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

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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.

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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.

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Authors and 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
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  2. Bertrand Tuan
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  3. Sara L. Swenson
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Correspondence to Felix H. Lui.

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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

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

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