Racial and ethnic disparities in gastric cancer trends: A retrospective analysis of tumor location and incidence patterns (2009–2022).

Abstract

e16127 Background: Gastric cancer is a globally prevalent malignancy, particularly in Eastern Asia, Eastern Europe, and South America, with lower incidence rates in North America and parts of Africa. In the United States, over 26,000 individuals are diagnosed annually, often at advanced stages, contributing to a nearly 50% mortality rate. Gastric cancer affects various regions of the stomach, with significant variations in incidence and outcomes by race and ethnicity. Understanding these patterns is critical for developing targeted prevention and treatment strategies. This study aims to analyze trends in gastric cancer incidence by tumor location and racial/ethnic subgroups within the U.S. from 2009 to 2022. Methods: We conducted a retrospective analysis of 378 patients diagnosed with gastric cancer at our institution between 2009 and 2022. Comprehensive clinical and demographic data were collected, including tumor location, cancer grade, comorbidities, insurance status, surgical interventions, colonoscopy findings, and baseline characteristics. Tumor locations were categorized as Cardia, Non-Cardia, or unspecified. Annual percent change in incidence (APCC) was calculated to assess temporal trends, while chi-square and multivariate analyses were used to evaluate disparities in incidence by race and ethnicity. Results: Of the 378 patients, 46.2% were female. Tumor locations included Cardia (36.5%), Non-Cardia (39.1%), and unspecified (25%). African Americans exhibited a higher incidence of Non-Cardia adenocarcinoma (p = 0.012). Whites demonstrated higher rates of Cardia adenocarcinoma (p < 0.01) and a notable rise in Non-Cardia incidence from 2015–2022. Asians showed higher Cardia incidence (p = 0.045) but a decline in Non-Cardia incidence during the same period (APCC = -2.4). Overall, the annual gastric cancer incidence remained stable from 2009–2022 (APCC = 0.1). Conclusions: Our study highlights significant racial and ethnic disparities in gastric cancer incidence patterns by tumor location. African Americans had a higher prevalence of Non-Cardia adenocarcinoma, while Whites and Asians demonstrated divergent trends in Cardia and Non-Cardia incidence. These findings underscore the need for tailored prevention, early detection, and intervention strategies to address disparities and improve gastric cancer outcomes in diverse populations. Future research should focus on the socioeconomic and biological factors driving these disparities.