Understanding disparities in survival outcomes for early-onset gastric cancer: A comprehensive multifactorial analysis using SEER database.

Abstract

e16148 Background: Despite a declining overall incidence of gastric cancer in the United States, Early-Onset Gastric Cancer (EOGC), diagnosed in individuals under 50, is rising. The unclear mechanisms and causality driving this trend underscore the need for further investigation into this distinct entity. By utilizing real-world evidence, our objective is to examine the disparities in survival outcomes of EOGC influenced by demographic, socioeconomic, and geographic factors. Methods: A retrospective analysis was performed on 13,385 patients diagnosed with EOGC from 2000 to 2021 from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curves and Cox proportional hazards models were utilized to assess the impact of sex, race, ethnicity, income, and geographic factors on survival. Results: Patients aged 45–49 were the largest age subgroup (40.89%) within the cohort, while the overall gender distribution was 55.47% males and 44.53% females. Males were noted to have a higher risk of cancer-specific mortality with a hazard ratio (HR) of 1.244 (95% confidence interval [CI ] = 1.20 - 1.31, p < 0.001). The cohort's racial distribution was predominantly White (68.44%), followed by Asian or Pacific Islander (14.52%), Black (14.43%), and American Indian/Alaska Native (1.47%). 35.85 % of the cohort are of Hispanic-Spanish origin and have higher mortality with HR of 1.28 (CI = 1.21-1.35, p < 0.001) compared to Non-Hispanic counterparts. Lower-income groups showed increased mortality with HR of 1.31 (CI = 1.1-1.52, p = 0.0004) compared to the higher-income subgroup with HR 1.18 (CI = 1.08-1.30, p = 0.0004). Conclusions: Disparities in cancer-specific mortality were observed across gender, ethnicity, and income levels. Male gender, Hispanic-Spanish origin, and lower-income status were associated with significantly higher cancer-specific mortality. These findings emphasize the importance of future research to develop targeted interventions aimed at addressing these disparities and improving outcomes. Factors affecting survival outcomes of EOGC patients. Covariates HR 95% CI (HR) P-value Sex: Males 1.259 (1.2035, 1.3170) <0.001 Race: Asian or Pacific Islander 0.552 (0.4625, 0.6581) <0.001 Race: Black 0.566 (0.4751, 0.6739) <0.001 Race: White 0.558 (0.4715, 0.6600) <0.001 Origin: Spanish-Hispanic-Latino 1.281 (1.2147, 1.3503) <0.001 Income: $45,000-$49,999 1.314 (1.1294, 1.5278) 0.0004 Income: $50,000-$54,999 1.164 (1.0086, 1.3438) 0.04 Income: $55,000-$59,999 1.172 (1.0229, 1.3422) 0.02 Income: $70,000-$74,999 1.187 (1.0800, 1.3040) 0.0004