Gastric carcinoma among younger individuals in Mississippi

During a time when gastric cancer in the United States appears to be decreasing in incidence and occurring primarily in older individuals, a 12-year review of our experience (1977 to 1989) has identified a disproportionate number of gastric cancers in the young black population. In this series of 97 patients with gastric adenocarcinoma, the mean age at diagnosis was 58 years (range, 22 to 84 years). There were 54 men (56%) and 43 women; 78 (80%) were black, 17 (18%) were white, one was American Indian, and one was Mexican. Fifty-two patients (54%) had stage IV disease at the time of presentation. Fifty-two patients (54%) were less than 60 years old at diagnosis; 45 (86%) of these were black men. We do not know the reason for this unusual age distribution, but a combination of environmental factors or an unusually susceptible population may be involved. Identification of a gastric ulcer in this cohort warrants careful follow-up and appropriate treatment.