Gastroenterology. 2020 Aug 4:S0016-5085(20)35013-7. doi: 10.1053/j.gastro.2020.07.049. Online ahead of print.
BACKGROUND & AIMS: There are 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 age 50 years or older. However, 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 United States. We aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals age 50 years or older.
METHODS: We analyzed California Cancer Registry data, from 2011 through 2015, to estimate incidences of gastric adenocarcinoma in specific anatomic sites for non-Hispanic white (NHW), non-Hispanic black, Hispanic, and the 7 largest Asian American populations. We calculated the differential incidence between non-white groups and NHW using incidence rate ratios and 95% CIs.
RESULTS: Compared to NHW subjects, all non-white groups had significantly higher incidences of noncardia gastric adenocarcinoma; the incidence was highest among Korean American men >50 years old (70 cases per 100,000). Compared to NHW subjects >50 years old, the risk of noncardia gastric adenocarcinoma was 1.8-fold (95% CI, 1.37-2.31) to 7.3-fold (95% CI, 5.73-9.19) higher in most non-white groups and 12.0-fold (95% CI, 9.96-14.6) to 14.5-fold (95% CI, 12.5-16.9) higher among Korean American men and women >50 years old, respectively. Compared to NHW men >50 years old, all non-white men, except Japanese and Korean American men, had a significantly lower risk of cardia gastric adenocarcinoma.
CONCLUSIONS: We identified several-fold differences in incidences of gastric adenocarcinoma in specific anatomic sites among racial and ethnic groups, with significant age and sex differences. These findings can be used to develop targeted risk reduction programs for gastric adenocarcinoma.