Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer

ABSTRACT Background There has been a paradoxical rise in young‐onset gastric cancer (YOGC), defined as gastric cancer (GC) diagnosed before age 50. Precursor lesions may contribute to pathogenesis, though their role in progression to different histologic subtypes is unclear. The impact of self‐repor...

Full description

Saved in:
Bibliographic Details
Main Authors: Patrick T. Magahis, Nicole Cornet, Laura Tang, Kanika Arora, Neha Hingorani, Stephanie King, Arnold J. Markowitz, Mark Schattner, Shoji Shimada, Steven B. Maron, Santosha Vardhana, Melissa Lumish, Andrea Cercek, Yelena Y. Janjigian, Daniel Coit, Robin B. Mendelsohn, Michael F. Berger, Vivian E. Strong, Zsofia K. Stadler, Monika Laszkowska
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.70451
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850060865201504256
author Patrick T. Magahis
Nicole Cornet
Laura Tang
Kanika Arora
Neha Hingorani
Stephanie King
Arnold J. Markowitz
Mark Schattner
Shoji Shimada
Steven B. Maron
Santosha Vardhana
Melissa Lumish
Andrea Cercek
Yelena Y. Janjigian
Daniel Coit
Robin B. Mendelsohn
Michael F. Berger
Vivian E. Strong
Zsofia K. Stadler
Monika Laszkowska
author_facet Patrick T. Magahis
Nicole Cornet
Laura Tang
Kanika Arora
Neha Hingorani
Stephanie King
Arnold J. Markowitz
Mark Schattner
Shoji Shimada
Steven B. Maron
Santosha Vardhana
Melissa Lumish
Andrea Cercek
Yelena Y. Janjigian
Daniel Coit
Robin B. Mendelsohn
Michael F. Berger
Vivian E. Strong
Zsofia K. Stadler
Monika Laszkowska
author_sort Patrick T. Magahis
collection DOAJ
description ABSTRACT Background There has been a paradoxical rise in young‐onset gastric cancer (YOGC), defined as gastric cancer (GC) diagnosed before age 50. Precursor lesions may contribute to pathogenesis, though their role in progression to different histologic subtypes is unclear. The impact of self‐reported race is also poorly characterized and may be unreliable as a proxy for genetic differences. We aimed to compare differences in histology and genetic ancestry between YOGC and average‐onset gastric cancer (AOGC). Methods This retrospective cohort included all patients with GC at Memorial Sloan Kettering (MSK) from January 2013 to March 2021. Data on demographics, tumor characteristics, and precursor lesions were collected. Genetic ancestry was inferred from MSK‐Integrated Mutation Profiling of Actionable Cancer Targets panel. Results Of 1685 individuals with GC, 290 had YOGC. Compared to AOGC, individuals with YOGC tended to be female, Hispanic, foreign‐born, and feature diffuse‐type histology. YOGC was less likely to have precursor lesions, including intestinal metaplasia (20% vs. 37%, p < 0.01) and dysplasia (4% vs. 14%, p < 0.01). Of 560 patients with ancestry data, 127 had YOGC. Admixed, East Asian, and South Asian ancestries were more likely to present with YOGC while Europeans presented with AOGC. Intestinal metaplasia was enriched among East Asians, maintained when stratifying by histology and GC onset. Conclusions We observed YOGC was more common in East and South Asians, and while YOGC may be less likely to develop in the setting of precursor lesions these high‐risk states may also be enriched in East Asians. Future research is needed to understand drivers behind such differences and outcome disparities given these individuals may be less amenable to endoscopic interventions.
format Article
id doaj-art-eb601c10f4674961bdedbb1bc0c8083b
institution DOAJ
issn 2045-7634
language English
publishDate 2024-12-01
publisher Wiley
record_format Article
series Cancer Medicine
spelling doaj-art-eb601c10f4674961bdedbb1bc0c8083b2025-08-20T02:50:26ZengWileyCancer Medicine2045-76342024-12-011323n/an/a10.1002/cam4.70451Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric CancerPatrick T. Magahis0Nicole Cornet1Laura Tang2Kanika Arora3Neha Hingorani4Stephanie King5Arnold J. Markowitz6Mark Schattner7Shoji Shimada8Steven B. Maron9Santosha Vardhana10Melissa Lumish11Andrea Cercek12Yelena Y. Janjigian13Daniel Coit14Robin B. Mendelsohn15Michael F. Berger16Vivian E. Strong17Zsofia K. Stadler18Monika Laszkowska19Weill Cornell Medical College of Cornell University New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USADepartment of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USAGastroenterology, Hepatology, and Nutrition Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York New York USAGastroenterology, Hepatology, and Nutrition Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USAGastric and Mixed Tumor Service, Department of Surgery Memorial Sloan Kettering Cancer Center New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USAGastrointestinal Oncology Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USADepartment of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USAGastrointestinal Oncology Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York New York USADepartment of Medicine Weill Cornell Medicine New York New York USAABSTRACT Background There has been a paradoxical rise in young‐onset gastric cancer (YOGC), defined as gastric cancer (GC) diagnosed before age 50. Precursor lesions may contribute to pathogenesis, though their role in progression to different histologic subtypes is unclear. The impact of self‐reported race is also poorly characterized and may be unreliable as a proxy for genetic differences. We aimed to compare differences in histology and genetic ancestry between YOGC and average‐onset gastric cancer (AOGC). Methods This retrospective cohort included all patients with GC at Memorial Sloan Kettering (MSK) from January 2013 to March 2021. Data on demographics, tumor characteristics, and precursor lesions were collected. Genetic ancestry was inferred from MSK‐Integrated Mutation Profiling of Actionable Cancer Targets panel. Results Of 1685 individuals with GC, 290 had YOGC. Compared to AOGC, individuals with YOGC tended to be female, Hispanic, foreign‐born, and feature diffuse‐type histology. YOGC was less likely to have precursor lesions, including intestinal metaplasia (20% vs. 37%, p < 0.01) and dysplasia (4% vs. 14%, p < 0.01). Of 560 patients with ancestry data, 127 had YOGC. Admixed, East Asian, and South Asian ancestries were more likely to present with YOGC while Europeans presented with AOGC. Intestinal metaplasia was enriched among East Asians, maintained when stratifying by histology and GC onset. Conclusions We observed YOGC was more common in East and South Asians, and while YOGC may be less likely to develop in the setting of precursor lesions these high‐risk states may also be enriched in East Asians. Future research is needed to understand drivers behind such differences and outcome disparities given these individuals may be less amenable to endoscopic interventions.https://doi.org/10.1002/cam4.70451ancestryprecursor lesionscreeningyoung‐onset gastric cancer
spellingShingle Patrick T. Magahis
Nicole Cornet
Laura Tang
Kanika Arora
Neha Hingorani
Stephanie King
Arnold J. Markowitz
Mark Schattner
Shoji Shimada
Steven B. Maron
Santosha Vardhana
Melissa Lumish
Andrea Cercek
Yelena Y. Janjigian
Daniel Coit
Robin B. Mendelsohn
Michael F. Berger
Vivian E. Strong
Zsofia K. Stadler
Monika Laszkowska
Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
Cancer Medicine
ancestry
precursor lesion
screening
young‐onset gastric cancer
title Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
title_full Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
title_fullStr Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
title_full_unstemmed Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
title_short Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young‐ and Average‐Onset Gastric Cancer
title_sort differences in ancestry and presence of gastric precursor lesions in individuals with young and average onset gastric cancer
topic ancestry
precursor lesion
screening
young‐onset gastric cancer
url https://doi.org/10.1002/cam4.70451
work_keys_str_mv AT patricktmagahis differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT nicolecornet differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT lauratang differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT kanikaarora differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT nehahingorani differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT stephanieking differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT arnoldjmarkowitz differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT markschattner differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT shojishimada differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT stevenbmaron differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT santoshavardhana differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT melissalumish differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT andreacercek differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT yelenayjanjigian differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT danielcoit differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT robinbmendelsohn differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT michaelfberger differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT vivianestrong differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT zsofiakstadler differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer
AT monikalaszkowska differencesinancestryandpresenceofgastricprecursorlesionsinindividualswithyoungandaverageonsetgastriccancer