To evaluate the racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the United States, based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. A lack of precise contemporary information on gastric adenocarcinoma incidence in specific anatomic sites for this age group has impeded prevention and early detection programs in the U.S.
To estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older, the California Cancer Registry data from 2011 through 2015 was evaluated to estimate incidences of gastric adenoma in specific anatomic sites for non-Hispanic White (NHW), non-Hispanic black, Hispanic and the seventh largest Asian-American populations. Calculation was carried out as to the differential incidence between non-White groups and NHW, using incidence rate ratios and 95% confidence intervals (CIs).
Compared with NHW subjects, all non-White groups had significantly higher incidences of noncardiac gastric adenocarcinoma. The incidence was highest among Korean-American men 50 years and older (70 cases per 100,000). Compared with NHW subjects 50 years and older, the risk of noncardiac gastric adenocarcinoma was 1.8-fold to 7.3-fold, higher in most non-White groups and 12- fold to 14.5-fold higher among Korean-American men and women 50 years and older, respectively.
Compared with NHW men 50 years and older, all non-White men, except Japanese and KoreanAmerican men had a significantly lower risk of cardia gastric adenocarcinoma.
There was identification of several-fold differences in evidence of gastric adenocarcinoma in specific anatomic sites among racial and ethnic groups, with significant age and sex differences. These findings should be used to develop targeted risk reduction programs for gastric adenocarcinoma.
Shah, S., McKinley, M., Gupta, S., et al. “Population-Based Analysis of Differences in Gastric Cancer Incidence Among Races and Ethnicities in Individuals Aged 50 Years and Older.” Gastroenterology 2020; Vol. 159, pp. 1705-1714.