Colorectal Cancer Rates Rose 4.4% In One Year After Decades Of Decline
A colonoscopy can do more than catch colorectal cancer early. It can also prevent it by removing precancerous polyps before they develop into cancer.
This has helped drive down colorectal cancer rates in the U.S. for years. But in 2023, that long-term decline reversed, with rates rising for the first time since tracking began in 2000.
A new analysis suggests the increase extends beyond younger adults, raising questions about what's changing and why.
About the study
Researchers analyzed colorectal cancer data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)
Program, which covers just under half of the U.S. population. They tracked cancer rates from 2000 to 2023, looking at overall trends and differences between age groups.
Colorectal cancer rates are rising across age groups
After years of decline, colorectal cancer rates began climbing again.
The overall rate dropped from 55.2 cases per 100,000 people in 2000 to 36.7 in 2022, then rose to 38.3 in 2023, a 4.4% increase and the first annual rise in the SEER data since 2000.
The increase wasn't limited to younger adults. Rates rose across nearly every age group up to 65 to 69, with incidence climbing by an average of 2.76% per year between 2021 and 2023.
Researchers point to several possible explanations:
- Generational risk: People born during and after the 1960s may face higher colorectal cancer risk as they age, although researchers don't yet know why.
- More screening among younger adults: Some of the increase in adults ages 45 to 49 may reflect guidelines lowering the recommended screening age from 50 to 45.
- Other risk factors in older adults: Rates are rising among those ages 65 to 69 and have stopped declining among adults ages 70 to 74. This is harder to explain because roughly 80% of these older adults are up to date on screening. Other risk factors may be offsetting some of screening's benefits.
Could pandemic-related screening delays explain the trend?
Researchers examined data from 10 U.S. health systems and found that screening had returned to normal by January 2021. The increase also persisted when 2020 and 2021 data were excluded, making pandemic disruptions an unlikely explanation.
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What you can do to protect your colorectal health
Researchers are still investigating what's driving the rise, but there are practical steps you can take now:
- Check when you're due for screening: If you're 45 or older, ask your doctor which screening test is right for you and when you should have it. Average-risk adults generally continue screening through age 75, with decisions after that based on individual health and history.
- Speak up about symptoms: Blood in your stool, persistent changes in bowel habits, unexplained fatigue, or ongoing abdominal pain warrant a medical conversation. Don't wait until your next routine screening to mention them.
- Share your family history: Tell your doctor if a close relative has had colorectal cancer or if you've previously had polyps. These factors can affect when you should start screening and how often you need it.
- Follow through on abnormal results: If a screening test comes back abnormal, ask what follow-up is needed and when. Screening works best when recommended next steps aren't missed.
The takeaway
Colorectal cancer rates are rising again, and researchers haven't figured out all the reasons why.
Keep your screening appointments, know your family history, and don't ignore changes in your gut. Your next checkup is a good time to make sure you're on track.