S710 Trends in Colorectal Cancer Incidence, Mortality, and Survival in the United States: A 48-Year SEER-Based Analysis

Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality in the United States. Over the past 5 decades, public health strategies, including expanded screening and treatment improvements, have aimed to reduce the national CRC burden. We aimed to evaluate trends in CRC incidence, mortality, and survival using SEER data from 1975–2023, hypothesizing that national initiatives have led to sustained improvements in outcomes. Methods: Annual age-adjusted data from SEER 8 and SEER 12 registries between 1975 and 2023 were analyzed, including CRC incidence per 100,000 population, U.S. mortality rates, and 5-year relative survival percentages. Descriptive trend analyses were performed, and data were visualized with line graphs. Major inflection points were correlated with historical milestones in screening guidelines and therapeutic advancements. Results: CRC incidence peaked in the mid-1980s (∼66.6/100,000) and declined to ∼35.8/100,000 by 2023—a 40.3% reduction. Mortality decreased from 28.08/100,000 in 1975 to 12.71/100,000 in 2023, a 54.7% decline. The 5-year relative survival rate improved from 49.4% to 69.0%, a 38.9% increase. These trends parallel the widespread implementation of screening programs and advances in treatment modalities, particularly after the early 2000s. Notably, CRC incidence among adults under 50 years increased by 2.4% annually from 2011 to 2016. Conclusion: This 48-year national analysis highlights significant reductions in CRC incidence and mortality, alongside nearly 40% improvement in survival. These findings support the effectiveness of public health and clinical interventions. However, recent plateaus in survival and rising incidence in younger adults underscore the need for personalized screening strategies and continued investment in early detection. Limitations include the descriptive nature of the analysis and the lack of granular data on race, treatment type, and stage-specific outcomes within this study, which may affect the generalizability of the findings.