Young age, disparities, and survival in gastric adenocarcinoma: Implications for screening strategies.

17Background: Recent foreign publications have demonstrated increasing frequencies of gastric cancer in younger patients with differing biology and outcomes. This study will be the largest of gastric adenocarcinoma (GA) in young adults and aims to examine disparities and the impact of age on overall survival (OS). Methods: All patients diagnosed with primary GA from 2004-2013 in the National Cancer Data Base (NCDB) were reviewed for patient demographics, tumor characteristics, and treatment. Patients were grouped by age (AYA < 40, adult ≥ 40) and appropriate statistical analyses performed. Results: Of 49,278 patients, 1517 (3%) were < 40 years old. Compared to older adults, AYAs were more commonly female, represented an ethnic minority, and had more markers of socioeconomic disadvantage (SES) (all p < 0.001). They presented with higher grade tumors, higher tumor and nodal staging, and more metastatic disease at diagnosis (all p < 0.001). AYAs also more commonly received adjuvant radiation and/or chemother...