Did you know that for every 50 people who read this blog post, 2 will be at risk of developing colorectal cancer (CRC) over their lifetime?1 That could be you or someone you love.
March is National Colorectal Cancer Awareness Month, making this a timely moment to share key statistics, risk factors, and symptoms that can help you better understand CRC and advocate for yourself in an overburdened healthcare system.
CRC is the third most commonly diagnosed cancer and the third deadliest in the United States for both men and women.1,2 While CRC rates have declined steadily since the 2000s in patients over 65 years of age, the proportion of cases in adults under 55 years of age has nearly doubled to 20% since the 1990s.1,2 Additionally, since the mid-1980s, CRC rates have increased in younger patients aged 20 to 39 years.3 Because CRC remains less common in patients under 50, the time between reporting an initial symptom and receiving a formal diagnosis is 40% longer than in older patients, often due to a misdiagnosis, usually a condition more common for this age group. This delay means that younger patients are more likely to be diagnosed with a more advanced and aggressive form of the disease.2,4
Although family history is associated with an increased risk of developing CRC, an estimated 50% of cases are attributed to modifiable risk factors, including but not limited to: smoking, diet, alcohol consumption, physical activity, and weight.1,5,6
- Long-term tobacco smoking is associated with 12% of CRC cases and can double or even triple the lifetime risk of developing CRC compared with non-smokers7,8
- Consuming red and processed meat can increase the risk of CRC by 20% to 30% for every additional 0.22 lbs (100 g) consumed daily9,10
- Consuming alcoholic beverages increases the risk of developing CRC by 20% for 2 to 3 drinks per day, 40% for more than 3 drinks, and 52% for more than 4 drinks11–13
- Physical inactivity has been associated with 25% to 50% greater risk of developing CRC than active individuals12,14
- Weight gain can be associated with a 3% increased risk of CRC for every 11 lbs (5 kg) gained15,16
The good news is that, because these risk factors are modifiable, a few lifestyle changes can significantly reduce your lifetime risk of developing CRC.
Because older people remain at higher risk of developing CRC, the United States Preventative Services Task Force recommends regular screening between the ages of 50 and 75 years. Screening can be done through stool-based tests or imaging procedures, such as colonoscopy. Both types of tests have been shown to be effective at decreasing the number of CRC cases and mortality.17,18 Thanks to screening, imaging, and improvements in treatment, the 5-year survival rate for CRC across all age categories has increased from 50% to 64% since the 1970s.1,19
Due to the strain on healthcare systems and the limited time doctors have with their patients, self-advocacy is essential. Symptoms of CRC are often similar to those of other, more common conditions, but it is important to share any of the following symptoms with your doctor:
- Blood in stool
- Pain in the abdomen
- Lump in the abdomen
- Change in bathroom habits
- Unexplained weight loss
- Low blood iron
Today, people are living longer than ever with CRC, including those with advanced disease. In 2022, there were 1.4 million CRC survivors in the United States alone.2,20 We encourage everyone to help increase this number by following screening recommendations and advocating for yourself, so that we can work toward making CRC a less common and less deadly disease.
References
1. Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145-164. doi:10.3322/caac.21601
2. Siegel RL, Wagle NS, Cercek A, Smith RA, Jemal A. Colorectal cancer statistics, 2023. CA Cancer J Clin. 2023;73(3):233-254. doi:10.3322/caac.21772
3. Siegel RL, Fedewa SA, Anderson WF, et al. Colorectal cancer incidence patterns in the United States, 1974–2013. JNCI J Natl Cancer Inst. 2017;109(8):djw322. doi:10.1093/jnci/djw322
4. Chen FW, Sundaram V, Chew TA, Ladabaum U. Advanced-stage colorectal cancer in persons younger than 50 years not associated with longer duration of symptoms or time to diagnosis. Clin Gastroenterol Hepatol. 2017;15(5):728-737.e3. doi:10.1016/j.cgh.2016.10.038
5. Islami F, Goding Sauer A, Miller KD, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018;68(1):31-54. doi:10.3322/caac.21440
6. Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers. 2021;13(9):2025. doi:10.3390/cancers13092025
7. Chao A, Thun MJ, Jacobs EJ, Henley SJ, Rodriguez C, Calle EE. Cigarette smoking and colorectal cancer mortality in the Cancer Prevention Study II. JNCI J Natl Cancer Inst. 2000;92(23):1888-1896. doi:10.1093/jnci/92.23.1888
8. Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomark Prev Publ. 2001;10(7):725-731.
9. Aykan NF. Red meat and colorectal cancer. Oncol Rev. 2015;9(1):288. doi:10.4081/oncol.2015.288
10. Chan DSM, Lau R, Aune D, et al. Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PLOS ONE. 2011;6(6):e20456. doi:10.1371/journal.pone.0020456
11. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015;112(3):580-593. doi:10.1038/bjc.2014.579
12. American Cancer Society. Colorectal Cancer Facts & Figures 2017-2019. Atlanta, GA: American Cancer Society; 2017.
13. Fedirko V, Tramacere I, Bagnardi V, et al. Alcohol drinking and colorectal cancer risk: an overall and dose–response meta-analysis of published studies. Ann Oncol. 2011;22(9):1958-1972. doi:10.1093/annonc/mdq653
14. Schmid D, Leitzmann MF. Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. JNCI J Natl Cancer Inst. 2014;106(7):dju098. doi:10.1093/jnci/dju098
15. Karahalios A, English DR, Simpson JA. Weight change and risk of colorectal cancer: a systematic review and meta-analysis. Am J Epidemiol. 2015;181(11):832-845. doi:10.1093/aje/kwu357
16. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Gastroenterol Rev. 2019;14(2):89-103. doi:10.5114/pg.2018.81072
17. Joseph DA, King JB, Dowling NF, Thomas CC, Richardson LC. Vital signs: colorectal cancer screening test use - United States, 2018. MMWR Morb Mortal Wkly Rep. 2020;69(10):253-259. doi:10.15585/mmwr.mm6910a1
18. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989
19. SEER Cancer Statistics Review, 1975-2016. SEER. Accessed March 7, 2025. https://seer.cancer.gov/csr/1975_2016/index.html
20. Miller KD, Nogueira L, Devasia T, et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin. 2022;72(5):409-436. doi:10.3322/caac.21731
