Abstract
BackgroundGastric and esophageal cancers are among the most lethal human malignancies. Their epidemiology is geographically diverse. This study compares the survival of gastric and esophageal cancer patients among several ethnic groups including Chinese, South Asians, Iranians and Others in British Columbia (BC), Canada.MethodsData were obtained from the population-based BC Cancer Registry for patients diagnosed with invasive esophageal and gastric cancer between 1984 and 2006. The ethnicity of patients was estimated according to their names and categorized as Chinese, South Asian, Iranian or Other. Cox proportional hazards regression analysis was used to estimate the effect of ethnicity adjusted for patient sex and age, disease histology, tumor location, disease stage and treatment.ResultsThe survival of gastric cancer patients was significantly different among ethnic groups. Chinese patients showed better survival compared to others in univariate and multivariate analysis. The survival of esophageal cancer patients was significantly different among ethnic groups when the data was analyzed by a univariate test (p = 0.029), but not in the Cox multivariate model adjusted for other patient and prognostic factors.ConclusionsEthnicity may represent underlying genetic factors. Such factors could influence host-tumor interactions by altering the tumor's etiology and therefore its chance of spreading. Alternatively, genetic factors may determine response to treatments. Finally, ethnicity may represent non-genetic factors that affect survival. Differences in survival by ethnicity support the importance of ethnicity as a prognostic factor, and may provide clues for the future identification of genetic or lifestyle factors that underlie these observations.
Highlights
Gastric and esophageal cancers are among the most lethal human malignancies
Cancer incidence and survival data for invasive primary esophageal and gastric cancers were obtained from the population-based British Columbia (BC) Cancer Registry (BCCR) for all BC patients diagnosed between 1984 and 2006
A higher proportion of Chinese and South Asian gastric cancer patients were female as compared to the other ethnic groups
Summary
Gastric and esophageal cancers are among the most lethal human malignancies Gastric cancer is the fourth most common cancer, but the second most common cause of death from cancer [1]. Esophageal cancer is the eighth most common cancer, but the sixth most common cause of cancer death [1]. The epidemiology of these cancers is geographically diverse. The 5-year survival is usually about 20% [2]; countries with higher incidence rates of gastric cancer generally have better survival rates
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