Tumor Stage of the Gastric Cancers in the Generation Younger Than 50 Years was More Advanced Compared to the Older Generations in Japan

Abstract

Introduction: Whereas the populations younger than 40 years old do not ordinarily receive gastric cancer (GC) screening in Japan, there are several cases to suffer GC in the young generation. The present study reviewed retrospectively the chart of all the GC patients in our hospital during the recent 5 years to characterize the GC patients in the generation younger than 50 years old. Methods: All the 345 consecutive GC patients in our hospital from 2010 to 2014 were divided into the 3 age groups: ≤ 50 years old, 51 - 60 years old, and > 60 years old. The patient - and tumor - characteristics including onset age, sex, tumor tissue differentiation, and staging were compared among the groups. Results: The average age of GC onset for the entire cohort was 72.3 years old, and the age was significantly younger in men compared to women (71.4 vs 74.7 years old; P < 0.03). The onset age in the poorlydifferentiated + signet-ring cell GC cases was younger compared to the moderately-differentiated cases (69.6 vs 74.5 years; P = 0.03) and well-differentiated cases (69.6 vs 73.4 years; P < 0.01). The ≤ 50-year-old group was only 4.6% (16/345) of the cohort, and 75% (12/16) of them had poorly-differentiated or signetring cell GC, and the stage of the group was high including more than stage II (75%), and 37.5% (6/16) of stage IV (average stage: 2.5). The percentage of the poorly-differentiated GC + signet-ring cell GC was less in the 51 - 60 years old group (36.4%) and the > 60 years group (30.5%). The tumor staging was less advanced in these groups compared to the groups 50 years old (average stage: 1.8 and 2.0 vs 2.5). The Helicobacter pylori infection rate in the cohort was more than 95% in the present cohort, and 15 out of 16 in the 50 years old group was positive in Helicobacter pylori. Conclusion: GC in the generation younger than 50 years old was relatively uncommon in the present observation, and the staging of the tumor was more advanced compared to the older generations. The advanced stage in the young generation might be due to the GC screening system in Japan, which is focused on the old generation. The eradication therapy of Helicobacter pylori might rescue the onset of GC in Japan, which lead to improve the prognosis in the Japanese GC patients in the near further.