Introduction: Colorectal cancer (CRC) is the third most common cancer and the third leading cause of cancer deaths in the United States. Overall, CRC incidence and mortality rates are higher in men and highest in African Americans, followed by Caucasians. Few studies demonstrated a preventive role of thyroid hormone (TH) in the development and invasiveness of CRC. Methods: In a retrospective cohort, we identified 48 patients with CRC and hypothyroidism (cases). The patients were sex-matched with 174 patients who had CRC without hypothyroidism (controls). Data were collected for depth of tumor invasion, lymphovascular invasion, tumor location, staging (TNM), histologic type, level of differentiation, and positive-to-total lymph node ratio. Results: Females constituted 83.3% of cases. Mean age at diagnosis in case and control was (74.7±11.05 years, 76.3±12.28 years, respectively; p=-0.25). The other demographic variables were similar in 2 groups except race, with the patients in the cases being overwhelmingly Caucasian (91.6% versus 54.0% in control; p<0.001). In the unadjusted regressions, patients with hypothyroidism were more likely to have deep tumor invasions (OR 0.874; 95% CI -0.01, 1.76). In the adjusted regressions, Hispanic patients with hypothyroidism had significantly lower odds of high stage than Caucasian patients (OR -7.007; 95% CI -13.47, -0.55). The point estimates for hypothyroidism and the interaction with age at diagnosis for the TNM stage (OR 10.222; 95% CI 0.91, 19.53; OR -0.138; 95% CI -0.26, -0.02, respectively) and for lymphovascular invasion, (OR 8.618; 95% CI 0.09, 17.15; OR -0.120; 95% CI -0.23, -0.01, respectively), imply that at age 74 years or younger at diagnosis of CRC, hypothyroidism raises the odds of having higher TNM stage and lymphovascular invasion. Conclusion: Cyclin D1 is an oncogenic cyclin, which is frequently overexpressed in CRC and Wnt, signaling pathway is involved in development sporadic CRC. TH-bound thyroid receptors (TRs) inhibit the transcription of cyclin D though the Tcf/Lef-1 site, which is positively regulated by Wnt signaling pathway. In patients with hypothyroidism, colorectal tumor exhibit reduced TRB1 expression. This may be the basis for why our study demonstrated that female Caucasian patients with hypothyroidism are more likely to have worse tumor characteristics of CRC at age less than 74 years.