Over 20 Years of Colorectal Cancer Disparities Reveal Racial and Regional Gaps in US Mortality
A comprehensive 20-year analysis of colorectal cancer (CRC) mortality in the United States published in Cureus has revealed persistent and significant disparities by race, sex, and geography—despite overall progress in screening and treatment.
“Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States,” the authors noted. “While overall mortality has declined due to improvements in screening and treatment, persistent disparities by race, sex, and geography raise concerns about equitable healthcare access.”
Utilizing national mortality data from the CDC WONDER database, researchers analyzed CRC deaths from 2000 to 2020, stratified by race, sex, and U.S. state. Age-adjusted death rates were calculated using ICD-10 codes C18–C21, and Poisson regression was employed to assess the independent effects of race and sex.
The findings highlighted that Black men had the highest CRC mortality rate nationally (17.7 per 100,000), followed by White men (15.3 per 100,000). Across all racial groups, men experienced higher mortality than women. Asian/Pacific Islander and American Indian or Alaska Native (AI/AN) populations had the lowest rates. Poisson regression analyses showed that White (rate ratio [RR]: 2.46), Black (RR: 2.24), and Asian (RR: 1.13) individuals had higher mortality than AI/AN individuals. Men had a 9.2% higher risk of CRC mortality compared to women (RR: 1.09), with all differences reaching statistical significance (p < 0.001).
Geographic disparities were also pronounced. States in the South and Midwest recorded the highest average mortality rates, further underscoring the intersection of racial and regional inequities in cancer outcomes.
“These findings highlight the urgency of expanding access to screening, addressing systemic inequities, and implementing risk-based public health strategies in underserved communities,” the authors concluded.
Reference
Appiah JK, Asante R, Asiedu EK. Two decades of disparity: racial and geographic trends in colorectal cancer mortality in the United States (2000–2020). Cureus. 2025;17(5):e84847. Published 2025 May 26. doi:10.7759/cureus.84847
