Colorectal cancer is the fourth most common cancer in the United States, with an estimated 154,270 new cases expected in 2025. That translates to about 37 new diagnoses per 100,000 people each year, making it roughly 8% of all new cancer cases. It’s also the second deadliest cancer in the country, behind only lung cancer.
How It Ranks Among Other Cancers
Breast cancer leads in total new cases (319,750 in 2025), followed by prostate cancer (313,780) and lung cancer (226,650). Colorectal cancer comes next at 154,270. But when it comes to deaths, the picture shifts. An estimated 52,900 people will die from colorectal cancer in 2025, placing it ahead of pancreatic cancer (51,980) and breast cancer (42,680) in mortality. Only lung cancer kills more people annually.
The overall five-year survival rate for colorectal cancer is 65.4%. That number varies dramatically depending on how early it’s caught, which is why screening matters so much.
The Rise in Younger Adults
One of the more striking trends in cancer epidemiology right now is what’s happening in people under 50. Colorectal cancer diagnoses in this age group have been climbing by nearly 3% per year, even as overall rates have declined slightly in the general population. This shift prompted major health organizations to lower the recommended screening age from 50 to 45 in recent years.
Researchers are still working to pin down why younger adults are increasingly affected. Diet, obesity, sedentary lifestyles, and changes in the gut microbiome are all under investigation, but no single factor explains the full trend. What’s clear is that colorectal cancer is no longer a disease you can assume only affects older people.
Screening Has Cut Rates Significantly
Among adults 50 and older, colorectal cancer incidence and death rates have dropped by more than 30% over the last fifteen years. A substantial portion of that decline comes from screening, particularly colonoscopy, which can both detect cancer early and prevent it entirely by removing precancerous polyps before they become dangerous.
This is what makes colorectal cancer unusual among common cancers: routine screening doesn’t just find it sooner, it can stop it from developing in the first place. The challenge is getting people screened. Many eligible adults still skip or delay recommended screening, and the benefits are concentrated among those who actually follow through.
Rates Differ by Race and Ethnicity
Colorectal cancer does not affect all populations equally. Black Americans have the highest incidence rate at 41.9 per 100,000, compared to 37.0 per 100,000 for White Americans and 33.5 per 100,000 for Hispanic Americans. Asian Americans and Hispanic Americans both have lower-than-average rates.
The disparities in death rates are even more pronounced. Black Americans die from colorectal cancer at a rate of 16.8 per 100,000, compared to 12.9 for White Americans and 10.8 for Hispanic Americans. These gaps reflect a combination of factors: differences in screening access, later-stage diagnoses, unequal access to high-quality treatment, and potentially biological differences in tumor behavior. Native Americans also face elevated mortality, at 14.0 per 100,000.
The Global Picture
Colorectal cancer is common worldwide, not just in the United States. Globally, about 20 million new cancer cases of all types were diagnosed in 2022, and colorectal cancer consistently ranks among the top three or four most common cancers in most countries. Rates tend to be highest in high-income countries, particularly in North America, Europe, and Australia, where diets higher in processed meat and lower in fiber are more common. Rates are generally lower in parts of Africa and South Asia, though they’re rising in many middle-income countries as lifestyles shift.
What These Numbers Mean for You
At the population level, colorectal cancer is common enough that most people will know someone who has been diagnosed. Your individual risk depends on several factors: age, family history, diet, physical activity level, smoking, alcohol use, and whether you have inflammatory bowel conditions like Crohn’s disease or ulcerative colitis. Having a first-degree relative (parent, sibling, or child) with colorectal cancer roughly doubles your own risk compared to someone with no family history.
The single most impactful thing you can do is get screened starting at age 45, or earlier if you have risk factors. Screening options range from colonoscopy every 10 years to stool-based tests done annually or every few years. The 30% drop in incidence among older adults is direct evidence that screening works at a population level, and it works at an individual level too. Polyps caught during a colonoscopy are removed on the spot, often eliminating the cancer risk before it begins.