The worldwide incidence of gastric cancer (GC) has been increasing in young patients (YP) over the past few decades. It is unclear whether there are differences in disease characteristics and prognosis between YP and older patients (OP). This review examines the differences in presentation and outcomes between YP and OP.
A retrospective review of all cases of sporadic GC referred to the Kuwait Cancer Control Center (KCCC) between 2008 and 2016 was conducted. We collected data on patients’ demographics, risk factors, disease clinicopathologic characteristics, stage at diagnosis and survival. Patients at the age of 50 years or younger at the time of diagnosis were designated as YP. Continuous variables were summarized with mean and standard deviation, or median and interquartile range (IQR) as appropriate and compared with Mann-Whitney U test. Categorical variables were described as frequencies (percent) and compared with Fisher’s exact test. A level of 0.05 was defined as statistically significant.
Evaluable data were available for 167 patients. 52 (31.1%) where YP. The mean age was 43.2 (±5.7) years for YP compared with 64.3 (±8.4) years for OP. In YP 63.5% were males compared to 72.2% in EG, p = 0.28. YP tends to present more with epigastric pain as opposed to OP who presented with GI bleed (hematemesis, melena or symptomatic anemia). There were less smokers in YP (23.1%) relative to OP (42.5%), p = 0.009. We found no difference with regards to family history, H. Pylori status, histological subtype, grade or stage at diagnosis. The overall survival was 78.8% for YP versus 63.5% for OP, p = 0.051.
Compared to their older counter parts, YP with GC tend to present with more epigastric pain and less likely to be smokers. No significant differences were found in disease characteristics or outcomes between YP and OP. More research is needed to further understand the raise of GC among YP.
Clinical trial identification
Legal entity responsible for the study
Ministry of Health of Kuwait.
Has not received any funding.
All authors have declared no conflicts of interest.