Gastroesophageal malignancies are associated with poorer outcomes in young patients seen in California comprehensive Cancer Centers

Abstract While the overall incidence of adenocarcinomas of the stomach and esophagus (GEA) has been declining in the United States, there has been an increase in cases among those under 50. Clinical and demographic data on GEA in young patients, especially in the United States, is limited. A retrospective cohort study was performed using the TrinetX database to investigate the association between patient demographics, geography, and clinical outcomes in patients with GEA between academic centers in California and a national, multi-institutional cohort. Young patients in both cohorts were more likely to be female, Hispanic, and have metastatic disease at the time of diagnosis. In California, young patients with GEA had significantly worse overall survival compared to older patients (HR 0.69, p = 0.002) whereas nationally, young patients did significantly better than old patients (HR 1.4, p < 0.0001). These disparate survival outcomes among the young UC cohort raises significant concerns and warrants further investigation.