Trends and projections of colorectal carcinoma mortality in U.S. adults, 1999-2050: A CDC WONDER-based ecological time-series analysis.
8 affiliations
- 1College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
- 2Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan.
- 3Department of Anatomy, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
- 4Khyber Medical College, Peshawar, Pakistan.
- 5Department of Medicine, Peshawar Medical College, Riphah International University (Peshawar Campus), Peshawar, Pakistan.
- 6CMH Institute of Medical Sciences, Multan, Pakistan.
- 7Rawal Institute of Health Sciences, Islamabad, Pakistan.
- 8Ayub Medical College, Abbottabad, Pakistan.
Abstract
Colorectal carcinoma (CRC) remains a major cause of cancer mortality in the United States (U.S.); however, contemporary long-term projections by demographic and geographic strata are limited. This study examined national colorectal cancer mortality trends from 1999 to 2025 and projected age-adjusted mortality rates (AAMRs) through 2050. We conducted an ecological time-series analysis of U.S. adults aged ≥ 25 years using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death data. CRC-related deaths were identified by any mention of International Classification of Diseases, Tenth Revision codes C18-C20 on the death certificate. AAMRs per 100,000 population were calculated overall and stratified by sex, age group, race and ethnicity, urbanization, census region, state, and place of death. Joinpoint regression was used to estimate the annual percent change and average annual percent change. A demographically optimized ensemble forecasting model was used to project AAMRs from 2026 to 2050. From 1999 to 2025, 1,674,393 CRC-related deaths were recorded. Overall, the AAMR declined from 38.11 in 1999 to 23.14 in 2025 (average annual percent change, -1.99%; 95% confidence interval, -2.13 to -1.85; P < .001), but recent rates have stabilized. The mean AAMR was higher among men than women (34.13 vs 23.43) and higher in nonmetropolitan than metropolitan areas (32.43 vs 28.49). Non-Hispanic Black adults had the highest racial and ethnic burdens (37.45). Adults aged 25 to 44 years showed a significant increase in mortality (annual percent change, 1.13%; 95% confidence interval, 0.93 to 1.33; P < .001). Most deaths occurred at home (41.15% of deaths). The overall AAMR was projected to continue declining slowly, from 23.02 in 2026 to 21.56 in 2050, at a slower pace than the 1999 to 2016 decline. U.S. CRC mortality has declined substantially and is projected to continue declining slowly through 2050, rather than resume its earlier faster decline, with persistent sex, racial, rural, age, and geographic disparities. Targeted strategies are needed to improve screening completion, diagnostic follow-up, rural access, equity, and early-onset colorectal cancer detection.
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BibTeX
@article{atif2026trends,
title = {{Trends and projections of colorectal carcinoma mortality in U.S. adults, 1999-2050: A CDC WONDER-based ecological time-series analysis.}},
author = {Kanza Atif and Eshal Atif and Vishan Das and Sadia Qazi and Mazhar Ali and Abdal Ahmad and Fnu Urooba and Mohib Ali Hassan and Muhammad Mukhlis and Muhammad Atif Mazhar and Akef Obeidat},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051146},
url = {https://europepmc.org/article/MED/42888599},
note = {CC BY},
}
RIS
TY - JOUR
TI - Trends and projections of colorectal carcinoma mortality in U.S. adults, 1999-2050: A CDC WONDER-based ecological time-series analysis.
AU - Kanza Atif
AU - Eshal Atif
AU - Vishan Das
AU - Sadia Qazi
AU - Mazhar Ali
AU - Abdal Ahmad
AU - Fnu Urooba
AU - Mohib Ali Hassan
AU - Muhammad Mukhlis
AU - Muhammad Atif Mazhar
AU - Akef Obeidat
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051146
UR - https://europepmc.org/article/MED/42888599
AB - Colorectal carcinoma (CRC) remains a major cause of cancer mortality in the United States (U.S.); however, contemporary long-term projections by demographic and geographic strata are limited. This study examined national colorectal cancer mortality trends from 1999 to 2025 and projected age-adjusted mortality rates (AAMRs) through 2050. We conducted an ecological time-series analysis of U.S. adults aged ≥ 25 years using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death data. CRC-related deaths were identified by any mention of International Classification of Diseases, Tenth Revision codes C18-C20 on the death certificate. AAMRs per 100,000 population were calculated overall and stratified by sex, age group, race and ethnicity, urbanization, census region, state, and place of death. Joinpoint regression was used to estimate the annual percent change and average annual percent change. A demographically optimized ensemble forecasting model was used to project AAMRs from 2026 to 2050. From 1999 to 2025, 1,674,393 CRC-related deaths were recorded. Overall, the AAMR declined from 38.11 in 1999 to 23.14 in 2025 (average annual percent change, -1.99%; 95% confidence interval, -2.13 to -1.85; P < .001), but recent rates have stabilized. The mean AAMR was higher among men than women (34.13 vs 23.43) and higher in nonmetropolitan than metropolitan areas (32.43 vs 28.49). Non-Hispanic Black adults had the highest racial and ethnic burdens (37.45). Adults aged 25 to 44 years showed a significant increase in mortality (annual percent change, 1.13%; 95% confidence interval, 0.93 to 1.33; P < .001). Most deaths occurred at home (41.15% of deaths). The overall AAMR was projected to continue declining slowly, from 23.02 in 2026 to 21.56 in 2050, at a slower pace than the 1999 to 2016 decline. U.S. CRC mortality has declined substantially and is projected to continue declining slowly through 2050, rather than resume its earlier faster decline, with persistent sex, racial, rural, age, and geographic disparities. Targeted strategies are needed to improve screening completion, diagnostic follow-up, rural access, equity, and early-onset colorectal cancer detection.
SN - 0304-5412
SN - 1536-5964
ER -