S3182 Early Onset Gastric Cancer in Young Americans: Three Decades of Change and Future Risk Projections

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 (e.g., dyspepsia, nausea). It usually presents with late diagnosis and carries therapeutic challenges. This study aims to assess the epidemiological trend and risk factors of EOGC from 1990-2021 in the U.S. with projection extending to 2050, using the Global Burden of Disease database (GBD). Methods: The U.S.-specific data were extracted from the GBD database for the age group between 15 years and 49 years from 1990 to 2021. The primary outcome was the age-specific mortality rate attributable to EOGC 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 (confidence interval [CI] 0.94-0.91) in 1990, and 0.74 (CI 0.71-0.76) in 2021). Gender-specific data showed that in 1990, men had a death rate of 1.18 (CI 1.15-1.21) per 100,000 and women had death rate of 0.68 (CI 0.66-0.69). In 2021, men had a death rate of 0.81 (CI 0.78-0.84) per 100,000 and women 0.66 (CI 0.63-0.69) per 100,000. The age specific disability-adjusted life year 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 the EOGC death rate will decrease 0.47 (CI 0.39-0.56) per 100,000. Smoking was responsible for 12.27% of EOGC-related death in 1990 and 7.29% in 2021. Diet high in sodium was responsible for 7.39% and 7.90% of EOGC in 1990 and 2021, respectively. Conclusion: The overall mortality of EOGC in the U.S. has declined over the course of 3 decades, although the disease still imposes a significant health impact on individuals between 15 years and 49 years. Gender disparities persist, with higher mortality rates among men. 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.