Early-Onset Gastric Cancer in Casablanca, Morocco: A 10-Year Epidemiological and Etiological Retrospective Study

Abstract

Background and Objective: Gastric cancer remains a major cause of mortality worldwide. It is frequently diagnosed in elderly individuals. However, its incidence is increasing among young patients (≤40 years). Gastric cancer in young subjects often presents particular clinical and etiological characteristics that may differ from those observed in older populations. The main risk factors include Helicobacter pylori infection, smoking, and a family history of gastric cancer. This trend has been reported in some Moroccan studies. However, no specific local study focusing on this population has been conducted, hence the relevance of our work. The objective of this study was to establish the epidemiological and etiological profile of gastric cancer in young subjects. Materials and Methods: This was a retrospective study conducted in the Hepato-Gastroenterology Department over a 10-year period, between September 2015 and August 2025. All patients aged 16 to 40 years hospitalized for histologically confirmed primary gastric cancer were included. Data, included demographic characteristics, risk factors, clinical presentation, diagnostic delay, histopathological findings, and disease stage at diagnosis, were collected from medical records, entered, and analyzed using Jamovi software. Results: During the study period, a total of 131 hospitalized cases of gastric cancer, 9 cases (6.8%) involved patients aged ≤40 years, representing an annual average of 0.9 cases. The mean age was 33.5 years (range: 20–40 years), with a predominance in the 36–40 age group (55.6%). A female predominance was noted (56%) with a female-to-male ratio of 1.2. The mean diagnostic delay was 6.7 months (range: 1–24 months). The predominant symptoms were epigastric pain (89%), anemia (78%), general deterioration of health status (56%), and upper gastrointestinal bleeding (44%). Risk factors were identified in 78% of cases. Helicobacter pylori infection and smoking were the two main risk factors, identified in 56% and 33% of cases, respectively. Adenocarcinoma accounted for 89% of cases. The majority of patients (67%) had metastatic disease at diagnosis. The prognosis was poor. Conclusion: Gastric cancer in young patients is a real and significant entity, with a predominance of adenocarcinoma. The identified risk factors justify targeted screening and preventive measures.