title: Ethnic disparities in gastric cancer incidence and survival in the USA: an updated analysis of 1992-2009 SEER data.
abstract: BACKGROUND
  Gastric cancer (GC) is the second-leading cause of cancer-related deaths worldwide, with overall 5-year survival less than 20%. However, limited data exist investigating ethnic disparities in stage-specific GC incidence and survival in the USA.
  
  
  OBJECTIVE
  To evaluate ethnicity-specific differences in GC incidence and survival in the USA.
  
  
  METHODS
  Using data from the surveillance, epidemiology, and end results 1992-2009 population-based cancer registry, we evaluated ethnic disparities in GC incidence stratified by year of diagnosis, cancer stage at presentation, and geographical distribution of disease. Ethnic disparities in survival were evaluated using Kaplan-Meier and multivariate Cox proportional hazards models.
  
  
  RESULTS
  Among men and women combined and among all cancer stages, Asians had the highest incidence of GC, more than double that among Whites (15.6 vs. 7.4 per 100,000/year, p < 0.005). In addition, Asians had the highest survival of all race groups (3-year survival: 26.6%, p < 0.001). Compared with Whites, Blacks (12.8 vs. 7.4 per 100,000/year, p < 0.005) and Hispanics (12.9 vs. 7.4 per 100,000/year, p < 0.005) also had significantly higher incidence of GC. Multivariate Cox models (adjusted for age, year of diagnosis, sex, race/ethnicity, stage of disease, and treatment received) demonstrated significantly higher survival in Asians compared with Whites (HR 0.82, 95% CI 0.80-0.85, p < 0.04).
  
  
  CONCLUSIONS
  Racial/ethnic disparities in GC incidence and survival exist in the USA Asians have the highest incidence of GC and the highest overall survival. Outlining high-risk groups may inform potential screening practices and physician awareness for GC.
authors.affiliation: Department of Internal Medicine, California Pacific Medical Center, 2351 Clay Street, Suite #360, San Francisco, CA, 94115, USA, fhlui88@gmail.com.
authors.forename: Felix H
authors.initials: FH
authors.lastname: Lui
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tuan
authors.forename: Sara L
authors.initials: SL
authors.lastname: Swenson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology