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...
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Wiley
2024-12-01
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| Online Access: | https://doi.org/10.1002/cam4.70451 |
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| 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 |
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