Most individuals under 60 who develop gastric
or stomach cancer
have a "genetically and clinically distinct" disease, new Mayo Clinic research has discovered. Compared to stomach cancer i
n older adults, this new, early onset form often grows and spreads more quickly, has a worse prognosis, and is more resistant to traditional chemotherapy treatments, the study finds. The research was published recently in the journal Surgery
Though rates of stomach cancer
in older patients have been declining for decades, this early onset gastric cancer
is increasing and now makes up more than 35% of stomach cancer
Senior author Dr Travis Grotz, M.D., a Mayo Clinic surgical oncologist told Thailand Medical
News, "I think this is an alarming trend, as stomach cancer
is a devastating disease.There is little awareness in the U.S. of the signs and symptoms of stomach cancer
, and many younger patients may be diagnosed late when treatment is less effective."
The study team researched 75,225 cases using several cancer databases to review stomach cancer
statistics from 1973 to 2015. Today, the average age of someone diagnosed with stomach cancer
is 68, but people in their 30s, 40s and 50s are more at risk than they used to be.
While there's no clear cutoff age for the definition of early onset and late-onset stomach cancer
, the researchers found the distinctions held true whether they used an age cutoff of 60, 50 or 40 years. The researchers found that the incidence of late-onset stomach cance
r decreased by 1.8% annually during the study period, while the early onset disease decreased by 1.9% annually from 1973 to 1995 and then increased by 1.5% through 2013. The proportion of early onset gastric cancer
has doubled from 18% of all cases in 1995 to now more than 30% of all gastric cancer
Dr. Grotz added,"Typically, we see stomach cancer
being diagnosed in patients in their 70s, but increasingly we are seeing 30- to 50-year-old patients being diagnosed."
The startling increased rate of the early onset disease is not from earlier detection or screening, Dr. Grotz adds. "There is no universal screening for stomach cancer,
and the younger patients actually presented with later-stage disease than the older patients," he says.
Besides being more deadly, early onset stomach cancer
is also genetically and molecularly distinct, researchers found. Furthermore, traditional risk factors for developing stomach cancer
among older Americans, such as smoking tobacco, did not appear to correlate with its early onset counterpart.
Dr. Grotz added, &
quot;Hopefully, studies like this will raise awareness and increase physician suspicion of stomach cancer
, particularly in younger patients. Younger patients who feel full before finishing a meal, or have reflux, abdominal pain, unintentional weight loss and difficulty eating should see their health care provider.”
or stomach cancer
is the 16th most common cancer in the U.S., according to the American Cancer
Society. It has a five-year survival rate of 31.5%, and there will be an estimated 27,510 new cases in 2019, according to the National Cancer
Institute. The World Health Organization reports that cancer
was the second leading cause of death globally in 2018 and that stomach cancer
was the third most common cause of cancer death that year.
The medical research team hopes to better identify risk factors for early onset stomach cancer
using the Rochester Epidemiology Project and potentially other large databases.
Reference : John R. Bergquist et al. Early-onset gastric cancer is a distinct disease with worrisome trends and oncogenic features, Surgery (2019). DOI: 10.1016/j.surg.2019.04.036