☆ 4.3 Article

Racial/ethnic differences in survival among gastric cancer patients in california

CANCER CAUSES & CONTROL (2019)

Journal

CANCER CAUSES & CONTROL

Volume 30, Issue 7, Pages 687-696

Publisher

SPRINGER

DOI: 10.1007/s10552-019-01184-0

Keywords

Gastric cancer; Survival; Disparities; Race; Epidemiology

Funding

California Department of Public Health [103885]
Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries [5NU58DP006344]
National Cancer Institute's Surveillance, Epidemiology and End Results Program [HHSN261201800032I, HHSN261201800015I, HHSN261201800009I]
COLCIENCIAS [110565843382 -204-2015]
University of Tolima [160114, 160120516]
University of California Davis (School of Medicine Dean's Fellowship in Precision Health Equity)
University of California Davis (Office of the Provost funding for the Latino Cancer Health Equity Initiative)
National Institute of Environmental Health Sciences [P30ES023513]
National Cancer Institute [R01CA223978, R21CA199631, U54CA233306, P30CA093373]

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Abstract

Background Gastric cancer is an important cause of death among racial/ethnic minorities in the U.S. The objective of this study was to investigate racial disparities in survival among gastric cancer patients within demographic and disease subgroups. Methods Patients diagnosed with invasive epithelial gastric cancer between 2006 and 2015 were identified from the California Cancer Registry. Cox proportional hazards regression was used to identify factors associated with survival among non-Hispanic whites (NHWs, n= 7,475), non-Hispanic blacks (NHBs, n=1,246), Hispanics (n= 6,274), and Asians/Pacific Islanders (APIs, n= 4,204). Survival was compared across race/ethnicity within subgroups of demographic and disease factors. Five-year relative survival was also calculated within subgroups. Results There were notable differences in patient characteristics by race/ethnicity, but predictors of survival were similar for each group. Overall, APIs (HR = 0.83, 95% CI: 0.79, 0.88, p < 0.0001) and Hispanics (HR = 0.94, 95% CI: 0.90, 0.99, p = 0.0104) had better survival than NHWs, but NHBs and NHWs did not have different prognosis (HR = 1.06, 95% CI: 0.98, 1.15, p = 0.2237). The survival advantage of APIs persisted in nearly every demographic and disease subgroup, but Hispanics and NHBs had similar survival as NHWs in most groups. Race was not a significant predictor of survival among those with public or no insurance and patients with cardia tumors. Conclusions There are some differences in survival by race/ethnicity, but race/ethnicity alone cannot explain disparate outcomes in gastric cancer. Future studies, particularly ones that investigate the role of population-specific etiological factors and molecular tumor profiles, are needed to further understand factors associated with survival.

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