Abstract B013: Epidemiology of early-onset gastrointestinal cancers in Nepal: A scoping review
Bibliographic record
Abstract
Abstract Introduction: The incidence of early-onset gastrointestinal cancers (EO-GICs, diagnosed <50 years) is rising globally. Low- and middle-income countries such as Nepal face distinct exposures that might influence the disease patterns in younger populations. However, systematic evidence on EO-GICs in these settings is limited. This scoping review aimed to map the available evidence on EO-GICs from Nepal and identify gaps to guide future research and early detection strategies. Methods: This scoping review adhered to the PRISMA-ScR guidelines. Eligible studies included observational studies reporting on patients younger than 50 years with gastrointestinal malignancies (esophageal, gastric, colorectal, hepatobiliary, pancreatic, or gallbladder cancers) in Nepal, while secondary data articles and case reports were excluded. Databases searched included PubMed, NepJol, and relevant grey literature. Reference lists of included articles were also screened. After duplicate removal, titles and abstracts were independently screened by two reviewers, followed by full-text review. Data were synthesized descriptively in narrative formats. Results: A total of 17 hospital-based studies from Nepal were included among 39 records. The colorectal cancer burden was increasing among young adults, with approximately 28% of cases in patients ≤40 years (mean age 31.8-34.1 years). Gastric cancer predominantly affected older adults (mean age 57-63 years), yet 10-22% were under 50. Early-onset gastric cancer cases showed a female predominance and often presented at an advanced stage. Esophageal cancer was most frequent in patients aged 61-70 years (34%); however, 20% were diagnosed before 50 years. Hepatocellular carcinoma affected mainly middle-aged to older adults (mean ages 54-67 years), with 8-26% of cases in younger individuals. Linked risk factors included male sex, viral hepatitis, alcohol use, and cirrhosis; late-stage diagnosis was common. Gallbladder and biliary tract cancers presented in middle-aged adults (mean age 53-56 years), typically presenting at advanced stages, with associated risk factors including gallstones, high parity, early menarche, Terai/Madhesi and Janajati ethnicity, alcohol and pesticide exposure, and low fruit/vegetable intake. Conclusions: Early-onset gastrointestinal cancers in Nepal constitute a significant proportion of the cancer burden, particularly for colorectal and gastric cancers, with younger patients often presenting with distinct clinical features. However, the scarcity of population-based data, national screening programs, and large cohort studies highlights critical knowledge gaps that must be addressed to inform early detection strategies, risk stratification, and targeted interventions in this population. Citation Format: Saroj GC, Bishal Paudel. Epidemiology of early-onset gastrointestinal cancers in Nepal: A scoping review [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr B013.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.022 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".