Gastric cancer at a western tertiary referral center Travel Award

Background
The high prevalence of gastric cancer (GC) in eastern Asian countries has allowed those regions to become world experts on diagnosis and management. Data surrounding GC in the West is sparse. We aim to share the demographic and histologic data from GC cases in Vancouver, Canada.
Methods
Patients in our histological database with GC resected between 2007-2024 were included. Patients with only biopsies, or gastric cardia lesions were excluded.
Results
The cohort included 366 patients (mean age 68, 63% male). Mean lesion size was 4.3cm. Nearly half (45%) of the patients were of East Asian ethnicity. Early GC was rare (n=85, 23%), as was usage of endoscopic therapy (n=29, 7.9%).
Differentiated-type lesions made up 35% (n=127) of the cohort. These patients were older (72 vs 66, p=<0.01), more often male (74% vs 56%, p=<0.01) and with smaller lesions (3.4cm vs 4.8cm, p=<0.01). There were no differences in ethnicity (p=0.492), or HP status (p=0.51). Gastric atrophy was rarely reported (5.5%), but 76% of differentiated lesions had histological background intestinal metaplasia (76%).
Conclusions
Early GC represented only a small minority of this western cohort. These are often still receiving surgical intervention. Nearly half the cohort was of east Asian background. HP status is not well tested or documented in the west, nor are endoscopic or histologic findings of atrophic gastritis.