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Colorectal cancer (CRC) incidence rates are rising in younger Americans and mortality rates are increasing among younger white Americans. We used New York State Cancer Registry data to examine New York City CRC incidence and mortality trends among adults ages 20-54 years by race from 1976 to 2015. Annual percent change (APC) was considered statistically significant at  less than .05 using a two-sided test. CRC incidence increased among those ages 20-49 years, yet blacks had the largest APC of 2.2% (1993-2015; 95% confidence interval [CI] = 1.4% to 3.1%) compared with 0.5% in whites (1976-2015; 95% CI = 0.2% to 0.7%). Among those aged 50-54 years, incidence increased among blacks by 0.8% annually (1976-2015; 95% CI = 0.4% to 1.1%), but not among whites. CRC mortality decreased among both age and race groups. These findings emphasize the value of local registry data to understand trends locally, the importance of timely screening, and the need for clinicians to consider CRC among all patients with compatible signs and symptoms.

Colorectal Cancer Incidence and Mortality Rates Among New York City Adults Ages 20–54 years during 1976–2015