Observational studyJournal of gastrointestinal cancer2026
Epidemiologic Trends in Secondary Malignant Neoplasms of the Liver in the United States: A 25-Year National Study.
Observational study in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSecondary malignant neoplasms of the liver are more common than primary liver cancers but remain understudied. This study provides the first nationwide analysis of liver metastases-related mortality trends and disparities in the US.
methodsThis study analyzed CDC WONDER mortality data (1999-2023) and US Cancer Statistics incidence data for adults ≥ 45 years. Liver metastases-related (ICD-10: C78.7) mortality was stratified by demographics, geographic regions, and primary site of malignancy. Age-adjusted mortality and incidence rates (AAMRs, AAIRs) and crude mortality rates (CMRs) were reported per 100,000 population. Temporal trends were analyzed using Joinpoint regression to calculate annual and average annual percentage changes (APC, AAPC).
resultsLiver metastases-related AAMR rose from 23.8 (1999) to 25.1 (2023) (AAPC = 0.22%*, 95% CI: 0.14-0.29). Males accounted for 51.3% of the 597,332 deaths and had higher AAMRs than females throughout. Lung (25.6%) and colon (24.6%) cancers were the leading primary sites causing deaths related to liver metastases. AAIRs and AAMRs (irrespective of metastasis) declined for most primary cancers. CMRs had an increasing trend, with nearly a 10-fold difference between ages 45-54 and 85+. Non-Hispanic (NH) Blacks had the highest AAMR with a declining trend (AAPC=-0.66%*), while NH Whites saw a significant increase (AAPC = 0.49%*). The West showed the biggest regional increase (AAPC = 1.24%*). AAMR rose the most in Vermont (AAPC = 5.30%*). Rural areas consistently had higher AAMRs (1999-2020).
conclusionMortality from liver metastases has risen among older US adults, with notable demographic and geographic disparities. Improved survival among patients with primary cancers means more individuals are living long enough to experience recurrence and develop late liver metastases, underscoring the need for enhanced detection, surveillance, and management.
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