Gastric Cancer in Young Patients: Demographic and Clinicopathological Features in a Culturally Diverse Immigrant Population

Abstract

Purpose: Gastric cancer is one of the most common cancers worldwide and the second leading cause of cancer death. Several reports have suggested that younger patients are often diagnosed with advanced stages and carry much worse prognosis. This study was undertaken to define the demographic and clinicopathological features in young patients with gastric adenocarcinoma in a community hospital serving culturally diverse immigrant population in New York City. Methods: A retrospective chart review of a total of 238 patients with diagnosis of gastric cancer at Elmhurst Hospital Center from year 2000 to 2011 was performed. There were a total of 22 patients who were age </=40 and were defined as young patients. Results: The mean patient age was 34 years (range 27-40 years). There was a male preponderance; with a male to female ratio of 2:1. Five patients (22%) were Asian; 17 patients (78%) were non Asian. All the 22 patients (100%) were born outside United States (US). Among non Asian patient group, all the 17 patients were Hispanic (100%). The predominant symptom at the time of diagnosis was abdominal pain in 9 patients followed by symptomatic anemia in 6 patients and gastrointestinal bleed in 6 patients. The differences between the groups can be seen in the Table.Table: No Caption available.Conclusion: Our study suggests that younger immigrant patients may present with a more advanced disease and cure is not always achievable in this situation. The only hope is for aggressive diagnostic and therapeutic intervention. This may be made more difficult given that immigrants do not always have the same access to care. Young Hispanic males seem to represent a group at high risk for aggressive gastric cancer. Further studies are needed to better delineate the genetic and epidemiologic risk factors in this population. This is critical as the population of Hispanic immigrants is expanding rapidly in the U.S. and clinicians should entertain the possibility of gastric cancer despite a young age of presentation. Another interesting finding in our study is the normal hemoglobin seen among young Asian patients with advance stage gastric cancer which may make pursuing the diagnosis of gastric cancer more difficult in this population.