title: Gastric adenocarcinoma among Hmong in California, USA, 1988-2000.
abstract: BACKGROUND
  This study examined gastric adenocarcinoma incidence, mortality, and tumor characteristics in the Hmong population of California, 1988-2000. Many Hmong relocated to the United States at the conclusion of the Vietnam War. Resettlement difficulties encountered by Hmong have included socioeconomic and healthcare issues. Hmong are wary of Western medicine and would resort to it as the last option, which may delay the diagnosis and treatment of diseases such as cancer.
  
  
  METHODS
  Data from the California Cancer Registry were used to calculate incidence and mortality rates for Hmong, and were compared to these in Asian Pacific Islanders (API) and non-Hispanic whites (NHW). The population at risk was estimated through linear interpolation, using data from the 1990 and 2000 decennial censuses.
  
  
  RESULTS
  Hmong experienced incidence and mortality rates of gastric adenocarcinoma several times higher than those of API and NHW. More than 97% of Hmong patients chose no treatment, compared to only 25.6% of API and 30.3% of NHW patients. Hmong were more likely to be diagnosed with cancer at later stages but at better histologic grades than API and NHW.
  
  
  CONCLUSIONS
  Further investigations into Helicobacter pylori, Epstein-Barr virus, acid reflux, and dietary practices of Hmong living in the United States are needed before any firm conclusion can be made, as these risk factors may impact gastric cancer development. Hmong should also be encouraged to use traditional and Western medicines simultaneously, provided that traditional healthcare practices do not interfere with biomedicines.
authors.affiliation: Public Health Institute, Cancer Registry of Central California, 1320 E. Shaw Ave., Suite 160, Fresno, CA 93710, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Yang
authors.forename: Paul K
authors.initials: PK
authors.lastname: Mills
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Riordan
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology*; D000328:Adult; D001210:Asia, Southeastern / Q000208:ethnology; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000208:ethnology*