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Significant Racial Disparities Exist in Noncardia Gastric Cancer Outcomes Among Kaiser Permanente’s Patient Population

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Abstract

Introduction

Racial and ethnic differences in gastric cancer are not well understood. This study sought to compare the clinicopathological features and survival of noncardia gastric adenocarcinoma (NCGA) patients with different racial/ethnic backgrounds in Kaiser Permanente Northern California (KPNC), a large integrated health care system.

Methods

This was a retrospective cohort study of 1,366 patients with newly diagnosed NCGA between 2000 and 2010. The subjects were categorized into four racial/ethnic groups: non-Hispanic Whites, Blacks, Asians, and Hispanics. Clinicopathological information and survival data were obtained from the KPNC electronic databases and compared among the four racial/ethnic groups.

Results

The incidence of NCGA declined in Blacks and Whites, but remained stable in Asians and Hispanics. Whites had a lower incidence of NCGA compared with non-Whites. Asians and Hispanics were diagnosed at a younger age compared with Whites (mean age at diagnosis: 66, 63, and 72 years, respectively; P < 0.0001). Diffuse/mixed histological type (Lauren classification) was more prevalent in Asians and Hispanics than in Whites and Blacks (46 and 45 vs. 36 and 29 %, respectively, P = 0.001). History of Helicobacter pylori testing was associated with better survival. Asians had the highest survival rates at 1, 2, and 5 years, while Whites had the lowest (P < 0.0001).

Conclusions

Significant racial/ethnic differences exist in patients with noncardia gastric cancer. Asians and Hispanics were younger at diagnosis and had more diffuse/mixed histological type. Asians had the highest survival, while Whites had the lowest. Such differences may be related to biological, environmental, and treatment-related factors.

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Abbreviations

NCGA:

Noncardia gastric adenocarcinoma

OR:

Odds ratio

CI:

Confidence interval

H. pylori :

Helicobacter pylori

DM:

Diabetes mellitus

CAD:

Coronary artery disease

HTN:

Hypertension

COPD:

Chronic obstructive pulmonary disease

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Conflict of interest

Mary Anne Armstrong and Debbie Postlethwaite are supported by Bayer HealthCare Pharmaceutical Inc., for an unrelated research project. Other authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gastroenterology (#248), Kaiser Permanente Northern California, 710 Lawrence Expressway, Santa Clara, CA, 95051, USA

    Marita C. Bautista & Dan Li

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Sheng-Fang Jiang, Mary Anne Armstrong & Debbie Postlethwaite

  3. Department of Pathology, Veterans Affairs Medical Center, San Francisco, CA, USA

    Sanjay Kakar

  4. University of California, San Francisco, CA, USA

    Sanjay Kakar

Authors
  1. Marita C. Bautista
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  2. Sheng-Fang Jiang
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  3. Mary Anne Armstrong
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  4. Sanjay Kakar
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  5. Debbie Postlethwaite
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  6. Dan Li
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Correspondence to Dan Li.

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Bautista, M.C., Jiang, SF., Armstrong, M.A. et al. Significant Racial Disparities Exist in Noncardia Gastric Cancer Outcomes Among Kaiser Permanente’s Patient Population. Dig Dis Sci 60, 984–995 (2015). https://doi.org/10.1007/s10620-014-3409-7

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  • DOI: https://doi.org/10.1007/s10620-014-3409-7

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