Purpose: Incidence rates of Colorectal Cancer (CRC) are decreasing in the United States, possibly due to preventive screening. These programs target older populations and may not apply to younger patients. Our aim is to analyze racial disparity, stage at diagnosis, and location of CRC among patients below age 50 years compared to patients above age 50 years. Methods: Patients with CRC were identified retrospectively from tumor registries at St. Joseph's Regional Medical Center, NJ and California Pacific Medical Center, CA., for the period of 1992 to 2004. Statistical analysis was done by Chi-square test. Results: Overall number of patients diagnosed with CRC was 2723 [1963(72.1%) white, 287(10.5%) black, 473(17.4%) others]. We identified 279 (10.2%) less than 50 years of age. We found statistically significant increase in CRC prevalence in blacks compared to white below age 50 years (table 1). Blacks have approximately two (2.12) times greater odds of being diagnosed with CRC than whites below age 50 years (95% Confidence Interval (CI) 1.5–3.03). Regarding location of CRC, patients below 50 years have approximately two (1.75) times greater odds of having their lesion in the rectosigmoid than in the remaining colon (95% CI 1.35–2.27).(table 2) Regarding staging of CRC, patients below age 50 years have almost 2 times (1.85) greater odds of having advanced stage at the diagnosis as compared to above 50 (95% CI 1.43–1.85). (table 2)Table: Racial disparity in the diagnosis of CRC in individuals < 50yrsTable: Distal site distribution and Advanced stage at the diagnosis of CRC in individuals < 50yrsConclusions: In this study there is a significant increase in the diagnoses of CRC in black patients below the age of 50 years. Our study reinforced the new CRC screening recommendation by ACG for blacks to begin screening at the age of 45 years rather than at age 50 years. Also, CRC in younger populations is diagnosed at later stages and is frequently in distal locations.