直肠癌（CRC）是美国第二大致癌死因。美国癌症协会每三年根据人口统计癌症登记处的发病率和国家卫生统计中心的死亡率提供CRC统计数据更新。预计到2023年，大约有153020人被诊断出患有CRC，其中52550人死于该疾病，包括19550例和3750例<50岁的患者死亡。在2000年代期间，CRC发病率的下降从每年3％-4％下降到2011年至2019年每年1％下降，部分原因是< 55岁的患者自20世纪90年代中期以来每年增加1％-2％。因此，<55岁的患者中的病例比例从1995年的11％增加到2019年的20％。自2010年左右起，地区期疾病<65岁的患者发病率每年增加约2％-3％，远距期疾病每年增加0.5％-3％，这逆转了1995年至2005年期间发生的整体早期诊断趋势。例如，2019年所有新病例中有60％是晚期病例，而中期2000年代的比例为52％，1995年为57％，普遍筛查之前的情况。也存在向左侧肿瘤转移的趋势，直肠癌的比例从1995年的27％增加到2019年的31％。2011-2020年，CRC死亡率总体上每年下降2％，但在<50岁的患者和<65岁的美国原住民中每年增加0.5％-3％。总之，尽管CRC的总体下降趋势持续存在，但它正在迅速向更年轻的患者、更晚期的阶段和左结肠/直肠诊断转移。找出自1950年代以来出生的人群中不断增加的发病原因，增加对所有人群特别是美国原住民的高质量筛查和治疗的接触，可以加快治疗CRC的进展。 © 2023 The Authors.由Wiley Periodicals LLC代表美国癌症协会出版的CA：癌症临床杂志。

Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC statistics based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. In 2023, approximately 153,020 individuals will be diagnosed with CRC and 52,550 will die from the disease, including 19,550 cases and 3750 deaths in individuals younger than 50 years. The decline in CRC incidence slowed from 3%-4% annually during the 2000s to 1% annually during 2011-2019, driven partly by an increase in individuals younger than 55 years of 1%-2% annually since the mid-1990s. Consequently, the proportion of cases among those younger than 55 years increased from 11% in 1995 to 20% in 2019. Incidence since circa 2010 increased in those younger than 65 years for regional-stage disease by about 2%-3% annually and for distant-stage disease by 0.5%-3% annually, reversing the overall shift to earlier stage diagnosis that occurred during 1995 through 2005. For example, 60% of all new cases were advanced in 2019 versus 52% in the mid-2000s and 57% in 1995, before widespread screening. There is also a shift to left-sided tumors, with the proportion of rectal cancer increasing from 27% in 1995 to 31% in 2019. CRC mortality declined by 2% annually from 2011-2020 overall but increased by 0.5%-3% annually in individuals younger than 50 years and in Native Americans younger than 65 years. In summary, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age, at a more advanced stage, and in the left colon/rectum. Progress against CRC could be accelerated by uncovering the etiology of rising incidence in generations born since 1950 and increasing access to high-quality screening and treatment among all populations, especially Native Americans.© 2023 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.