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Increasing risk for early onset CRC under age 50 has been well established. More recent trends suggest that this risk is extending beyond age 50, potentially expanding the public health impact of the factors driving increased risk. This symposium will: 1) Review the changing epidemiology of colorectal cancer; 2) Review potential causes from epidemiologic and basic science perspectives; 3) Discuss implications of the changing epidemiology for basic/translational research, as well as clinical research and clinical practice.