of CRC.18 About one-third (35%) of these individuals were diagnosed within the preceding 5 years, and more than half (56%) were ages 65-84 years. Some of these people were cancerfree, while others still had evidence of cancer and may have been undergoing treatment. What is the risk of developing colorectal cancer? Approximately 4.4% of men (1 in 23) and 4.1% of women (1 in 25) will be diagnosed with CRC in their lifetime.19 Lifetime risk is similar in men and women despite higher incidence rates in men because women have longer life expectancy. In addition to sex, age and race/ethnicity also have a large influence on risk. Table 1. Estimated Number of Colorectal Cancer Cases and Deaths in the US in 2020 by Age Cases Deaths* Age Colorectum Colon Rectum Colorectum 0-49 years 17,930 11,540 6,390 3,640 50-64 years 50,010 32,290 17,720 13,380 65+ years 80,010 60,780 19,230 36,180 All ages 147,950 104,610 43,340 53,200 Estimates are rounded to the nearest 10 and exclude in situ carcinoma. *Deaths for colon and rectal cancers are combined because a large number of rectal cancer deaths are misclassified as colon. ©2020, American Cancer Society, Inc., Surveillance Research 4 Colorectal Cancer Facts & Figures 2020-2022 Sex CRC incidence rates are 30% higher in men than in women, with a larger disparity for rectal cancer (60% higher) than for colon cancer (20% higher; Figure 3). As expected, women also have a lower prevalence of both adenomas overall and of advanced adenomas.20, 21 However, among individuals 50 and older, women are more likely than men to develop adenomas in the proximal colon,20 which are less efficiently detected through screening.22 Gender disparities likely reflect differences in exposures to risk factors (e.g., cigarette smoking) and sex hormones, as well as complex interactions between these influences.23 Notably, CRC incidence rates in men and women younger than 45 years are comparable. Age Like most types of cancer, the risk of CRC increases with age. For every subsequent 5-year age group, the incidence rate approximately doubles until age 50, and thereafter increases by about 30% (Figure 4). The exception is ages 50-54 years versus ages 55-59 years, for which there is only a 15% difference (60 versus 68 per 100,000, respectively), partly because the natural age-associated influence on risk is disrupted by first-time CRC screening in the younger age group. The screening effect is magnified in current rates by single year of age (Figure 4), which are actually higher in individuals ages 50-51 years than in those ages 52-55 years. This phenomenon is absent in incidence rates during the 1970s, prior to the uptake of screening. Source: Main figure: NAACCR, 2019. Inset: Surveillance, Epidemiology, and End Results (SEER) Program, 2019. ©2020, American Cancer Society, Inc., Surveillance Research Rate per 100,000 population Figure 4. Age-specific Male Female Incidence Mortality* 0 5 10 15 20 25 30 35 40 45 50 Colorectum Colon Rectum Colorectum Colorectal Cancer Facts & Figures 2020-2022 5 The median age at CRC diagnosis is 66 years in men and 69 years in women, but is younger for rectal cancer (age 62 and 63, respectively) than for colon cancer (age 67 and 71, respectively).24 CRC patients overall are increasingly younger, shifting from a median age of 72 years for diagnoses in the early 2000s to 66 years today.25 This is because incidence is increasing in younger adults and declining in older age groups.17 Race/ethnicity Among broadly defined racial and ethnic groups, CRC incidence and mortality are highest in non-Hispanic blacks (hereafter, blacks), followed closely by American Indians and Alaska Natives (AIANs), and lowest in Asians/ Pacific Islanders (APIs; Figure 5). During 2012-2016, CRC incidence rates in blacks were about 20% higher than those in non-Hispanic whites (NHWs) and 50% higher than those in APIs. The disparity for mortality is twice that for incidence; CRC death rates in blacks are almost 40% higher than those in NHWs and double those in APIs. Reasons for racial/ethnic disparities in CRC are complex, but largely reflect differences in risk factor prevalence and health care access, both of which are related to socioeconomic