Abstract  INTRODUCTION: Colorectal cancer is the third cause of cancer-related death in the world, with 468,000 estimated deaths in 1993. In some countries mortality rates have started to decline, and survival rates have increased. In this study performed in Mexico, information is presented on the increase in mortality from this form of cancer, especially in more economically developed areas. METHODS: The mortality trend for colorectal cancer was evaluated and standardized by five-year age groups in the period 1980 to 1993. Also, the standardized mortality ratio was calculated for Mexico's 32 states, as was the possible association between mortality and indicators of rurality level and fertility rates in the different regions of Mexico. RESULTS: In the period studied, 18,962 deaths were officially reported. The average age of death was 66 years. The mortality rate among women (1.8) was significantly higher than among men (1.55 per 100,000 inhabitants). Mortality from colorectal cancer grew by 100 percent in both genders (=0.089;P<0.001), especially in the age group 34 and younger, in the 45 to 49 age group, and in the older than 75 age group (P<0.05). The standardized mortality ratio was greater in the states in the north of Mexico. Finally, an inverse correlation was observed throughout Mexico between the rurality index (r=–0.60;P<0.001) and the fertility rates (r=–0.43;P<0.05) and mortality from colorectal cancer. CONCLUSIONS: In this study, there is evidence that mortality from this cancer is higher in geographic areas with greater socioeconomic development, similar to regional patterns observed in other countries. In Mexico, the coming years will see a serious epidemic in mortality from this disease; therefore, immediate attention must be given to identifying the profile of high-risk subjects and implementing early cancer detection measures.