Path to a Cure 2026
Path to a Cure is Fight Colorectal Cancer’s visionary roadmap for the future of colorectal cancer research. It’s a call to action — for patients, clinicians, researchers, and advocates — to unite and accelerate progress across every stage of the disease continuum.
Fight CRC’s 2026 Path to a Cure report is a national blueprint for accelerating equitable, patient-centered progress against colorectal cancer (CRC). It synthesizes the state of CRC research and care as of early 2026, highlights scientific momentum, exposes funding gaps, and charts a path forward.
CRC Remains a Leading Killer
- 2nd leading cause of cancer-related death in the U.S.; 3rd most commonly diagnosed cancer.
- About 150,000 Americans are diagnosed annually; 18,000+ under age 50.
- Black Americans are about 20% more likely to be diagnosed and about 40% more likely to die from CRC than non-Hispanic whites.
- Precision care is not yet the norm; recurrence rates remain high; early-age onset CRC continues to rise.
Early-Age Onset CRC: An Emerging Crisis
- CRC incidence in adults under 50 has risen around 50% since the mid-1990s.
- CRC is now the #1 cause of cancer death in men and women under 50 combined.
- Nearly 30% of under-50 diagnoses are linked to family history or genetic factors.
- Screening uptake for ages 45–49 is just 27%, despite guidelines lowering the age to 45 in 2021.
- About 95% of individuals with Lynch syndrome remain undiagnosed.
Learn more about early-age onset CRC
Biology, Genetics, and Hereditary Risk
Key subtypes—MSI-H, BRAF V600E, KRAS/NRAS—inform treatment response. MSI-H tumors respond well to immunotherapy; most CRC cases are MSS and remain immunotherapy-resistant.
- PROSPECT project ($25M, 2024): investigating lifetime exposures and microbiome factors in early-age onset CRC.
- Global Early-Onset CRC Think Tank (2025): experts from 6 continents aligned on etiologic underpinnings.
- MIPS Measure #491 (2025): promotes universal MMR/MSI testing to identify Lynch syndrome risk.
2026–2028 priorities: fund diverse cohort studies, implement universal Lynch syndrome testing, support vaccine research.
Find out more about Genetics and Family History in CRC
Prevention and Early Detection
CRC is one of the most preventable cancers, yet screening rates remain low—especially among Black, Hispanic, low-income, and rural populations.
- Fight CRC secured FY23 federal budget language urging NCI to address early-age onset disparities.
- ARPA-H funded multi-cancer early detection initiatives, including liquid biopsy research for CRC.
- Fight CRC’s screening risk quiz has reached 3M+ users.
2028 target: 80% screening rate for average-risk patients; 80% with abnormal non-invasive results receive colonoscopy within 90 days.
Learn when and how to get screened
Treatment Advances: Precision Oncology in Action
- Dostarlimab trial: 100% complete clinical response in dMMR rectal cancer—no chemo, radiation, or surgery needed.
- Botensilimab + Balstilimab (NEST-1): about 61% disease control in heavily pretreated MSS metastatic CRC.
- BREAKWATER: Encorafenib + cetuximab + chemo → 30.3 mo median OS for BRAF V600E-mutant mCRC (FDA-approved May 2025).
- KRAS G12C inhibitors (adagrasib, sotorasib): FDA-approved for about 4% of mCRC patients.
- Trastuzumab + Tucatinib (MOUNTAINEER CRC): FDA-approved for HER2-positive mCRC.
- ctDNA now used in trials to tailor adjuvant chemo, reduce overtreatment, and detect minimal residual disease.
Key barrier: NCI faces 11% budget cut in FY2025, disrupting trials and research momentum.
Here are several treatment choices and checklist to explore
Survivorship and Long-Term Outcomes
1.5M+ Americans live after a CRC diagnosis. Survivors face chronic bowel dysfunction, fatigue, depression, fear of recurrence, and employment discrimination.
- ctDNA (Signatera, Guardant Reveal): validated as a recurrence predictor, outperforming imaging in many stage II/III patients.
- FDA-approved MRD testing platforms guide post-surgery decisions and reduce unnecessary chemotherapy.
- Many MRD and navigation services are unreimbursed, disproportionately affecting rural and Medicaid patients.
- Sexual dysfunction remains unaddressed and non-standardized despite ASCO/NCCN/CoC recognition.
2026–2028 priorities: universal MRD/ctDNA coverage, standardized survivorship care plans, digital navigation programs, expanded survivorship definition.
Why This Report Matters
Colorectal cancer research and care are evolving rapidly, from biomarker-informed treatment and immunotherapy to ctDNA/MRD tools and survivorship innovation. At the same time, significant gaps remain in screening access, equitable treatment delivery, and implementation of precision care.
Path to a Cure outlines the research, policy, and implementation priorities needed to help close these gaps and improve outcomes for all patients.
What’s New in the 2026 Update
Expanded Focus Areas
- Early-age onset colorectal cancer
- Universal biomarker and germline testing
- ctDNA/MRD and recurrence monitoring
- Survivorship and quality of life
- Equity and implementation science
From Priorities to Accountability
Several implementation goals highlighted in Path to a Cure align with findings from Fight CRC’s Care Report, helping translate research priorities into measurable patient-centered outcomes.
Key Metrics We Aim to Advance
| Focus Area | Goal |
| Screening Uptake | 80% screening rate among average-risk populations |
| Follow-Up Care | 80% follow-up colonoscopy completion within 90 days after abnormal noninvasive testing |
| Germline Testing | 80% of newly diagnosed patients receive germline testing |
| Treatment Access | 80% of patients initiate treatment within six weeks of diagnosis |
| Survivorship | 75% survivorship care plan delivery for stage I–III survivors |
These goals reflect Fight CRC’s commitment to pairing scientific progress with measurable accountability.
FOUR PILLARS OF PTAC
Pillar One: Biology and Etiology
Progress Indicator:
Applying advances in biology, hereditary risk, and molecular research to reduce late-stage colorectal cancer and improve prevention strategies.
Key Messages
- Research into microbiome, inflammation, hereditary syndromes, and environmental exposures is expanding understanding of colorectal cancer biology and early-age onset disease.
- Early-age onset colorectal cancer continues to rise globally, disproportionately impacting younger adults and underserved populations.
- Universal biomarker and germline testing are increasingly recognized as essential components of high-quality care.
What We Are Doing
Fight CRC’s Early-Age Onset Disease Initiative brings together global researchers, clinicians, advocates, and patients to advance research and improve equitable access to innovation.
Pillar Two: Prevention and Early Detection
Progress Indicator
Advancing equitable colorectal cancer prevention, screening, and early detection strategies.
Key Messages
- Colorectal cancer remains one of the most preventable cancers when detected early through appropriate screening and follow-up care.
- Screening disparities persist across racial, ethnic, rural, and medically underserved communities.
- Expanding access to noninvasive screening tools, navigation support, and follow-up colonoscopy remains critical to improving outcomes.
What We Are Doing
Fight CRC advocates for evidence-based screening policies, expanded access to preventive care, and implementation strategies that help patients complete the full screening continuum.
Pillar Three: Treatment
Progress Indicator:
Expanding access to precision treatment strategies and equitable innovation in colorectal cancer care.
Key Messages:
- Biomarker-informed treatment is transforming colorectal cancer care through targeted therapies, immunotherapy, and precision medicine approaches.
- Most colorectal cancer cases remain microsatellite stable (MSS), highlighting the need for continued research and treatment innovation.
- Access to biomarker testing, clinical trials, and emerging therapies remains inconsistent across geographic and socioeconomic populations.
What We Are Doing:
Fight CRC supports research advocacy, biomarker education, clinical trial awareness, and federal policy efforts that expand access to innovation and protect colorectal cancer research funding.
Pillar Four: Survivorship and Recurrence
Progress Indicator:
Enhancing survivorship, quality of life, and recurrence monitoring for all colorectal cancer survivors.
Key Messages:
- More than 1.5 million colorectal cancer survivors in the United States face ongoing physical, emotional, financial, and quality-of-life challenges after treatment.
- Survivorship includes mental health, recurrence anxiety, symptom management, care coordination, and support for caregivers and families.
- ctDNA/MRD tools and survivorship care planning are reshaping how recurrence monitoring and long-term support are delivered.
- Significant variability remains in survivorship services, navigation access, and long-term care coordination.
What We Are Doing:
Fight CRC advocates for survivorship standards, equitable access to recurrence monitoring tools, mental health integration, and patient-centered survivorship models that support long-term well-being.
Three Cross-Cutting Commitments
Three Cross-Cutting Commitments
Three Cross-Cutting Commitments
Champion Patient-Defined Research Priorities
Translate Discovery into Equitable Care
Elevate Survivorship as a Standard of Excellence
Champion Patient-Defined Research Priorities
Translate Discovery into Equitable Care
Elevate Survivorship as a Standard of Excellence
Meet the 2026 Collaborators
The 2026 Path to a Cure report was informed by Fight CRC leadership and external scientific and medical reviewers whose expertise helped shape the report’s priorities and recommendations.
External Scientific & Medical Reviewers
- Jennifer Weiss, MD | University of Wisconsin School of Medicine and Public Health
- Carlin Calloway, RN, BSN | University of Colorado Cancer Center
- Samir Gupta, MD — University of California San Diego
- Chris Lieu, MD — University of Colorado Cancer Center
- Van Morris, MD — The University of Texas MD Anderson Cancer Center
- Andrea Dwyer, MPH — The Colorado School of Public Health
Thank You to All of Our Experts
Our 2021 Collaborators
- Al Benson, MD | Northwestern University
- Yin Cao, ScD, MPH | Washington University School of Medicine in St. Louis
- Anjee Davis, MPPA | Fight Colorectal Cancer
- Dustin Deming, MD | University of Wisconsin Carbone Cancer Center
- Andrea (Andi) Dwyer | University of Colorado Cancer Center
- Ashley Glode, PharmD | University of Colorado
- Richard Goldberg, MD | West Virginia University Cancer Institute
- Samir Gupta, MD | University of California, San Diego
- Heather Hampel, MS, LGC | Ohio State University Comprehensive Cancer Center
- Chris Heery, MD | Precision BioSciences
- Rishi Jain, MD | Fox Chase Cancer Center
- Sheetal Kircher, MD | Northwestern University
- Jennifer Kolb, MD | VA Greater Los Angeles Health Care System
- Scott Kopetz, MD | MD Anderson
- Smitha Krishnamurthi, MD | University of Texas Southwestern
- Dung Le, MD | Johns Hopkins Medical Center
- Chris Lieu, MD | University of Colorado Cancer Center
- Fola May, MD, PhD | University of California, Los Angeles
- Noel de Miranda, PhD | Leiden University
- Caitlin Murphy, PhD, MPH | University of Texas Southwestern
- Linda Overholser, MD, MPH | University of Colorado Cancer Center
- Michael Overman, MD | MD Anderson
- Swati Patel, MD | University of Colorado
- José Perea, MD | Fundación Jiménez Díaz University Hospital
- Nicholas Petrelli, MD, FACS | Christiana Care Health System
- Leonard Saltz, MD | Memorial Sloan Kettering Cancer Center
- Nina Sanford, MD | UT Southwestern
- Cynthia Sears, MD | Johns Hopkins University
- Rebecca Seigel, MPH | American Cancer Society
- Robert Smith, PhD | American Cancer Society
- Peter Stanich, MD | Ohio State University
- Joel E Tepper, MD | University of North Carolina School of Medicine
- Erin Van Blarigan, ScD | University of California, San Francisco
- Jennifer Weiss, MD, MS | University of Wisconsin
- Karen Wheling | Survivor Advocate
- Ann Zauber, PhD | Memorial Sloan Kettering Cancer Center
Join the Movement Toward a Cure
Path to a Cure reflects Fight CRC’s commitment to accelerating research, advancing equitable care, and improving outcomes for everyone affected by colorectal cancer.
Questions?
For questions about our Path To A Cure or how to partner with us, please email research@fightcrc.org.