the National Institutes of Health that runs the Surveillance, Epidemiology, and End Results program supplying the incidence data used in the analysis.
Dana-Farber Cancer Institute
A Boston-based cancer center affiliated with Harvard Medical School, where study author Ng is based.
MD Anderson Cancer Center
A major cancer hospital and research institution in Houston, Texas, with which study author You is affiliated.
University of Minnesota
A public research university in Minneapolis, where study author Marmor is affiliated.
The details
Researchers examined age-specific colorectal cancer incidence in 5-year cohorts from ages 20-24 through 80-85, using National Cancer Institute data. Incidence increased in every 5-year cohort among adults aged 18-49 and up to ages 65-69, while rates among older adults flattened.
Timeline
2000: Colorectal cancer incidence began a steady decline.
2019-2023: Annual percentage change for ages 45-49 rose to 12.76%.
2023: Age-adjusted incidence rose to 38.3 per 100,000, reversing the decline.
Health Landscape
For more than two decades, U.S. colorectal cancer incidence fell steadily in National Cancer Institute SEER data, making the 2023 reversal a notable break in that trajectory. The increase concentrated among adults under 50 raises questions about how screening guidance introduced for average-risk adults at age 45 is shaping population-level trends.
Adults under 50 and those approaching the screening age of 45 should understand that colorectal cancer incidence is rising in younger cohorts, so symptoms such as persistent changes in bowel habits or rectal bleeding warrant medical evaluation regardless of age. Screening guidance that starts at 45 for average-risk adults is the main tool the study authors cite, and older adults already in screening programs are the group where rates were reported to have flattened.
The takeaway
Colorectal cancer is no longer declining across all ages in the United States, so people under 50 should discuss symptoms and screening timing with a clinician rather than assume they are low risk. Keeping up with recommended screening is the step the study authors point to as most relevant.
Further reading
For related coverage, see the Cancer section.
Source note: This article includes information reported by Medscape.
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