Stomach Cancer Disparity among Korean Americans by Tumor Characteristics: Comparison with Non-Hispanic Whites, Japanese Americans, South Koreans, and Japanese

Abstract

Stomach cancer incidence shows substantial racial-ethnic disparity in the United States, with Korean Americans experiencing by far the highest incidence. We examined stomach cancer incidence trends in Korean Americans by tumor subsite, histology, and stage and compared them with incidence rates in racial-ethnic groups with the second highest rate (Japanese Americans) and the lowest rate (non-Hispanic whites; NHWs) as well as populations in South Korea and Japan. We calculated age-adjusted incidence rates by racial-ethnic groups, sex, and tumor characteristics, using the 1988-2012 California Cancer Registry data. Data on South Korea and Japan were obtained from the literature and other resources. Between 1988 and 2012 in California, Korean Americans had about five times greater incidence than NHWs and twice that of Japanese Americans. Tumor characteristics differed by ethnic group and gender. The incidence in Korean Americans has declined during recent years, for both cardia and noncardia sites and for both intestinal- and diffuse-type histology. Although Korean Americans were diagnosed at an earlier stage than other Californians, the proportion with localized disease (43%) was much smaller than in South Korea (57%), where population-based screening is available. Stomach cancer incidence declined in the highest risk ethnic groups. However, the persistent disparity between Korean Americans and other racial-ethnic groups warrants additional strategies for prevention and earlier diagnosis. Analysis of California Cancer Registry data identified a racial-ethnic subgroup with stomach cancer disparity that may benefit from targeted prevention and screening efforts. .

Gastric cancer in Alaska Native people: A cancer health disparity

“…Further, AN patients were more likely to be younger at time of diagnosis, develop non-cardia gastric cancer, and have gastric cancers with signet ring cell histological features. These findings correlate to what has been observed in gastric cancer patients in developing countries and in Asian American populations[ 3 , 5 ]. However, gastric cancer patients in developing countries and in the US tend to be more often male (3:1 male to female), which was not seen represented in our patient population (1.6:1 male to female).…”

“…In recent years, gastric cancer incidence has declined in Eastern Asia and Asian patients have been shown to have better outcomes compared to other ethnic groups such as in South American, United States Hispanic, and African American patients[ 2 , 3 ]. In the United States (US), gastric cancer incidence rates are also declining in the general population[ 4 ] and recently in racial ethnic subgroups such as Asian Americans who have had a historically high prevalence of gastric cancer[ 5 ]. In contrast, gastric cancer incidence and mortality rates have remained the same among the Alaska Native (AN) population, becoming one of the leading cancer health disparities[ 6 - 8 ].…”

Increased Incidence and Mortality of Gastric Cancer in Immigrant Populations from High to Low Regions of Incidence: A Systematic Review and Meta-Analysis

“…Lee et al 60 noted that the incidence of gastric cancer in Korean Americans is similar to the incidence of colorectal cancer in the US population, a cancer routinely screened for in the United States, and is estimated to be more than 5 times higher than the incidence of NCGA among US-born whites. For this reason, some consensus recommendations advise a test and treat strategy for H pylori among immigrants from endemic countries.…”

New observations regarding Helicobacter pylori and gastric cancer in Mongolia

“…The incidence of proximal to distal gastric cancer varies geographically with the majority of cancer from East Asian countries such as Japan, Korea, and China arising from the distal part of stomach . In these regions, most H. pylori contain CagA of the East Asian type which has been suggested to be especially virulent .…”

“…5,6 The incidence of proximal to distal gastric cancer varies geographically 7 with the majority of cancer from East Asian countries such as Japan, Korea, and China arising from the distal part of stomach. 8,9 In these regions, most H. pylori contain CagA of the East Asian type which has been suggested to be especially virulent. 10,11 Globally, there has been a trend for gastric cancer to decrease in part related to the fall in H. pylori prevalence as well as changes in food preservation and year around availability of fresh fruits and vegetables.…”