In a large skillet or sauté pan over medium-high heat, cook the ground beef until browned and cooked through, breaking it up with a wooden spoon or spatula as it cooks.
If using, add the chopped onion and minced garlic to the skillet and cook until the onion is translucent and the garlic is fragrant, about 2-3 minutes.
Stir in the crushed tomatoes, tomato paste, Worcestershire sauce, oregano, basil, salt, and black pepper. Bring the mixture to a simmer and let it cook for about 10 minutes, stirring occasionally.
While the sauce is simmering, cook the macaroni according to the package instructions in a large pot of salted boiling water. Drain the macaroni in a colander and set aside.
Add the water and cooked macaroni to the skillet with the beef and sauce, stirring to combine. Bring the mixture to a simmer and let it cook for an additional 5-7 minutes, or until the macaroni is tender and the sauce has thickened slightly.
Serve the American Chop Suey hot, topped with shredded cheddar cheese if desired. Enjoy!