Racial and ethnic differences in gastric cancer by stage of diagnosis in the United States (2009-2019).

Despite the United States having a low overall gastric cancer (GC) incidence rate, there remain disparities by race/ethnicity. We examined the incidence of GC by stage at diagnosis among Hispanic, Asian/Pacific Islander (A/PI), American Indian/Alaska Native (AI/AN), and non-Hispanic Black (NHB) populations, compared to non-Hispanic White (NHW) population, during 2009-2019.Using Surveillance, Epidemiology, and End Results data, age-adjusted GC incidence rates, rate ratios (RRs) and 95% confidence intervals (CIs) were calculated by stage and race/ethnicity. Stratified analyses were performed by sex, age and anatomical site.Compared to NHW individuals, incidence rates of regional and distant stage GC diagnosis were nearly two times higher in Hispanic (RRRegional, 1.87; 95% CI, 1.78-1.97; RRDistant, 1.92; 95% CI, 1.84-2.00), A/PI (RRregional, 2.17; 95% CI, 2.04-2.30; RRDistant, 1.58; 95% CI, 1.49-1.68), and NHB (RRregional, 1.78; 95% CI, 1.67-1.88; RRDistant, 1.80; 95% CI, 1.71-1.89) individuals. In stratified analyses, the increased rate of advanced-stage diagnosis for Hispanic, A/PI, and NHB individuals remained generally consistent by sex and age, although young AI/AN individuals also had a significantly higher rate of distant GC (RR, 2.38; 95% CI, 1.36-3.83). By site, the increased rates of advanced-stage diagnosis were limited to non-cardia and overlapping/unspecified GC, whereas these populations had lower rates of cardia GC than NHW individuals.Hispanic, A/PI, and NHB individuals have disproportionately high advanced-stage non-cardia GC rates compared to NHW individuals.This study has identified significant disparities in advanced-stage non-cardia GC, suggesting the need to identify strategies to improve early detection in these populations.

Duke Scholars

Author Meira Epplein Population Health Sciences