Colorectal Cancer Rates Rise Again Among U.S. Adults
Adults aged 45-49 saw the sharpest increase, prompting renewed attention to screening.
Updated on Nov. 5, 2026 in Cancer
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Colorectal cancer incidence in the United States, which had declined steadily since 2000, reversed course and rose in 2023. The increase was seen across all 5-year age cohorts from 18-49 and up to ages 65-69, with the sharpest jump among adults aged 45-49.
Why it matters
For adults in their 40s and 50s, the findings signal that the long-running downward trend in colorectal cancer can no longer be assumed, which makes timely screening more important. The study also suggests that screening uptake among younger adults may be shifting rates, a development that could influence how screening programs are planned in the years ahead.
This analysis of SEER incidence data compared age-specific rates across 5-year cohorts from 2000 through 2023, excluding 2020 because of the COVID pandemic. The age-adjusted rate fell from 55.2 to 36.7 per 100,000 before rising to 38.3 in 2023, and the 45-49 cohort's annual change climbed to 12.76% over 2019-2023.
The players
National Cancer Institute
The federal agency that runs the Surveillance, Epidemiology, and End Results program and supports cancer research across the United States.
Dana-Farber Cancer Institute
A Boston-based cancer center known for research and treatment across a wide range of malignancies, including colorectal cancer.
MD Anderson Cancer Center
A Houston-based cancer center within the University of Texas system, recognized for clinical care and research in gastrointestinal and other cancers.
University of Minnesota
A Minneapolis-based public research university with a substantial cancer research program and academic medical centers.
The details
Colorectal cancer incidence reflects how often new cases are diagnosed, and changes in that count can come from shifts in risk, in how many people are screened, or both. Screening tests can detect precancerous polyps and early tumors, so higher screening rates in a given age group typically raise detected incidence in the short term. The study's authors point to improved screening and adherence to guidance recommending average-risk screening begin at age 45 as a factor in the rise among 45-49-year-olds.
Timeline
2000: Colorectal cancer incidence began its steady decline.
2019-2023: The annual percentage change for ages 45-49 rose to 12.76%.
2023: The age-adjusted incidence rate rose to 38.3 per 100,000.
Health Landscape
For decades, colorectal cancer screening was recommended to begin at age 50, and the shift to age 45 in 2018 marked a turning point in how U.S. guidelines approached early-onset disease. The new incidence data show that the policy's effects are now visible in population-level trends, even as rates among older adults flattened.
If you are between 45 and 49, this is a good moment to ask your doctor whether colorectal screening is due and which test fits your situation. Adults with symptoms such as persistent changes in bowel habits, rectal bleeding, or unexplained weight loss should discuss them with a clinician rather than wait for routine screening.
The takeaway
The key insight is that colorectal cancer rates in younger and middle-aged adults are no longer falling, and the trend deserves attention. Ask your physician whether your age and risk profile call for screening now, since earlier detection remains one of the most effective tools available.
Further reading
For more on how cancer rates are tracked across the country, explore our Cancer coverage.
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