Ann Surg Treat Res.  2025 Apr;108(4):245-255. 10.4174/astr.2025.108.4.245.

Proposal of age definition for early-onset gastric cancer based on the Korean Gastric Cancer Association nationwide survey data: a retrospective observational study

• Jeong SA
• Lee JS
• Seong BO
• Oh Sg
• Ko CS
• Min SH
• Gong CS
• Kim BS
• Yoo MW
• Yook JH
• Lee IS
• the Information Committee of the Korean Gastric Cancer Association

• KMID: 2566628
• DOI: http://doi.org/10.4174/astr.2025.108.4.245

Abstract

Purpose
This study aimed to define an optimal age cutoff for early-onset gastric cancer (EOGC) and compare its characteristics with those of late-onset gastric cancer (LOGC) using nationwide survey data.
Methods
Using data from a nationwide survey, this comprehensive population-based study analyzed data spanning 3 years (2009, 2014, and 2019). The joinpoint analysis and interrupted time series (ITS) methodology were employed to identify age cutoffs for EOGC based on the sex ratio and tumor histology. Clinicopathologic characteristics and surgical outcomes were compared between the EOGC and LOGC groups.
Results
The age cutoff for defining EOGC was suggested to be 50 years, supported by joinpoint and ITS analyses. Early gastric cancer was predominantly present in the EOGC and LOGC groups. Patients with EOGC comprised 20.3% of the total study cohort and demonstrated a more advanced disease stage compared to patients with LOGC. However, patients with EOGC underwent more minimally invasive surgeries, experienced shorter hospital stays, and had lower postoperative morbidity and mortality rates.
Conclusion
This study proposes an age of ≤50 years as a criterion for defining EOGC and highlights its features compared to LOGC. Further research using this criterion should guide tailored treatment strategies and improve outcomes for young patients with gastric cancer.

Keyword

Diagnosis; Early-onset gastric cancer; Interrupted time series analysis; Joinpoint trend analysis; Stomach neoplasms