413 Clinicopathological Profile and Prevalence of Early-Onset Oesophago-Gastric Cancer: A Retrospective Cohort Study

Abstract Aim Early-onset oesophago-gastric (OG) cancer, defined as malignancy of the oesophagus or stomach diagnosed before the age of 50 is increasingly recognised as a distinct clinical entity. Global data suggest a rising incidence, with younger patients often presenting with different biological behaviour and diagnostic challenges. This study aimed to assess the prevalence of early-onset OG cancer within our population and to describe its clinicopathological features. Method A retrospective cohort study was performed across a single health board, including all patients diagnosed with oesophageal or gastric cancer between January 2017 and December 2022. Electronic records were reviewed to collect demographic, clinical, pathological, and treatment data. Patients diagnosed before age 50 were classified as early-onset OG cancer and included in the analysis. Variables assessed included presenting symptoms, tumour site, histological subtype, disease stage, and treatment intent (curative or palliative). Results A total of 784 patients were diagnosed with OG cancer during the study period, of whom 533 (68%) were male. Early-onset OG cancer accounted for 38 (4.8%) cases. Among these, 23 (60.5%) were oesophageal cancers and 29 (76.3%) were adenocarcinomas. The median age at diagnosis in this group was 42 years (IQR 38–47). Regarding treatment intent, 20 patients (52.6%) were referred for palliative chemotherapy, while 11 (28.9%) underwent treatment with curative intent. Conclusions Although infrequent, early-onset OG cancer represents a clinically relevant subgroup. Increased awareness is vital, as younger patients may present with advanced disease. Further research is needed to inform risk stratification and optimise management.