Abstract
Background Hepatotoxicity is a significant concern for patients with colorectal cancer (CRC), potentially leading to severe complications, including death. This study aims to quantify the overall and long-term risks of chronic liver disease and cirrhosis (CLDC) death among CRC patients following surgery. Methods Data of the patients with colon cancer or rectal cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (1992-2021). Cumulative mortality functions, standardized mortality ratios (SMRs), and absolute excess risk (AER) were calculated to evaluate the risk of CLDC mortality. Results CRC survivors had higher CLDC mortality than the general population (colon SMR 1.76; rectal SMR 1.42). Significantly, the highest AER was recorded among individuals diagnosed with colon cancer within the age bracket of 60 to 69 years. This elevated risk persists even with targeted therapies and immunotherapy, highlighting the need for personalized follow-up. Moreover, it is important to note that long-term survivors of colon and rectal cancer continue to face an elevated risk of CLDC-related mortality. Conclusion The study highlights the importance of personalized medicine, comprehensive follow-up, and proactive management of liver health in CRC survivors to mitigate long-term adverse effects of cancer treatments.