Stomach cancer, or gastric cancer, involves the uncontrolled growth of cells in the stomach lining. While more common in older adults, its occurrence in younger individuals, such as those in their 20s, is a concern. This article provides information on stomach cancer’s relevance to this age group.
Understanding Stomach Cancer in Younger Adults
Stomach cancer is not common in individuals in their 20s, with incidence rates significantly lower than in older populations. Between 2000 and 2019, gastric cancer incidence showed minimal variation in those aged 10-24 in the United States. During this time, 41,327 gastric cancer cases were reported in adults younger than 55, with most being adenocarcinoma, the most common type.
Globally in 2019, about 49,000 stomach cancer cases occurred among adolescents and young adults (ages 15-39), with an age-standardized incidence rate of 1.62 per 100,000. Incidence rates per 100,000 annually decreased across all age groups from 1990 to 2019, including those aged 20-24 (from 0.81 to 0.56) and 25-29 (from 1.53 to 1.11). Despite this overall decline, some reports suggest a stable or slightly increasing trend in young adults in certain regions, like the United States.
Rates for the 0-24 age group have remained stable in the UK, while older age groups have seen decreases. Stomach cancer incidence generally increases with age due to accumulated cell DNA damage. However, about 5% of stomach cancer patients are diagnosed before age 40, showing it can affect younger individuals despite being uncommon.
Identifying Potential Risk Factors
Several factors can increase the likelihood of developing stomach cancer. A major cause, especially for cancers in the lower stomach, is Helicobacter pylori (H. pylori) bacteria infection. Long-term H. pylori infection can lead to atrophic gastritis and pre-cancerous changes in the stomach lining, and it is more prevalent in younger stomach cancer patients.
Genetic predispositions also play a role, with 1% to 3% of stomach cancer cases linked to inherited cancer predisposition syndromes. These include hereditary diffuse gastric cancer (HDGC), often associated with CDH1 gene mutations, and Lynch syndrome, which can predispose individuals to various cancers, including stomach cancer. Most stomach cancer patients affected by these syndromes are young.
Lifestyle factors also contribute to risk. Being overweight or obese is linked to an increased risk of stomach cancer, especially in the upper stomach near the esophagus. Dietary habits, such as high intake of salted, smoked, pickled, or processed foods, are associated with elevated risk. Tobacco use and regular alcohol consumption can also increase the risk, even in young men.
Recognizing Early Symptoms
The early signs of stomach cancer can be subtle, often resembling less serious digestive conditions. Persistent indigestion or heartburn is common, along with mild nausea and feeling full after eating small amounts. These symptoms might be easily dismissed as typical digestive upset.
Other indicators include loss of appetite and unexplained weight loss, which can occur as the disease progresses. Abdominal pain or discomfort, typically in the upper abdomen, is another symptom. Difficulty swallowing, also known as dysphagia, can also be a sign. These symptoms are frequently caused by other conditions like viral infections or ulcers, but their persistence warrants medical evaluation.
Importance of Early Detection and Diagnosis
If someone experiences persistent or worsening digestive symptoms, consulting a healthcare professional is sensible. Early-stage stomach cancer rarely causes noticeable symptoms. In countries without routine screening, it is often detected at later stages when it has grown larger or spread, making it more difficult to treat.
A doctor will typically begin with a medical history and physical examination. Further diagnostic tests may include an endoscopy, using a thin, flexible tube with a camera to examine the stomach lining, or imaging studies like CT scans. Early detection significantly improves treatment outcomes, as localized stomach cancer can often be cured with surgery.