S559 Trends in Early-Onset Colorectal Cancer Mortality by Sex in the United States, 2018–2023: A CDC WONDER Analysis

Introduction: Colorectal cancer (CRC) mortality among younger adults is an emerging public health concern. This study evaluates trends in CRC-related mortality from 2018 to 2023 among individuals aged 25–54 years, stratified by sex, using CDC WONDER data. Methods: We analyzed U.S. Multiple Cause of Death data for CRC (ICD-10: C18.0–C20) in adults aged 25–54. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, along with 95% confidence intervals (CIs), separately for men and women. Temporal trends in AAMRs were assessed using the Joinpoint log-linear regression model to compute the Annual Percent Change (APC). Results: A total of 39,951 CRC-related deaths were identified (16,879 women and 23,072 men). The average AAMR was 4.4 (95% CI: 4.3–4.5) for women and 6.1 (95% CI: 6.0–6.2) for men. Female AAMRs rose modestly from 4.3 in 2018 to 4.6 in 2023, while male AAMRs increased from 6.0 to 6.3 over the same period. Men consistently exhibited higher mortality across all years. Joinpoint regression revealed a positive APC in AAMRs for both sexes, reflecting a gradual upward trend in early-onset CRC mortality. Conclusion: From 2018 to 2023, early-onset CRC mortality in the U.S. demonstrated a rising trend, with men experiencing consistently higher AAMRs than women. These findings highlight the urgent need for sex-specific strategies in screening, prevention, and public health interventions targeting young adults.