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May 30, 2026Journal of Clinical Oncology

US colorectal cancer mortality rates from 1999-2020 showed a continuous increase in adults ≤44 years (APC +0.78%; P=0.000001), contrasting with a decelerating decline in adults ≥45 years.

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Population

US population with colorectal cancer mortality data from CDC WONDER, stratified by early-onset and late-onset

Design

Cohort

Follow-up

22 years (1999-2020)

Key result

US colorectal cancer mortality rates from 1999-2020 showed a continuous increase in adults ≤44 years (APC +0.78%; P=0.000001), contrasting with a decelerating decline in adults ≥45 years.

Authors

GSG SharmaDSDosbai SaparovSKSuhas Kataveni

Discussion

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Overview

While late-onset colorectal cancer mortality has declined, early-onset mortality has steadily increased by nearly 23% over the past two decades in the US, highlighting an emerging public health crisis.

Key Points

  • The aim is to examine divergent trends in colorectal cancer mortality among different age groups over 22 years using US data.
  • Analyzed CDC WONDER data from 1999–2020
  • Utilized joinpoint regression analysis to identify trends
  • Calculated age-adjusted mortality rates for early-onset and late-onset CRC.
  • Late-onset CRC mortality decreased from 69.26 to 40.49 per 100,000, a reduction of 41.6%.
  • An inflection point in late-onset CRC was noted in 2014, with a significant slowdown in mortality improvement post-2014 (APC: −1.61%; p = 0.000006).
  • Early-onset CRC mortality rose from 0.92 to 1.13 per 100,000, representing a 22.8% increase throughout the entire 22-year period (APC: +0.78%; p = 0.000001).

Study Design

Type

Observational

Structured PICO

P
Population
US population with colorectal cancer mortality data from CDC WONDER (1999-2020), stratified by early-onset (≤44 years) and late-onset (≥45 years)
O
Outcome
Age-adjusted colorectal cancer mortality rates (ICD-10: C18-C20)hard clinical

Main Result

Effect estimate: APC +0.78% (95% CI +0.54 to +1.02)

p-value: p=0.000001

While late-onset colorectal cancer mortality has declined, early-onset mortality has steadily increased by nearly 23% over the past two decades in the US, highlighting an emerging public health crisis.

Cite This Study

Sharma et al. (2026) conducted an observational in Colorectal cancer. Early-onset (≤44 years) vs. Late-onset (≥45 years) was evaluated on Annual Percent Change (APC) in age-adjusted CRC mortality rates (APC +0.78%, 95% CI +0.54 to +1.02, p=0.000001). US colorectal cancer mortality rates from 1999-2020 showed a continuous increase in adults ≤44 years (APC +0.78%; P=0.000001), contrasting with a decelerating decline in adults ≥45 years.

synapsesocial.com/papers/6a1a808f0307b78509432869https://doi.org/10.1200/jco.2026.44.16_suppl.e15722
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