Abstract: Objective To elucidate the epidemiological characteristics of colorectal cancer mortality from 2004 to 2018, and to provide useful data for the prevention and control of colorectal cancer morbidity and mortality. Methods The data of colorectal cancer deaths from 605 surveillance sites were collected from the Chinese Center for Disease Control and Prevention from 2004 to 2018. The data were stratified according to age, sex, and area and then used to calculate crude mortality rate (CMR), age-standardized mortality rate (ASMR), and the annual percent change (APC). Results  A total of 213, 513 patients died of colorectal cancer from 2004 to 2018, with the CMR and ASMR of 9.67/10⁵ and 6.52/10⁵, respectively. From 2004 to 2018, the CMR of colorectal cancer in China showed an increasing trend (APC=3.30%, P<0.001). There was no significant change in the ASMR of colorectal cancer in cities. The ASMR of colorectal cancer showed an increasing trend in eastern and western rural areas (APC=1.13%, P=0.004), whereas the ASMR of colorectal cancer in central rural areas showed a decreasing trend (APC=-1.22%, P=0.010). The CMR of colorectal cancer in males was higher than that in females (P<0.001).  The ASMR of colorectal cancer in urban females showed a decreasing trend (APC=-1.10%, P<0.001). The ASMR of colorectal cancer in urban residents aged 20-39 and 40-59 years showed decreasing trends (APC=-3.04%, P=0.007; APC=-1.98%, P=0.002). The ASMR of colorectal cancer in residents ≥60 years in rural areas showed an increasing trend (APC=0.86%, P=0.030). Conclusions  The mortality rate of colorectal cancer keeps increasing in Mainland China, and the mortality rate differ in populations with different age group, gender and geographic areas.- Prevention and control of colorectal cancer in rural areas should be strengthened in the future.

Key words: Colorectal cancer, Mortality, Trend; , Mainland China