Stomach cancer in young people is unusual, but when it occurs, is often misdiagnosed as a more benign condition such as an ulcer or acid reflux.
Studies have shown 1 in 5 people are misdiagnosed with a benign condition when they have cancer, a truly shocking figure.
It feels as if it is becoming more common in younger age, although it still is quite rare.
Because of this, tumors are unfortunately diagnosed quite late and this results in poorer outcomes too.
So, what is going on?
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The answer is simple; doctors really just don’t suspect it! It’s true, because it is usually a condition thought of as occurring later on in life.
Diagnostic pathways, such as the “2 week cancer pathway” and the dyspepsia or “indigestion” guidelines recommend treating over investigation in young people, because of the rarity of malignancies in this group.
But, stomach malignancies in people under the age of 45 years accounts for approx. 1.8% of all gastric tumors (1).
So, how can we improve outcomes in young people? The saying prevention is better than cure is commonly quoted, but this can be difficult with gastric malignancies.
Obesity, diet, smoking and family history are all important independent risk factors and should be addressed by doctors and governments.
Targeting high risk groups with screening and surveillance programs may help, along with educating both the general public and health professionals may help so that tumors are picked up earlier.
Lifestyle changes such as increased dietary Vitamin C, possibly Vitamin D and reduced fat intake may help.
Rates are higher in some populations than others with Japan, Chile, Austria and Finland having the highest rates.
Targeting these populations with screening programs has been implemented in some areas.
Finding better ways to pick up this disease, such as tumor markers and genetics may help.
If you think you might have a tumor, see your doctor urgently. Symptoms that are concerning include:
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With or without heartburn or indigestion symptoms should be investigated urgently regardless of age.
If you have been given treatment (rather than investigation) and it doesn't work, returning to your doctor early is very important.
Uncomplicated Dyspepsia Is A Very Rare Presentation Of Gastric Cancer Under Age 55
Gillen, D et Al. Gastroenterology 110:A519