To describe the 2024 national estimates of colorectal cancer incidence and mortality and their rankings among all cancers in China, and to compare them descriptively with the 2022 estimates overall and by sex and urban-rural residence.

A descriptive secondary analysis of publicly available aggregate data was conducted using national model-based estimates released by the National Cancer Center. The main indicators included numbers of new cases and deaths, crude incidence and mortality rates, age-standardized incidence and mortality rates using the 2000 Chinese standard population (age-standardized incidence rates by Chinese population & age-standardized mortality rates by Chinese population), and those using the Segi world standard population (age-standardized incidence rates by world population & age-standardized mortality rates by world population). Absolute and relative differences were calculated using the published 2022 point estimates as the reference; no hypothesis testing was performed.

In 2024, the estimated numbers of new colorectal cancer cases and deaths were 561 800 and 255 700, respectively, which were numerically higher than the 2022 point estimates by 44 700 (8.64%) and 15 700 (6.54%). Crude incidence and mortality rates were higher by 3.35 per 100 000 (9.15%) and 1.20 per 100 000 (7.06%), respectively. Age-standardized incidence rates by Chinese population & age-standardized incidence rates by world population were higher by 0.59 per 100 000 (2.91%) and 0.55 per 100 000 (2.74%), whereas age-standardized mortality rates by Chinese population was lower by 0.01 per 100 000 (−0.12%) and age-standardized mortality rates by World population was unchanged. The overall incidence rank changed from second to third, while the mortality rank changed from fourth to third. Numerical differences for most indicators were greater in men than in women. In 2024, rural areas had higher crude rates, whereas urban areas had higher Chinese- and world-standardized rates.

The 2024 point estimates of case counts, deaths, and crude rates were higher than the corresponding 2022 estimates, whereas differences in age-standardized rates were small. Evaluation of colorectal cancer control should jointly consider absolute burden, crude rates, age-standardized rates, and rankings among all cancers. Risk-factor control should be strengthened, together with continuity across screening, diagnosis, treatment, and follow-up.