title: A rising trend in the incidence of advanced gastric cancer in young Hispanic men.
abstract: BACKGROUND
  Although the incidence of gastric cancer has been decreasing, recent reports suggest an increased rate in select populations. We sought to evaluate trends in gastric cancer incidence to identify high-risk populations.
  
  
  METHODS
  Gastric cancer incidence rates from 1992 to 2011 were computed with use of the Surveillance, Epidemiology, and End Results (SEER) registry. We evaluated trends in incidence rates by calculating the annual percent change (APC) across three age groups (20-49 years, 50-64 years, and 65 years or older) and four racial/ethnic groups (Hispanics, non-Hispanic whites, blacks, and Asian/Pacific Islanders).
  
  
  RESULTS
  We identified 41,428 patients with gastric cancer. For the entire cohort during the study period, the APC was decreased. When patients were grouped according to sex, the APC was flat or decreased in women regardless of age or race/ethnicity. The APC was also flat or decreased for all men except young Hispanic men (20-49 years), who had an increased APC of nearly 1.6 % (1.55 %, 95 % confidence interval 0.26-2.86 %). Furthermore, young Hispanic men were the only group to have increased incidence of stage IV disease (APC 4.34 %, 95 % confidence interval 2.76-5.94 %) and poorly differentiated tumors (APC 2.08 %, 95 % confidence interval 0.48-3.70 %).
  
  
  CONCLUSIONS
  The APC of the incidence of gastric cancer in young Hispanic men places it among the top cancers with rising incidence in the USA. This is concomitant with increased incidence of advanced disease at presentation. This major public health concern warrants additional research to determine the cause of the increasing incidence in this group.
authors.affiliation: Division of Surgical Oncology, Queen's University, Kingston, ON, Canada.
authors.forename: Shaila J
authors.initials: SJ
authors.lastname: Merchant
authors.affiliation: Division of Surgical Oncology, Stony Brook Medicine, Stony Brook, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kim
authors.affiliation: Divisions of Surgical Oncology, City of Hope, Duarte, CA, USA.
authors.forename: Audrey H
authors.initials: AH
authors.lastname: Choi
authors.affiliation: Nursing Research and Education, City of Hope, Duarte, CA, USA.
authors.forename: Virginia
authors.initials: V
authors.lastname: Sun
authors.affiliation: Medical Oncology, City of Hope, Duarte, CA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chao
authors.affiliation: Department of Biostatistics, City of Hope, 1500 East Duarte Rd, Duarte, CA, 91010, USA. rnelson@coh.org.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D018426:SEER Program; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American
keywords: Advanced disease; Gastric cancer; Hispanic; Incidence