Skip to main content

Ethnic Disparities in Gastric Cancer Incidence and Survival in the USA: An Updated Analysis of 1992–2009 SEER Data

Digestive Diseases and Sciences volume 59, pages 3027–3034 (2014)Cite this article

Abstract

Background

Gastric cancer (GC) is the second-leading cause of cancer-related deaths worldwide, with overall 5-year survival less than 20 %. However, limited data exist investigating ethnic disparities in stage-specific GC incidence and survival in the USA.

Aim

To evaluate ethnicity-specific differences in GC incidence and survival in the USA.

Methods

Using data from the surveillance, epidemiology, and end results 1992–2009 population-based cancer registry, we evaluated ethnic disparities in GC incidence stratified by year of diagnosis, cancer stage at presentation, and geographical distribution of disease. Ethnic disparities in survival were evaluated using Kaplan–Meier and multivariate Cox proportional hazards models.

Results

Among men and women combined and among all cancer stages, Asians had the highest incidence of GC, more than double that among Whites (15.6 vs. 7.4 per 100,000/year, p < 0.005). In addition, Asians had the highest survival of all race groups (3-year survival: 26.6 %, p < 0.001). Compared with Whites, Blacks (12.8 vs. 7.4 per 100,000/year, p < 0.005) and Hispanics (12.9 vs. 7.4 per 100,000/year, p < 0.005) also had significantly higher incidence of GC. Multivariate Cox models (adjusted for age, year of diagnosis, sex, race/ethnicity, stage of disease, and treatment received) demonstrated significantly higher survival in Asians compared with Whites (HR 0.82, 95 % CI 0.80–0.85, p < 0.04).

Conclusions

Racial/ethnic disparities in GC incidence and survival exist in the USA Asians have the highest incidence of GC and the highest overall survival. Outlining high-risk groups may inform potential screening practices and physician awareness for GC.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11.

  2. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.

    CAS  PubMed  Article  Google Scholar 

  3. De Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors. Gastroenterol Clin N Am. 2013;42:219–240.

    Article  Google Scholar 

  4. El-Serag HB, Mason AC, Petersen N, et al. Epidemiological differences between adenocarcinoma of the esophagus and adenocarcinoma of the gastric cardia in the USA. Gut. 2002;50:368–372.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  5. Abrams JA, Gonsalves L, Neugut A. Diverging trends in the incidence of reflux-related and Helicobacter pylori-related gastric cardia cancer. J Clin Gastroent. 2013;47:322–327.

    PubMed Central  PubMed  Article  Google Scholar 

  6. Devessa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–2053.

    Article  Google Scholar 

  7. Andeson WF, Camargo MC, Fraumeni JF Jr, et al. Age-specific trends in incidence of noncardia gastric cancer in US adults. JAMA. 2010;303:1723.

    Article  Google Scholar 

  8. Ries LAG, Melbert D, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2004. Bethesda, MD: National Cancer Institute; 2007.

    Google Scholar 

  9. Surveillance, Epidemiology, and End Results (SEER) Program Pubic Use CD-ROM (1973-2009). National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch.

  10. Zhu AL, Sonnenberg A. Is gastric cancer again rising? J Clin Gastroenterol. 2012;46:804.

    PubMed  Article  Google Scholar 

  11. Correa P. Gastric cancer: two epidemics? Dig Dis Sci. 2011;56:1585.

    PubMed  Article  Google Scholar 

  12. Parkin DM, Bray F, Ferlay J, Pisani P. Global CA statistics, 2002. CA Cancer J Clin. 2005;55:74–108.

    PubMed  Article  Google Scholar 

  13. Kim J, Sun CL, Mailey B, Prendergast C, et al. Race and ethnicity correlate with survival in patients with gastric cancer. Ann Oncol. 2010;21:152–160.

    CAS  PubMed  Article  Google Scholar 

  14. Stressin AM, Sherr DL. Demographic disparities in patterns of care and survival outcomes for patients with resected gastric adenocarcinoma. Cancer Epidemiol Biomark Prev. 2011;20:223–233.

    Article  Google Scholar 

  15. Adachi Y, Kitano S, Sugimachi K. Surgery for gastric cancer: 10-year experience worldwide. Gastric Cancer. 2001;4:166–174.

    CAS  PubMed  Article  Google Scholar 

  16. Pacelli F, Papa V, Caprino P, et al. Proximal compared with distal gastric cancer: multivariate analysis of prognostic factors. Am Surg. 2001;67:697–703.

    CAS  PubMed  Google Scholar 

  17. Gill S, Shah A, Le N, et al. Asian ethnicity-related differences in gastric cancer presentation and outcome among patients treated at a Canadian cancer center. J Clin Oncol. 2003;21:2070–2076.

    PubMed  Article  Google Scholar 

  18. Theuer CP, Kurosaki T, Ziogas A, et al. Asian patients with gastric carcinoma in the United States exhibit unique clinic features and superior overall and cancer specific survival rates. Cancer. 2000;89:1883–1892.

    CAS  PubMed  Article  Google Scholar 

  19. Theuer CP. Asian gastric cancer patients at a southern California comprehensive cancer center are diagnosed with less advanced disease and have superior stage-stratified survival. Am Surg. 2000;66:821–826.

    CAS  PubMed  Google Scholar 

  20. Lee JH, Ryu KW, Park SR. Learning curve for total gastrectomy with D2 lymph node dissection: cumulative sum analysis for qualified surgery. Ann Surg Oncol. 2006;13:1175–1181.

    PubMed  Article  Google Scholar 

  21. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–730.

    CAS  PubMed  Article  Google Scholar 

  22. Al-Rafaie WB, Tseng JF, Gay G, et al. The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Database. Cancer. 2008;113:461–469.

    Article  Google Scholar 

  23. Walker AR, Walker BF, Funani S, Segal I. Survival of black patients with gastric cancer in Soweto, Johannesburg, South Africa. Trop Gastroenterol. 1989;10:102–105.

    CAS  PubMed  Google Scholar 

  24. Jinjuvadia R, Jinjuvadia K, Liangpunsakul S. Racial disparities in gastrointestinal cancers-related mortality in the US population. Dig Dis Sci. 2013;58:236–243.

    PubMed Central  PubMed  Article  Google Scholar 

  25. Lhemelandu CU, DeWitty RL Jr, Leffall LD Jr, et al. Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution’s experience. J Surg Res. 2009;156:325–332.

    Article  Google Scholar 

  26. Brown R, Ponce NA, Rice T. The State of Health Insurance in California: Recent Trends, Future Prospects. Los Angeles, CA: UCLA Center for Health Policy Research; 2001.

    Google Scholar 

  27. Wu X, Chen VW, Andrews PA, Ruiz B, Correa P. Incidence of esophageal and gastric cancers among Hispanics, non-Hispanic whites and non-Hispanic blacks in the United States: subsite and histology differences. Cancer Causes Control. 2007;18:585–593.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

No funding was provided for this study.

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose as described by Digestive Diseases and Sciences.

Author information

Affiliations

  1. Department of Internal Medicine, California Pacific Medical Center, 2351 Clay Street, Suite #360, San Francisco, CA, 94115, USA

    Felix H. Lui & Sara L. Swenson

  2. Department of Hematology/Oncology, California Pacific Medical Center, 2351 Clay Street, Suite 360, San Francisco, CA, 94115, USA

    Bertrand Tuan

  3. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, Alway Building Room M-211, Stanford, CA, 94305, USA

    Robert J. Wong

Authors
  1. Felix H. Lui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bertrand Tuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sara L. Swenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert J. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felix H. Lui.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lui, F.H., Tuan, B., Swenson, S.L. et al. Ethnic Disparities in Gastric Cancer Incidence and Survival in the USA: An Updated Analysis of 1992–2009 SEER Data. Dig Dis Sci 59, 3027–3034 (2014). https://doi.org/10.1007/s10620-014-3275-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-014-3275-3

Keywords

  • Gastric adenocarcinoma
  • Racial disparities
  • Outcomes
  • Epidemiology