Shailja Shah, MD, MPH. at Vanderbilt Ingram Cancer Center discusses a Study which gauges specific site gastric cancer risks among ethnic groups
Compared to non-Hispanic white Americans, non-white Americans, especially Asian Americans, are at a disproportionately higher risk for gastric cancer. According to specific ethnicities and locations within the stomach, a new study breaks down this risk.
The California Cancer Registry data for the seven largest Asian American populations (Chinese, Japanese , Korean, Filipino, Vietnamese, South Asian and Southeast Asian) as well as for non-Hispanic whites, non-Hispanic blacks and Hispanic populations were analyzed in the study published Aug. 6 in Gastroenterology.
The population-based analysis found that compared to the non-Hispanic white population, non-white race and ethnic groups had a few times higher risk of developing stomach cancer in the main region of the stomach (noncardia gastric cancer). This risk was most striking among Korean Americans aged 50 and older who displayed a 12-fold to 14.5-fold greater risk compared to non-Hispanic whites. This is the most prominent area to grow stomach cancer. However, Asian Americans – except for Japanese American men – had a lower risk of developing gastric cancer in the upper portion of the stomach where it meets the esophagus (cardia gastric cancer) than non-Hispanic whites.
The study sets the stage in the United States for the implementation of tailored risk reduction strategies for gastric cancer. Shah and colleagues have recently published two studies showing that screening of gastric cancer in non-white race and ethnic groups beginning at age 50 is cost-effective. Shah was also one of the leading members of the Scientific Review committee of the American Gastroenterology Association on gastric intestinal metaplasia (gastric precancer) surveillance for early detection of gastric cancer. Shah’s study is aimed at establishing a solid base of evidence to create gastric cancer screening recommendations in the United States, where the number of people at risk of cancer rises as the population of the nation grows more diverse.
The fifth most common cancer and the third leading cause of cancer-related death is gastric cancer worldwide. Gastric cancer ranks 15th among cancers in the United States, but it disproportionately afflicts population groups.
The Gastroenterology research showed that the incidence rate for gastric cancer in the main region of the stomach was 49 cases per 100,000 individuals for Korean Americans, 23.9 for Vietnamese Americans, 21.1 for Southeast Asian Americans (Cambodian, Laotian, Hmong and Thai), 19.2 for Japanese Americans, 17.6 for Chinese Americans, 14.0 for Hispanic Americans, 11.2 for non-Hispanic black Americans, 7.2 for Japanese Americans, 17.6 for Chinese Americans, 11.2 for non-Hispanic black Americans, 7.
As compared to women, men had substantially higher rates of gastric cancer. For example, for Korean American men, the incidence of gastric cancer in the main region of the stomach was 70.0 per 100,000, compared to 33.5 for Korean American women.