Trends in liver metastases at diagnosis among young adults with colorectal cancer: A SEER-based analysis, 2010–2022.

Abstract

e15543 Background: Early-onset colorectal cancer (CRC) is increasing in incidence among young adults, yet contemporary trends in metastatic presentation remain incompletely defined. We evaluated temporal changes in liver metastases at diagnosis among young adults with CRC in the United States. Methods: Using the SEER database, we identified patients aged 25–49 years diagnosed with CRC from 2010–2022. The primary outcome was presence of liver metastases at diagnosis. Multivariable logistic regression assessed the association between year of diagnosis and liver metastases, adjusting for age group, sex, and race/ethnicity. Year was analyzed as a continuous variable and by period (2010–2012, 2013–2016, 2016–2019, 2019–2022). Effect modification by sex and race/ethnicity was assessed using interaction terms. Results: Among 48,210 patients with newly diagnosed CRC identified, 8,778 (18.2%) had liver metastases at diagnosis while 39,432 (81.8%) did not. In adjusted analyses, more recent year of diagnosis was associated with lower odds of liver metastases (adjusted odds ratio [aOR] per year, 0.99; 95% CI, 0.98–0.99; p < 0.001). When year of diagnosis was grouped into four time periods (2010–2012, 2013–2016, 2016–2019, and 2019–2022), there were no meaningful differences in the odds of liver metastases at diagnosis for patients diagnosed between 2013–2016 or 2016–2019 compared with 2010–2012. In contrast, patients diagnosed in 2019–2022 had significantly lower odds of liver metastases at diagnosis (aOR 0.87; p < 0.001), indicating that the decline was concentrated in the most recent era. Temporal trends did not differ by sex (interaction p = 0.39) and were consistent across racial and ethnic groups. Conclusions: The prevalence of liver metastases at diagnosis among young adults with CRC has modestly but significantly declined over the past decade, driven primarily by improvements since 2019. These findings suggest potential stage migration related to earlier detection or evolving diagnostic practices in early-onset CRC and have important implications for screening strategies and outcomes in this growing population. Annual proportion of young adults (aged 25–49 years) presenting with liver metastases at the time of colorectal cancer diagnosis in SEER, 2010–2022. Year N total N with liver mets at diagnosis (%) with liver mets at diagnosis 2010 3085 565 18.3 2011 3139 613 19.5 2012 3126 579 18.5 2013 3099 628 20.3 2014 3392 620 18.3 2015 3597 654 18.2 2016 3673 692 18.8 2017 3864 724 18.7 2018 3805 703 18.5 2019 4065 756 18.6 2020 3986 730 18.3 2021 4482 762 17.0 2022 4897 752 15.4