Clinicopathological profile of gastric cancer in a Bolivian cohort: A retrospective analysis from the Instituto Gastroenterológico Boliviano Japonés (2020–2025).

Abstract

e16022 Background: Gastric cancer remains a leading cause of cancer-related mortality worldwide, particularly in low- and middle-income countries. Regional epidemiological data are critical to inform public health strategies and clinical decision-making. Methods: We conducted a retrospective review of the clinical records of patients admitted with clinically suspected gastric malignancy based on symptoms or findings during endoscopy at the Instituto Gastroenterológico Boliviano Japones (La Paz, Bolivia) between 2020 and 2025. Of 106 initially identified cases, 3 were excluded due to confirmed benign disease, leaving 103 patients for analysis. Histopathological confirmation was available in 80 cases (77.7%); the remaining 23 cases were clinically or endoscopically highly suspicious for malignancy but lacked histopathological confirmation. Demographic, clinical, endoscopic, pathological, and treatment-related variables were extracted and analyzed descriptively. Results: Of the 80 patients included, the median age at diagnosis was 55 years (range: 21–83), with 17.7% (n = 11) of patients under 40 years. Female patients comprised 53.2% (n = 33) of the cohort. Notably, no patient reported tobacco use, while 16.7% (n = 10) consumed alcohol and 6.5% (n = 4) had a family history of gastric cancer. Helicobacter pylori was detected in 69% (29/42) of tested patients. The most common occupations were housewives (21.7%), technical workers (20%), and farmers (15%). Among the 40 patients with documented timelines, the median symptom-to-diagnosis interval was 116 days (range: 2–461). Endoscopically, 83.6% of lesions were proximal. Histologically, 77.5% (n = 62) had adenocarcinoma, 17.5% (n = 14) gastric lymphoma, and 5% (n = 4) GIST. The majority (61.3%, n = 38) had poorly or undifferentiated tumors, and 37.1% (n = 23) presented with signet-ring cell histology. At diagnosis, 61% (n = 36) were stage IV, and 49.2% (n = 30) had carcinomatosis. Only 13.1% (n = 8) underwent curative-intent surgery (total or partial gastrectomy); 18% (n = 11) received palliative surgery or laparoscopy, and 65% (n = 39) were managed with palliative intent. In-hospital mortality was 11.3% (n = 7). Conclusions: This is the first data collected in Bolivia about gastric cancer. This cohort reflects a pattern of late diagnosis, aggressive histology, and limited access to curative therapy, despite a complete absence of tobacco use—a notable finding in global gastric cancer epidemiology. The high prevalence of H. pylori , prolonged symptom-to-diagnosis interval, and predominance of proximal, poorly differentiated tumors underscore the need for region-specific prevention programs, including H. pylori eradication and early endoscopic screening in high-risk populations. Keywords: gastric cancer, epidemiology, Bolivia, Helicobacter pylori , ASCO Global Health.