Epidemiological trends in stage IV colorectal cancer

Epidemiological trends in stage IV colorectal cancer are concerning. As older adults in highly developed countries enjoy decreasing colorectal cancer incidence and mortality, younger patients are developing metastatic disease with increasing frequency, and profound systemic disparities persist in screening, treatment, and survival. Globally, the young populations of low- and middle-income countries are exposed to ever higher levels of colorectal cancer risk factors without colorectal cancer screening systems in place or ability to provide care, leading to an impending crisis. Scientific discoveries reveal the complex interplay between inherent, tumor-specific, and environmental risks, but the most profound factor underlying the epidemiology of metastatic colorectal cancer is inequality, globally and within the United States.