Colorectal cancer incidence in Saudi Arabia, 2002–2023: Age-specific trends and implications for screening and prevention

To examine trends in colorectal cancer incidence in Saudi Arabia and assess implications for screening and prevention. A population-based analysis of Saudi Cancer Registry data (2002−2023) was conducted. Annual percent changes in age-standardized incidence rates were estimated using Joinpoint regression. Interrupted time-series and regression analyses assessed post-2020 and age-specific changes. A total of 30,346 colorectal cancer cases were reported. Incidence increased in both sexes, with average annual percent changes of 5.33% in males and 4.28% in females. Colorectal cancer accounted for an increasing share of all cancers, rising from 8.5% to 13.1% overall and from 9.0% to 16.7% in males. Annual percent changes were higher in adults aged ≥50 years than <50 years (males: 5.39% vs 3.69%; females: 5.28% vs 2.60%). Colon cancer increased more rapidly than rectal cancer in both sexes (males: 5.99% vs 3.86%, interaction p = 0.01; females: 5.65% vs 3.14%, interaction p < 0.01). The odds of localized-stage diagnosis increased by 5.8% annually. Post-2020 slope increases were 17.6% in males and 18.4% in females. Colorectal cancer incidence in Saudi Arabia increased substantially, particularly among adults aged ≥50 years, supporting age-targeted screening, stronger early detection pathways, and continuity of diagnostic services. • Rising colorectal cancer incidence has implications for screening in Saudi Arabia. • Long-term increases in colorectal cancer were greater among adults aged ≥50 years. • Colon cancer incidence rose more rapidly than rectal cancer. • Colorectal cancer represents a growing share of the national cancer burden. • Findings support stronger colorectal cancer early detection and diagnostic pathways.