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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Colorectal cancer mortality for people aged 45 years and older declined nationally across racial and ethnic groups. Some counties have mortality rates twice the national average for certain populations. Colorectal cancer mortality has declined sharply among adults aged 45 years and older across the U.S. since 2000, but some counties continue to have exceedingly high rates among certain racial and ethnic populations. These \u201chotspots\u201d are most prevalent among Black men in the Southeast and American Indian or Alaska Native men in Alaska and the Midwest, Paula D. Strassle, PhD, MSPH, assistant professor of epidemiology in the school of public health at University of Maryland, told Healio.
Data derived from GBD US Health Disparities Collaborators, et al. JAMA Oncol. 2026;doi:10.1001\/jamaoncol.2026.3194.
Paula D. Strassle \u201cRoughly 8% of counties are being left behind in this overall positive news and progress we\u2019re seeing in colorectal cancer mortality,\u201d she said. \u201cWe see places where they have over 100 deaths per 100,000 in 2019, twice the national average.\u201d Is it \u2018consistent\u2019? Efforts to improve and expand colorectal cancer screening have saved more than 740,000 lives between 1975 and 2020, according to study background. However, American Cancer Society still projected 55,230 deaths from colorectal cancer in 2026, the second most of any malignancy behind lung and bronchial cancer (124,990 deaths), according to its Cancer Statistics 2026 report. Disparities persist, too. The AACR Cancer Disparities Progress Report 2026 detailed how American Indian or Alaska Native individuals have the greatest increase in early-onset incidence, and people who live in rural areas have a 17% higher risk for being diagnosed and 27% greater risk for colorectal cancer mortality. Additionally, Black individuals have approximately 20% higher colorectal cancer incidence and 30% lower survival than white patients, Healio previously reported. \u201cWe know that, nationally, we\u2019ve seen these huge declines in colorectal cancer mortality, because colonoscopy not only catches cancer earlier, but can actually remove precancerous polyps,\u201d Strassle said. \u201cWhen we look geographically, most of the time we\u2019re looking at state-level estimates, if we\u2019re getting granular. If they get smaller, like a specific county, census tract or hospital catchment area, they\u2019re typically not stratifying by age, sex, and race or ethnicity because of small sample sizes. We wanted to build out this effort to look at not just which racial, ethnic or sex populations are having better or worse outcomes in the United States, but where it\u2019s happening, and if it\u2019s consistent across the U.S.\u201d Strassle and colleagues evaluated data from 3,110 counties or combined counties from 2000 to 2019 to investigate. The included counties had a mean annual population of 306 million. Colorectal cancer mortality rates per 100,000 individuals served as the primary endpoint. Mortality not falling for all Nationally, colorectal cancer mortality fell substantially among men (82.5 deaths per 100,000 to 54.4) and women (58.9 deaths per 100,000 to 39.7) aged 45 years and older between 2000 and 2019. Colorectal cancer mortality among individuals aged less than 45 years ranged from 0.7 to 1.8 deaths per 100,000 in 2019. All racial and ethnic groups had reduced mortality, with the largest drops observed in Black men (\u201342.9 deaths per 100,000) and Black women (\u201331.8 deaths per 100,000) aged 45 years and older. Researchers did not see much change among those aged less than 45 years. Among those aged 45 years and older, colorectal cancer mortality fell in 100% of counties for Black individuals, 99.9% for white, 94.6% for Asian, 88.4% for Latino and 79.5% for American Indian and Alaska Native. \u201cThat national decline is great,\u201d Strassle said. \u201cWe see a decline in almost every county, across each racial and ethnic group in adults 45 and older, who are the ones recommended for screening.\u201d Black men aged 45 years and older still had the worst colorectal cancer mortality in 2019 (76.1 deaths per 100,000), with the next highest rates occurring in American Indian and Alaska Native men (67.6 deaths per 100,000) and white men (53.7 deaths per 100,000) of the same age. Similar trends could be seen among women. Black women aged 45 years and older had the worst mortality (50 deaths per 100,000), then American Indian and Alaska Native women (47.9 deaths per 100,000) and white women (40.1 deaths per 100,000) of the same age. Researchers observed considerable variation among racial and ethnic groups across the U.S. For example, county-level mortality among American Indian and Alaska Native men aged 45 years and older ranged from a low of 13.6 deaths per 100,000 to 213.5 in 2019. Differences of at least 100 also could be seen among Latino, Black and white men, and American Indian and Alaska Native women. Among individuals aged 45 years and older, 275 counties had mortality rates that surpassed 100 deaths per 100,000 among at least one racial, ethnic and\/or sex population, mostly for Black men (182 counties), and American Indian and Alaska Native men (92 counties). \u201cThese are excessively high rates of colorectal cancer mortality,\u201d Strassle said. \u201cI don\u2019t think any of us expected to see rates so high.\u201d Researchers acknowledged study limitations, including possible inaccuracies in data that could have affected their model. Strassle noted future research will try to get more granular, with a focus on counties with higher mortality rates. \u201cLook to see if these hotspots are more likely to be rural counties, or low-income counties, or counties that have healthcare deserts,\u201d she said. \u201cSome of the known risk factors for colorectal cancer are diet. Do they have higher prevalence of food deserts? \u201cNone of this will be causative analyses, but at least they would give us<\/p>\n","protected":false},"author":1,"featured_media":3962,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3961","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3961","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3961"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/3961\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/3962"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3961"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3961"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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