ArticleEClinicalMedicine2025
Increased risk of early-onset gastric cancer among young adults age 20-49 years with diabetes: a nationwide cohort study.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Stage-Dependent Prognostic Impact of Younger Age in Gastric Cancer: A Nationwide Cohort Study.Journal of gastric cancer · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although overall gastric cancer (GC) incidence has declined, the incidence of early-onset GC (EOGC) is rising. Given the increasing prevalence of diabetes in younger populations and its link to malignancies, we investigated the association between glycemic status and EOGC risk. Methods: This nationwide cohort study followed 2,439,112 adults (aged 20-49 years) without a prior cancer diagnosis who underwent national health screening in 2012, through 2022. EOGC risk was assessed using multivariable Cox models, with restricted cubic spline and sensitivity analyses (inverse probability weighting [IPW] and exclusion of early diabetes). Findings: The incidence rate (IR) per 1000 person-years rose with worsening glycemic status: 0.23 (95% confidence interval [CI], 0.22-0.23) in individuals with normoglycemia, 0.30 (95% CI, 0.28-0.32) in individuals with impaired fasting glucose, 0.41 (95% CI, 0.34-0.48) in newly diagnosed individuals with diabetes, 0.51 (95% CI, 0.40-0.64) in individuals with diabetes <5 years, and 0.62 (95% CI, 0.48-0.80) in individuals with diabetes ≥5 years. In adjusted models, EOGC risk was higher in newly diagnosed diabetes (adjusted hazard ratio [aHR], 1.27; 95% CI, 1.07-1.52), diabetes <5 years (aHR, 1.36; 95% CI, 1.07-1.74), and diabetes ≥5 years (aHR, 1.53; 95% CI, 1.17-2.01). Results were consistent in spline, IPW, and exclusion analyses. Current smoking and both light-to-moderate and heavy alcohol consumption were associated with increased risk across all glycemic groups, with the highest risk in diabetes. Interpretation: Worsening glycemic status is associated with increased risk of EOGC in a dose-dependent manner. Optimal glycemic control, smoking cessation and reduced alcohol consumption may mitigate EOGC risk. However, residual confounding, missing data on Funding: None.
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