title: Effects of sex and racial/ethnic group on the pattern of gastric cancer localization.
abstract: BACKGROUND
  In Western countries, the overall incidence of gastric cancer is declining, while the incidence of proximal gastric cancer is rising. We evaluated the effect of sex, racial/ethnic group, and age on the localization of gastric cancer.
  
  
  METHODS
  The records of all gastric cancer patients who registered at The University of Texas M. D. Anderson Cancer Center from January 1, 1985, to May 31, 1998, were reviewed. Tissue diagnosis and established tumor location were required.
  
  
  RESULTS
  The case records of 1242 eligible patients, consisting of 821 non-Hispanic white, 230 Hispanic, 125 African American, 63 Asian, and 3 Native American patients, were analyzed. Among the 459 women, racial/ethnic group did not have a significant impact on gastric cancer localization (P = 0.57). However, among the 783 men, proximal cancers were significantly more frequent in the non-Hispanic white patients (57% vs 38% Hispanic, 41% African American, 17% Asian; P < 0.0001). Symptoms at diagnosis significantly varied for proximal vs non-proximal cancers.
  
  
  CONCLUSIONS
  Proximal gastric cancer localization was more frequent among non-Hispanic white men, while non-Hispanic white women had a localization pattern similar to those of other racial/ethnic groups. Proximal gastric cancer represents a distinct subtype of gastric cancer that may have different biology, risk factors, and clinical behavior.
authors.affiliation: Department of Gastrointestinal Medical Oncology, Unit 426, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Yao
authors.forename: Isac I
authors.initials: II
authors.lastname: Schnirer
authors.forename: Satish
authors.initials: S
authors.lastname: Reddy
authors.forename: Silvia
authors.initials: S
authors.lastname: Chiang
authors.forename: Azmeena
authors.initials: A
authors.lastname: Najam
authors.forename: Christina
authors.initials: C
authors.lastname: Yu
authors.forename: Geoff
authors.initials: G
authors.lastname: Giacco
authors.forename: Keneth
authors.initials: K
authors.lastname: Hess
authors.forename: Asif
authors.initials: A
authors.lastname: Rashid
authors.forename: Keping
authors.initials: K
authors.lastname: Xie
authors.forename: Patrick
authors.initials: P
authors.lastname: Lynch
authors.forename: Jaffer A
authors.initials: JA
authors.lastname: Ajani
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology* / Q000473:pathology; D000328:Adult; D001741:Black or African American; D000368:Aged; D001213:Asian; D016009:Chi-Square Distribution; D006630:Hispanic or Latino; D006801:Humans; D007198:Indians, North American; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000208:ethnology* / Q000473:pathology; D014481:United States / Q000453:epidemiology; D044465:White People