Conference Abstracts - Summit on Cancer Health Disparities (SCHD25)
Vol. 5, Issue Supplement 1, 2025 · S1-3
Racial disparities in incidence and mortality among AYA patients with stomach cancer in the US: a SEER database analysis.
Chalothorn Wannaphut, MD,Pojsakorn Danpanichkul, MD,Chanakarn Kanitthamniyom, MD,Chanokporn Puchongmart, MD,Karan Srisurapanont, MD,Patan Gultawatvichai, MD
Submission received: 2025-02-02 / Accepted: 2025-02-14 / Published: 2025-04-24
Abstract
Background
Despite a steady increase in the incidence of adolescent and young adult (AYA) stomach cancer in the US, racial disparities involving stomach cancer in this population are still understudied. We performed the Surveillance, Epidemiology, and End Results (SEER) database analysis to determine the effect of race/ethnicity and the incidence, trend, and mortality in AYA patients with stomach cancer.
Methods
AYA cases (aged 15-39) with stomach cancer diagnosed between 2000 and 2021 were retrieved through the SEER database. Age-adjusted incidence rate (AAIR), annual percent change (APC), and incidence rate ratio (IRR), survival outcome compared among the racial groups (Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Non-Hispanic Asian/Pacific Islander (NHAPI), Non-Hispanic American Indian/Alaska Native (NHAIAN), and Hispanic patients while R (v4.3.2) was used for survival analysis.
Results
In total, 37,747 cases of stomach cancer were retrieved from the SEER database, with 18,030 (47.8%) being female. NHW, NHB, NHAPI, NHAIAN, and Hispanic patients comprised 8,846 (49.1%), 2,454 (13.6%), 1,946 (10.8%), 215 (1.2%), and 4,569 (25.3%) cases, respectively. The incidence of stomach cancer increased from 4.8 per 100,000 in 2000 to 8.0 per 100,000 in 2021. From 2000 to 2010, incidence increased from 4.8 to 5.6 per 100,000, and from 2010 to 2020, it rose from 5.6 to 8.0 per 100,000. NHB and NHAIAN of both sexes had slightly increased IRR for stomach cancer compared to NHW. In contrast, Hispanic males had a decreased risk compared to NHW males. (Table 1). All AAIR of Females increased most in Hispanic (APC: 4.2%, 95% CI: 3.45–4.96), followed by white (APC: 4.03%, 95% CI: 3.58–4.48), Black (APC: 2.54%, 95% CI: 1.77–3.31), NHAIAN (APC: 2.51%, 95% CI: 0.46–1.82), and NHAPI (APC: 1.14%, 95% CI: 0.47–1.82) respectively. The AAIR of male stomach patients increased the most in White (APC: 2.51%, 95% CI: 2.17–2.85). Only the AAIR of male NHAPI patients decreases (APC: -0.92%, 95% CI: -1.17– (-0.13). In terms of mortality, all racial groups (NHB, NHAIAN, NHAPI, and Hispanic) and both sexes experienced higher mortality rates compared to NHWs, with the greatest increase observed in NHAIAN females (hazard ratio [HR]: 1.47, 95% CI: 1.20–1.81, p < 0.0001).
Conclusion
Over the past two decades, the age-adjusted incidence rates (AAIR) for stomach cancer have increased among most racial and ethnic groups, particularly Hispanic females and White males, while declining only in NHAPI males. Mortality risks were disproportionately higher across all non-White racial and ethnic groups compared to NHWs, with the highest mortality observed in NHAIAN females. These disparities highlight the urgent need for targeted preventive interventions, early detection strategies, and equitable healthcare access to mitigate racial and ethnic inequities in stomach cancer outcomes among AYA patients.