A Longitudinal Study of Premalignant Gastric Lesions and Early Onset Gastric Cancer Among Young Adults in Central Saudi Arabia

Sep 23, 2026

Observational longitudinal research evaluated premalignant gastric lesions (PGLs) and early onset gastric cancer (EOGC) in young Saudi adults, a population historically considered lower risk yet underrepresented in gastric cancer studies. Using a prospective cohort design from 2021–2024 (1823 participants aged 18–45) and zoom high-definition chromoendoscopy, investigators quantified prevalence and associated factors. Results showed high Helicobacter pylori infection (78.0%), PGLs in 1.9% of participants, and EOGC-adenocarcinoma in 0.7%, with EOGC arising from dysplasia and PGLs largely at OLGA/OLGIM stage II/III. Significant associations included H. pylori, older age within the cohort, family history, poor diet, obesity, and smoking, plus age 36–45, EBV infection, and diabetes mellitus. Findings support earlier detection and targeted prevention strategies and further region-specific risk research.

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Article A Longitudinal Study of Premalignant Gastric Lesions and Early Onset Gastric Cancer Among Young Adults in Central Saudi Arabia Ahmed Albadrani 1,2, Georgios Zacharakis 1, *, Mohammed Saad Alqahtani 3, Abdulrahman AlHarbi 1, Abdulaziz Alkudam 1, Abdullah Bawazir 1,4, Naif Albulayhid 1, Majed Zaki Bahader 2, Ahmed Mohammed Alghayyamah 2 and Zahraa Saeed Alzaher 2 Received: 12 June 2025 Revised: 21 July 2025 Accepted: 29 July 2025 Published: 30 July 2025 Citation: Albadrani, A.; Zacharakis, G.; Alqahtani, M.S.; AlHarbi, A.; Alkudam, A.; Bawazir, A.; Albulayhid, N.; Bahader, M.Z.; Alghayyamah, A.M.; Alzaher, Z.S. A Longitudinal Study of Premalignant Gastric Lesions and Early Onset Gastric Cancer Among Young Adults in Central Saudi Arabia. Curr. Oncol. 2025, 32, 428. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)curroncol32080428 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University Hospital, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia; [a.albadrani@psau.edu.sa](a.albadrani@psau.edu.sa) (A.A.); [abdulrahmanha03@gmail.com](abdulrahmanha03@gmail.com) (A.A.); [al.kadam@hotmail.com](al.kadam@hotmail.com) (A.A.); [abawazir@kfmc.med.sa](abawazir@kfmc.med.sa) (A.B.); [nalbulayhid@gmail.com](nalbulayhid@gmail.com) (N.A.) 2 Endoscopy Unit, Department of Internal Medicine, Arryan Hospital, Dr. Sulaiman Al Habib Ar Rayyan Hospital, Riyadh 14212, Saudi Arabia; majed.bahader@hmg.local (M.Z.B.); [amalghayyamah@kaauh.edu.sa](amalghayyamah@kaauh.edu.sa) (A.M.A.); zahraa.alzaher@hmg.local (Z.S.A.) 3 Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj 11942, Saudi Arabia; [ms.alqahtani@psau.edu.sa](ms.alqahtani@psau.edu.sa) 4 Department of Internal Medicine, King Fahad Medical City, Riyadh 12231, Saudi Arabia * Correspondence: [g.zacharakis@psau.edu.sa or gzacharakis@yahoo.gr](g.zacharakis@psau.edu.sa or gzacharakis@yahoo.gr) Simple Summary We aimed to shed light on the prevalence and risk factors of early-onset gastric cancer (EOGC) and premalignant gastric lesions (PGLs) among young Saudi adults, a group traditionally considered to be at lower risk and underrepresented in gastric cancer research. By conducting a large-scale, prospective cohort study using zoom high-definition chromoendoscopy, the authors provided valuable epidemiological data that challenged existing age-related assumptions about gastric cancer. Their findings highlight the significant role of Helicobacter pylori, lifestyle factors, and comorbidities such as diabetes in EOGC development. This research may significantly impact medical and research communities by prompting earlier screening guidelines, informing targeted prevention strategies, and encouraging further investigation into region-specific risk factors. Abstract Gastric cancer traditionally affects older adults, and its precursor lesions and risk factors are well-documented in this population. Helicobacter pylori (H. pylori) infection remains highly prevalent in Saudi Arabia and contributes to gastric pathology. However, earlyonset gastric cancer (EOGC), diagnosed in individuals aged ≤ 45 years, presents unique challenges and remains poorly understood in young populations. Therefore, we conducted an observational cohort study using a prospective longitudinal design (2021–2024) involving 1823 Saudi nationals aged 18–45 years who underwent zoom high-definition chromoendoscopy to evaluate the prevalence of premalignant gastric lesions (PGLs) and EOGC. We found a high H. p

FAQs

What was the study population and study design used to assess PGLs and EOGC?

The study used an observational prospective longitudinal cohort design from 2021–2024 involving 1823 Saudi nationals aged 18–45 years.

How were premalignant gastric lesions and early onset gastric cancer evaluated?

Participants underwent zoom high-definition chromoendoscopy to assess the prevalence of premalignant gastric lesions and EOGC.

Which factors were significantly associated with premalignant gastric lesions and early onset gastric cancer?

Significant associations included Helicobacter pylori infection, increasing age, family history of gastric cancer, poor dietary habits, obesity, and smoking. Additional EOGC risk factors included age 36–45 years, EBV infection, and diabetes mellitus.

Sep 23, 2026

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