Background: Colorectal cancer (CRC) is a major global health issue, ranking fourth in incidence and third in cancer-related deaths. In 2022, it was most prevalent in Asia, Europe and North America. Although rates in Latin America, including Mexico, are lower, they still represent a substantial public health concern. However, CRC data in Mexico are limited and outdated.

Aim: This study aimed to assess the incidence trends of CRC in a secondary-level hospital in Mexico from 2011 to 2023.

Methods: A retrospective analysis was conducted on 819 individuals with CRC at Regional General Hospital 251 (Mexican Social Security Institute) in Metepec, Mexico. Incidence rates were calculated per 100,000 inhabitants and stratified by sex, age group, tumour site and body mass index. Trend analysis was performed using Joinpoint regression models to estimate annual percent change (APC).

Results: CRC incidence showed a significant upward trend (APC = 8.81%; p = 0.01) from 2011 to 2023. A one-joinpoint model revealed an increase from 2011 to 2021 (APC = 17.90%; < 0.01), followed by a sharp decrease from 2021 to 2023 (APC = −41.34%; p = 0.03). Males had slightly higher incidence rates than females; the ≥50 age group showed the highest burden. Over half of the individuals were diagnosed at advanced stages (III–IV), with similar trends observed across the sexes.

Conclusion: CRC incidence increased significantly over the last decade, with a recent drop likely influenced by the COVID-19 pandemic. Despite some limitations, this is the first study of CRC trends at a secondary-level hospital in Mexico that underscores the need for enhanced screening and timely diagnosis strategies.