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Age-Related Differences in Gastric Adenocarcinoma from 2000-2020: A SEER Database Analysis.

Abdul Qahar Khan Yasinzai1,2, Anwaar Saeed3,4

  • 1Department of Medicine, Division of Medical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA.

Journal of Gastrointestinal Cancer
|March 13, 2025
PubMed
Summary

Gastric adenocarcinoma (GAC) affects older adults, but early-onset cases show aggressive traits and poor survival, especially in Hispanic populations. Black individuals experience the worst survival outcomes across all age groups, highlighting the need for age-specific interventions.

Keywords:
Age FactorsGastric CancerHealthcare DisparitiesPrognosisRace FactorsSEER

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Area of Science:

  • Oncology
  • Epidemiology
  • Medical Statistics

Background:

  • Gastric cancer (GC) is a leading cause of cancer death globally, with adenocarcinoma (GAC) comprising 95% of cases.
  • While GAC typically affects older males, significant demographic and prognostic disparities exist across different age groups.
  • Understanding these age-related differences is crucial for effective GAC management.

Purpose of the Study:

  • To compare the demographic characteristics and prognostic outcomes of gastric adenocarcinoma (GAC) patients across various age groups.
  • To identify age-specific risk factors and survival trends in GAC.
  • To inform the development of tailored interventions for different patient demographics.

Main Methods:

  • Retrospective analysis of 103,674 GAC cases from the Surveillance, Epidemiology, and End Results (SEER) Program (2000-2020).
  • Cases were stratified into distinct age brackets for comparative analysis.
  • Demographic data, tumor characteristics, and survival outcomes were evaluated.

Main Results:

  • The median age of GAC patients was 69 years; 39.7% were aged 66-80.
  • Younger (<35 years) and older (≥81 years) groups showed higher female proportions.
  • Hispanic ethnicity was more prevalent in younger GAC patients, while non-Hispanic White ethnicity dominated the oldest group.
  • Liver metastasis was more common in the 51-65 and 66-80 age groups.
  • Early-onset GAC (<35 years) frequently presented at the cardia.
  • Male gender and Black race were associated with the worst survival outcomes across all ages, particularly in the youngest group.
  • Hispanic patients had poorer survival at younger ages but better survival in the oldest group (≥81 years).
  • Tumor location (greater curvature, overlapping lesions) and histology impacted prognosis.

Conclusions:

  • Gastric adenocarcinoma predominantly affects older adults in the US, but early-onset GAC exhibits aggressive features and poorer survival, particularly in Hispanic populations.
  • Black individuals face the most severe survival challenges across all age brackets.
  • Gender distribution varies at the extremes of age.
  • Significant demographic and prognostic variations across age groups necessitate customized GAC treatment strategies.