Introduction: The incidence of CRC is higher in minority racial and ethnic groups. However, studies assessing trends among sex and racial groups on the incidence and mortality of CRC are lacking. We aim to investigate disparities in CRC by reviewing a large national cancer registry. Methods: This is a retrospective cross-sectional study of the Surveillance, Epidemiology, and End Results Registry (SEER) of individuals aged 45–79 years from 2000–2017. Results: During the study period, the incidence of CRC decreased for both males and females, respectively (APC −2.14 vs −1.81). Among all racial groups, African American showed the least decline in incidence of CRC. African American females showed the highest risk for CRC (IRR 1.34; 95% CI 1.32−1.36, p< 0.001) compared to other females or males from different racial groups. Subgroup analysis using Kaplan−Meier estimations showed that African American females had the poorest 5-year survival rate (56%) compared to other female racial groups. Among males, American Indian/Alaska Natives had the poorest 5-year survival (54%) compared to male of other racial groups. Conclusion: Overall, the incidence of colorectal cancer is declining. However, the incidence of CRC remains highest in African Americans females who are also burden with poor survival rates.
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