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Objective: To investigate the incidence and trends in colorectal cancer (CRC) among Asian American populations in the United States. Methods: CRC incidence data from 1994 through 2013 were obtained from 13 Surveillance, Epidemiology and End Results registries. SEER✠ Stat and IBM SPSS Statistics were used. Results: The age-adjusted incidence of CRC among Asian Americans decreased from 45.6 per 100,000 in 1994 to 33.0 per 100,000 in 2013, with the annual percent change being -1.8% (P<0.05). The incidences were higher for men, the elderly (aged 60 years or older) and several geographic areas. For those younger than 70 years, the rectal site was more affected compared with those aged 70 years or older, in whom the proximal site were more affected. Most patients presented with localized and regional stages. Men, 80 years or older, in situ stage and some geographic areas such as Connecticut and California experienced significant incidence decreases in the 20-year observation period. Conclusion: Although CRC incidence has declined among Asian American populations in the United States in the past 2 decades, there are persistent differences by age and geographic areas. Further research is needed to guide the design and implementation of tailored strategies to reduce CRC outcome differences across Asian American populations. [ABSTRACT FROM AUTHOR]