Abstract: Introduction Colorectal cancer (CRC) screening generally starts screening by the age of 50 based on guidelines. Lately however, a U.S. guideline recommended to start CRC screening from age 45 and, very recently, two studies were published that addressed young-onset in Europe (in part) (Vuik et al., 2019; Araghi et al., 2019). Materials and Methods Flemish CRC incidence and mortality data contextualise trend results for age groups under 50 and what the implications could be for practice. Results CRC incidence rates showed considerable variability over a 12-year period without a clear increase in disease burden for the age group 45–49 in Flanders. In several age groups under 39 an increasing incidence trend was visible for both genders. Data was analysed in a period where no CRC screening was present in Flanders. Discussion Decreasing the target age for the Flemish CRC screening does not seem to be straightforward and primary prevention should be considered more prominently.