Abstract B48: Gastric cancer presentation and survival among California Asians

Abstract

Abstract Gastric cancer (GC) is the 4th cause of cancer death worldwide. In the US, GC results in more than 10,000 cancer related deaths annually. Furthermore, it is associated with significant morbidity in the affected individuals. The disease has a high incidence in Asian and Hispanic population. In the US, California has the highest number of GC cases per year, possibly due to high number of Asian and Hispanic population. We designed a study to explore the disparities in the presentation and outcome of GC in the Asian population. Using data from the California Cancer Registry (CCR), we investigated the GC incidence and survival rates among Asians in California from 2000-2010. We explored the significance of demographics in the anatomic presentation of gastric cancer and survival in the Asian population compared to non-Hispanic Whites (NHW). We identified 18,377 GC cases (inclusive of NHW and Asians) in this time period. In this population 70% were NHW, 8% Chinese, 7% Korean and 5% Japanese, the rest included Filipino, Vietnamese and other Asian sub-groups. Koreans have the highest age adjusted incidence rate of GC compared to NHW and all other Asian groups. Moreover, the frequencies of stomach cancer by anatomical subsites were statistically significantly different between Asians and NWH for both males and females (p<0.001). Compared to NHW, Asians had lower frequency of proximal (cardia and fundus) stomach cancer (44% in NHW and 14% in Asians). The difference was more dramatic in Korean population than other groups (only 7% had proximal cancers). Despite higher incidence, Koreans have better survival than NHW when adjusted for age, gender, SES, nativity, stage, anatomical subsite, and type of treatment received. Prognostic factors for death from gastric cancer included age > 65 and immigration status, with immigrants doing better than US born. The differences in the anatomical distribution of GC and outcome in the Asian population may be due to differences in etiologic factors that deserve further exploration. In Japan and Korea, early detection had resulted in a dramatic decline in mortality and morbidity. Although overall low incidence of the disease in US is prohibitive for a generalized screening program, there are subpopulations that may benefit from screening. Given that early detection has proven to be effective and cost saving in Asian countries with high incidence of gastric cancer consideration of screening for this population is intriguing and should be explored. Citation Format: Afsaneh Barzi, Mariana Stern, Juanjuan Zhang, Dennis Deapen, Lihua Liu. Gastric cancer presentation and survival among California Asians. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B48. doi:10.1158/1538-7755.DISP13-B48