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An Investigation into the Recent Increase in Gastric Cancer in the USA

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Abstract

Background

The USA has among the lowest gastric cancer incidence rates worldwide.

Aim

To investigate whether increasing immigration from high cancer incidence countries has altered the GC incidence in a large US metropolitan area.

Methods

This was a retrospective cohort study among an underprivileged, multiethnic population in Texas. Gastric cancer cases diagnosed during 2005–2015 were identified using the cancer registry of the public medical care system for Harris County. All cases were histologically confirmed; demographic and clinical data were obtained from review of electronic medical records. Census data were used to determine the distribution of the adult county population by race/ethnicity and age. Two time periods (2005–2009 and 2010–2015) were studied to correspond with census reporting intervals.

Results

In total, 299 cases were included: average age 55 years, 59% males and 63% Hispanics (predominantly recent immigrants of Central-American origin). The gastric cancer incidence remained stable among non-Hispanic Whites and Blacks but increased significantly among Hispanics (from 10 to 17 cases/100,000 persons/year, RR = 2.0, 95% CI 1.4–2.5, p = 0.001). Among Hispanics, gastric cancer incidence rose significantly among persons aged 40–59 years and ≥ 60 years and was likely to be at advanced stage at the time of diagnosis even in the younger age population.

Conclusion

Gastric cancer incidence significantly increased among Hispanics residing in Houston resulting in changes in gastric cancer incidence becoming more unevenly experienced across the US population. Consideration should be given to gastric cancer preventive efforts, especially among immigrant populations from high gastric cancer risk countries.

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Acknowledgments

Dr. Graham is supported in part by the Office of Research and Development Medical Research Service Department of Veterans Affairs, Public Health Service Grant DK56338 which funds the Texas Medical Center Digestive Diseases Center. Dr. Balakrishnan is supported in part by a prevention Grant from the Cancer Prevention and Research Institute of Texas–CPRIT (PP160089).

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Authors and Affiliations

  1. Section of Gastroenterology and Hepatology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    Maya Balakrishnan, Rollin George, Ashish Sharma, David Y. Graham & Hoda M. Malaty

  2. Michael E DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA

    David Y. Graham

Authors
  1. Maya Balakrishnan
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  2. Rollin George
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  3. Ashish Sharma
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  4. David Y. Graham
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  5. Hoda M. Malaty
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Contributions

MB contributed to study conception, interpretation of results, manuscript writing and editing. RG contributed to data collection; AS contributed to data collection; DYG contributed to interpretation of results and manuscript editing; HM contributed to data analysis, interpretation, and manuscript editing. All authors approved the final draft submitted.

Corresponding author

Correspondence to Maya Balakrishnan.

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Conflict of interest

Dr. Graham is a consultant for RedHill Biopharma regarding novel H. pylori therapies and has received research support for culture of Helicobacter pylori and is the PI of an international study of the use of antimycobacterial therapy for Crohn’s disease. He is also a consultant for BioGaia in relation to probiotic therapy for H. pylori infection and for Takeda in relation to H. pylori therapies. The other authors have nothing to disclose.

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Balakrishnan, M., George, R., Sharma, A. et al. An Investigation into the Recent Increase in Gastric Cancer in the USA. Dig Dis Sci 63, 1613–1619 (2018). https://doi.org/10.1007/s10620-018-5012-9

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  • DOI: https://doi.org/10.1007/s10620-018-5012-9

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