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Published on: May 1, 2019
Gastric cancer in children and adolescents in Japan
Masumi Okuda1,2, Keiko Nomura3, Mototsugu Kato4
1Department of Pediatrics, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
Insights
Childhood gastric cancer is rare, with most cases occurring in older children. While prognosis is poor, declining rates may link to reduced Helicobacter pylori infection, though more research is needed.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Epidemiology
Background:
- Childhood gastric cancer is exceedingly rare, with limited available data on its clinical presentation and characteristics.
- Understanding the epidemiology and clinical features of gastric cancer in pediatric and adolescent populations is crucial.
Purpose of the Study:
- To assess the clinical features, treatment, and prognosis of gastric cancer in children and adolescents.
- To investigate the potential role of Helicobacter pylori infection in childhood gastric cancer.
Main Methods:
- A retrospective survey of 518 hospitals in Japan was conducted to collect data on childhood gastric cancer cases.
- Literature reviews of PubMed and the Japan Medical Abstracts Society database, along with Japanese Vital Statistics, were used to identify additional cases.
- Data collected included patient demographics, onset symptoms, tumor location, histology, family history, H. pylori status, treatment, and outcomes.
Main Results:
- The study identified 80 pediatric gastric cancer cases (<16 years old), predominantly in children over 10 years old, with no sex predilection.
- Undifferentiated-type carcinoma was the predominant histology (approx. 80%), and a significant proportion of patients had a family history of cancer.
- Prognosis was extremely poor, with a high rate of H. pylori positivity (2/3 tested), although overall childhood gastric cancer deaths are declining.
Conclusions:
- Childhood gastric cancer is a rare entity in Japan, characterized by aggressive histology and poor outcomes.
- Limited data exist on H. pylori infection in pediatric gastric cancer patients, but declining incidence may correlate with decreasing infection rates.
- Further research is essential to elucidate the precise relationship between H. pylori and the development of gastric cancer in children.
Background:
Very limited data are available on childhood gastric cancer. Using a retrospective survey and literature review, we assessed the clinical features of gastric cancer in children and adolescents.
Methods:
We collected information on childhood gastric cancer from pediatricians of 518 hospitals that issue the title of "certified board pediatrician" approved by Japan Pediatric Society, using a questionnaire on background, diagnosis year, onset symptoms, tumor location, histology, nodular gastritis, Helicobacter pylori testing, treatment, and prognosis. Studies were collected using PubMed and the NPO Japan Medical Abstracts Society database. Data for childhood gastric cancer were abstracted from the Japanese Vital Statistics database.
Results:
Of the 518 hospitals, 349 returned the questionnaire, which identified four patients. Literature review identified 77 cases of gastric cancer, and we analyzed data for 80 children <16 years old. Most patients were >10 years old, and there were no sex differences. Onset symptoms ranged from abdominal pain to non-localized. Sixteen of 44 children had a family history of cancer; 10 had a family history of gastric cancer. Histologically, approximately 80% had undifferentiated-type carcinoma. Prognosis was extremely poor, and two of three tested children were positive for H. pylori infection. Childhood gastric cancer death has been declining.
Conclusions:
Childhood gastric cancer is rare in Japan, and information on H. pylori in childhood gastric cancer patients is limited. Declining childhood gastric cancer rates may reflect the decreasing prevalence of infection but further study is necessary to clarify the relationship between H. pylori and gastric cancer.
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