{"entity":{"id":"paper-siegel-colorectal-cancer-statistics-ca-2023","kind":"paper","name":"Colorectal cancer statistics, 2023","aka":[],"tldr":"The American Cancer Society's three-yearly stocktake: overall deaths are still falling, but one in five new cases is now in someone under 55, and more cancers are being found after they have spread than twenty years ago.","summary":"Siegel, Wagle, Cercek, Smith and Jemal's triennial update of United States colorectal cancer statistics, using incidence from population-based registries and mortality from the National Center for Health Statistics. The report projected roughly 153,020 diagnoses and 52,550 deaths in 2023, including 19,550 cases and 3,750 deaths in people younger than 50.\n\nThe headline is a shift rather than a reversal: total incidence and mortality continue to fall, but the disease is moving younger, later-stage and more left-sided, undoing part of the stage shift screening had produced.","asOf":"2026-09-24","links":[{"label":"CA Cancer J Clin 2023","url":"https://doi.org/10.3322/caac.21772"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/36856579/"}],"tags":["colorectal-evidence"],"related":["paper-siegel-colorectal-incidence-birth-cohort-jnci-2017"],"cancers":["colorectal","early-onset-colorectal","rectal-cancer"],"sections":["early-detection","prevention"],"technologies":["colorectal-screening"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["andrea-cercek"],"bottlenecks":["b-early-detection","b-global-access"],"keyPapers":[],"journals":["ca-cancer-journal"],"dependsOn":[],"notes":[],"journal":"CA: A Cancer Journal for Clinicians","year":2023,"doi":"10.3322/caac.21772","pmid":"36856579","authors":"Siegel RL, Wagle NS, Cercek A, Smith RA, Jemal A.","paperType":"observational","findings":["Roughly 153,020 diagnoses and 52,550 deaths projected in the United States in 2023, including 19,550 cases and 3,750 deaths under 50.","The decline in incidence slowed from 3 to 4 percent annually in the 2000s to 1 percent annually during 2011 to 2019.","The proportion of cases in people under 55 rose from 11 percent in 1995 to 20 percent in 2019.","60 percent of new cases were advanced in 2019 against 52 percent in the mid-2000s and 57 percent in 1995.","Rectal cancer rose from 27 percent of cases in 1995 to 31 percent in 2019.","Mortality fell 2 percent annually from 2011 to 2020 overall but rose 0.5 to 3 percent annually in people under 50."],"whatItMeans":"The numbers behind the argument that the screening programme is working for the people it covers and failing everyone below its start age; the stage shift going into reverse is the most uncomfortable figure on this roadmap.","caveats":["United States registry data; the age structure, screening offer and insurance context are not the UK's.","Projected 2023 counts are modelled forward from observed data, not counted.","Descriptive statistics: they establish the pattern, not its cause."]},"route":"/key-papers/paper-siegel-colorectal-cancer-statistics-ca-2023/","neighbours":{"paper":[{"id":"paper-siegel-colorectal-incidence-birth-cohort-jnci-2017","kind":"paper","name":"Colorectal cancer incidence patterns in the United States, 1974-2013","route":"/key-papers/paper-siegel-colorectal-incidence-birth-cohort-jnci-2017/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"early-onset-colorectal","kind":"cancer","name":"Early-onset colorectal cancer (under 50)","route":"/cancers/early-onset-colorectal/"},{"id":"rectal-cancer","kind":"cancer","name":"Rectal cancer","route":"/cancers/rectal-cancer/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"},{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"colorectal-screening","kind":"technology","name":"Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)","route":"/technologies/colorectal-screening/"}],"person":[{"id":"andrea-cercek","kind":"person","name":"Andrea Cercek","route":"/people/andrea-cercek/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"journal":[{"id":"ca-cancer-journal","kind":"journal","name":"CA: A Cancer Journal for Clinicians","route":"/journals/ca-cancer-journal/"}],"roadmap":[{"id":"colorectal-roadmap","kind":"roadmap","name":"Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation","route":"/roadmaps/colorectal-roadmap/"}],"idea":[{"id":"idea-crc-screening-uptake-and-age-extension","kind":"idea","name":"Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model","route":"/ideas/idea-crc-screening-uptake-and-age-extension/"},{"id":"idea-crc-uk-young-patient-referral-and-diagnostic-interval","kind":"idea","name":"UK gap: shorten the route to diagnosis for patients below the screening age, where the rise in incidence is","route":"/ideas/idea-crc-uk-young-patient-referral-and-diagnostic-interval/"}]}}