Mohammed Y. Youssef, MD1, Mohamed Eldesouki, MD2, Ahmed Salem, MD3, Mohammed Abusuliman, MD4, Mostafa Eysha, MD5, Mona A. Ali, MD6, Mohamad Elgozair, MD7, Hend A. Elsaka, MD6, Sherif E. Elhanafi, MD8 1Hunt Regional Medical Center, Greenville, TX; 2Saint Michael's Medical Center, New York Medical College, Newark, NJ; 3Maimonides Medical Center, Brooklyn, NY; 4Henry Ford Hospital, Detroit, MI; 5Texas tech University health science center El Paso, El Paso, TX; 6Mansoura University, Mansoura, Ad Daqahliyah, Egypt; 7Danbury / Yale New Haven Hospital, Danbury, CT; 8Texas Tech University Health Sciences Center, El Paso, TX Introduction: Early-onset gastric cancer (EOGC) gastric cancer diagnosed before age 50, is increasingly recognized as a distinct clinical entity with unique challenges in both diagnosis and treatment. Patients often present with vague symptoms (eg.. dyspepsia, nausea). It usually presents with late diagnosis and carries therapeutic challenges. This study aims to assess the epidemiological trend and risk factors of EOCG from 1990-2021 in the U.S. with projection extending to 2050, using the Global Burden disease database (GBD). Methods: The U.S. specific data were extracted from the GBD database for the age group between 15-49 years from 1990 to 2021. The primary outcome was the age specific mortality rate attributable to EOGC cancer and its attributable risk factors. National trends were visualized using GBD derived mortality figures and graphs, with data further stratified by sex. The GBD forecasting tool was used to project the disease burden trends through 2050 in the U.S. Results: EOGC was responsible for 1,245 deaths in 1990 and 1,117 deaths in 2021 in the U.S.
The age specific death rate of EOGC was 0.93 CI (0.94-0.91) in 1990, and 0.74 (0.71-0.76) in 2021). Gender specific date showed that in 1990 males had death rate of 1.18 CI (1.15-1.21) per 100,000 and females had death rate of 0.68 CI (0.66-0.69). in 2021 males had death rate 0.81 CI (0.78-0.84) per 100,000, females 0.66 CI (0.63-0.69) per 100,000.
The age specific DALY in 1990 was 45.91 CI (45.11-46.76) per 100,000 in 1990 and 36.27 CI (35.06-37.39).
The age specific incidence rate was 1.85 CI (1.81-1.81) per 100,000 and 1.73 CI (1.67-1.78) per 100,000 in 2021.
It is projected that in 2050 EOCG death rate will decrease 0.47 CI (0.39-0.56) per 100,000.
Smoking was responsible 12.27% of EOCG related death in 1990, and 7.29% in 2021.
Diet high in sodium was responsible for 7.39% and 7.90% of EOCG in 1990 and 2021 respectively. Discussion: The overall mortality of EOGC in the U.S. have declined over the course three decades, although the diseases still impose a significant health impact on individuals between 15-49 years. Gender disparities persist, with higher mortality rates among males. Despite the decreased burden of smoking, it still imposes a significant risk. Diet high in Sodium became the second leading cause of EOGC related death in 2021. These findings highlight the need for continued preventive strategies, targeted awareness, and early detection efforts to address the burden of EOGC in younger populations
Figure: The trend of the age specific death rate from 1990-2021
Figure: The trend of the age specific incidence rate from 1990-2021
Disclosures: Mohammed Y. Youssef indicated no relevant financial relationships. Mohamed Eldesouki indicated no relevant financial relationships. Ahmed Salem indicated no relevant financial relationships. Mohammed Abusuliman indicated no relevant financial relationships. Mostafa Eysha indicated no relevant financial relationships. Mona Ali indicated no relevant financial relationships. Mohamad Elgozair indicated no relevant financial relationships. Hend Elsaka indicated no relevant financial relationships. Sherif Elhanafi indicated no relevant financial relationships.
Mohammed Y. Youssef, MD1, Mohamed Eldesouki, MD2, Ahmed Salem, MD3, Mohammed Abusuliman, MD4, Mostafa Eysha, MD5, Mona A. Ali, MD6, Mohamad Elgozair, MD7, Hend A. Elsaka, MD6, Sherif E. Elhanafi, MD8. P6317 - Early Onset Gastric Cancer in Young Americans: Three Decades of Change and Future Risk Projections, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
