Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. In 2020, approximately 147,950 new cases and 53,200 deaths are expected, with 17,930 cases and 3,640 deaths in individuals under 50 years of age. Incidence rates vary by age, race/ethnicity, and sex, with higher rates in older adults, non-Hispanic blacks, and men. CRC incidence and mortality rates have declined since the 1980s, driven by changes in risk factors, increased screening, and improved treatment. However, recent trends show a reversal in incidence declines among those aged 50 to 64 years and a rise in incidence among those under 50 years. Racial disparities persist, with higher incidence and mortality rates among non-Hispanic blacks and American Indians/Alaska Natives (AI/ANs). Geographic disparities also exist, with lower rates in the West and higher rates in Appalachia and the South. CRC screening prevalence has increased, but remains low in some groups. Survival rates vary by stage at diagnosis, with higher rates for localized disease, and by race/ethnicity, with higher rates for non-Hispanic whites and older adults. The 5-year survival rate for CRC has improved from 50% in the mid-1970s to 64% in 2015, but progress is more pronounced among older and white patients. Addressing inequalities and furthering progress require equitable access to high-quality healthcare and healthier lifestyles.Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. In 2020, approximately 147,950 new cases and 53,200 deaths are expected, with 17,930 cases and 3,640 deaths in individuals under 50 years of age. Incidence rates vary by age, race/ethnicity, and sex, with higher rates in older adults, non-Hispanic blacks, and men. CRC incidence and mortality rates have declined since the 1980s, driven by changes in risk factors, increased screening, and improved treatment. However, recent trends show a reversal in incidence declines among those aged 50 to 64 years and a rise in incidence among those under 50 years. Racial disparities persist, with higher incidence and mortality rates among non-Hispanic blacks and American Indians/Alaska Natives (AI/ANs). Geographic disparities also exist, with lower rates in the West and higher rates in Appalachia and the South. CRC screening prevalence has increased, but remains low in some groups. Survival rates vary by stage at diagnosis, with higher rates for localized disease, and by race/ethnicity, with higher rates for non-Hispanic whites and older adults. The 5-year survival rate for CRC has improved from 50% in the mid-1970s to 64% in 2015, but progress is more pronounced among older and white patients. Addressing inequalities and furthering progress require equitable access to high-quality healthcare and healthier lifestyles.