C0689 - Anatomic Distribution of Gastric Adenocarcinoma Varies Among Patients of Different Gender, Ethnicity, and Race in the U.S.

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

AC

Andrew Chen, BS

SUNY Stony Brook
Jericho, NY

Andrew Chen, BS¹, Qi Yu, MD²
¹SUNY Stony Brook, Jericho, NY; ²NYC Health + Hospitals/King's County, SUNY Downstate, Brookyn, NY

Introduction: Although incidence of gastric adenocarcinoma (GAC) has been declining overall, incidence rate of esophagogastric junction, or cardia, cancer is rising. However, this change in GAC anatomical distribution has not been explored through the lens of gender, race, and ethnicity in recent years.

Methods: All persons with GAC recorded in the SEER database from 2000-2019 were characterized according to gender, race (White, Black, American Indian/Alaska Native or AI, and Asian/Pacific Islander or API) and ethnicity (Hispanic , non-Hispanic or NH). Statistical significance was calculated with one-way ANOVA.

Results: Data from 17 cancer registries in the US reveal incidence of 100,014 cases of GAC, 63% of which occurred in men. As known previously, the cardia was the site of most frequent occurrence in men (39%). The antrum was the site of most frequent occurrence in women (24%). Gender distribution of GAC was similar in Hispanic vs non-Hispanic populations. However, the antrum was the predominant site of GAC occurrence in Hispanic men (20%), Hispanic women (24%), and non-Hispanic women (24%), as opposed to non-Hispanic men, for which the site was the cardia (43%). In looking more closely at anatomical distribution of GAC in non-Hispanic men, racially AI men (24%) as well as White men (55%) were most likely to have GAC in the cardia, while Black (26%) and API (29%) men were most likely to have GAC in the antrum. In Hispanic male patients, racially White (20%) and Black (24%) men were most likely to have GAC in the antrum, while AI (27%) and API (27%) men were most likely to have GAC in the cardia. Furthermore, non-Hispanic White (28%) women were also most likely to have GAC in cardia, whereas non-Hispanic women of other races, as well as Hispanic women overall, regardless of race, were all most likely to have GAC in the antrum. However, analysis of anatomical distribution of GAC among racial groups within both non-Hispanic and Hispanic women revealed statistically significant differences (p< 0.001 for both). This difference disappears when comparing the distribution of GAC in Hispanic vs non-Hispanic women overall (p=0.208).

Discussion: Differences in distribution of GAC exist between genders, between ethnicities, and among races, and, in addition to non-Hispanic White men, other groups are also predisposed to developing GAC in the cardia in recent years.

	MALE AND FEMALE NONHISPANIC							MALE AND FEMALE HISPANIC
	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%
C16.0-Cardia, NOS	24,255	1,583	182	1,898	55	27,973	34.49%	2,945	32	14	30	31	3,052	16.13%
C16.1-Fundus of stomach	2,038	418	38	416	10	2,920	3.60%	762	11	0	3	4	780	4.12%
C16.2-Body of stomach	3,805	1,310	55	1,735	25	6,930	8.55%	2,291	17	13	20	27	2,368	12.52%
C16.3-Gastric antrum	7,141	3,274	145	4,568	41	15,169	18.71%	4,021	48	6	26	40	4,141	21.89%
C16.4-Pylorus	1,099	539	50	526	5	2,219	2.74%	693	5	4	10	7	719	3.80%
C16.5-Lesser curvature of stomach NOS	2,802	1,200	129	1,814	10	5,955	7.34%	1,681	14	4	15	27	1,741	9.20%
C16.6-Greater curvature of stomach NOS	1,544	481	49	673	4	2,751	3.39%	778	6	2	7	12	805	4.25%
C16.8-Overlapping lesion of stomach	3,196	1,036	76	1,304	8	5,620	6.93%	1,918	20	3	9	10	1,960	10.36%
C16.9-Stomach, NOS	7,051	2,177	168	2,102	59	11,557	14.25%	3,229	39	11	29	46	3,354	17.73%
SUM	52,931	12,018	892	15,036	217	81,094	100.00%	18,318	192	57	149	204	18,920	100.00%
													0.5846723044

	MALE NONHISPANIC							MALE HISPANIC
	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%
C16.0-Cardia, NOS	19,444	1,104	131	1,423	42	22,144	42.51%	2,099	21	11	21	20	2,172	19.63%
C16.1-Fundus of stomach	1,252	242	20	233	7	1,754	3.37%	462	6	0	1	2	471	4.26%
C16.2-Body of stomach	2,043	720	29	934	16	3,742	7.18%	1,260	9	7	12	17	1,305	11.80%
C16.3-Gastric antrum	3,800	1,883	76	2,503	18	8,280	15.89%	2,187	25	6	11	20	2,249	20.33%
C16.4-Pylorus	602	304	35	329	3	1,273	2.44%	421	2	3	5	4	435	3.93%
C16.5-Lesser curvature of stomach NOS	1,705	760	85	1,040	6	3,596	6.90%	994	3	3	8	16	1,024	9.26%
C16.6-Greater curvature of stomach NOS	874	295	32	358	1	1,560	2.99%	468	4	2	2	4	480	4.34%
C16.8-Overlapping lesion of stomach	1,822	635	44	693	4	3,198	6.14%	1,099	12	3	2	6	1,122	10.14%
C16.9-Stomach, NOS	4,038	1,235	104	1,139	30	6,546	12.57%	1,738	23	6	17	20	1,804	16.31%
SUM	35,580	7,178	556	8,652	127	52,093	100.00%	10,728	105	41	79	109	11,062	100.00%


	FEMALE NONHISPANIC							FEMALE HISPANIC
	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%	White	Black	American Indian/Alaska Native	Asian or Pacific Islander	Unknown	SUM	%
C16.0-Cardia, NOS	4,811	479	51	475	13	5,829	20.10%	846	11	3	9	11	880	11.20%
C16.1-Fundus of stomach	786	176	18	183	3	1,166	4.02%	300	5	0	2	2	309	3.93%
C16.2-Body of stomach	1,762	590	26	801	9	3,188	10.99%	1,031	8	6	8	10	1,063	13.53%
C16.3-Gastric antrum	3,341	1,391	69	2,065	23	6,889	23.75%	1,834	23	0	15	20	1,892	24.08%
C16.4-Pylorus	497	235	15	197	2	946	3.26%	272	3	1	5	3	284	3.61%
C16.5-Lesser curvature of stomach NOS	1,097	440	44	774	4	2,359	8.13%	687	11	1	7	11	717	9.12%
C16.6-Greater curvature of stomach NOS	670	186	17	315	3	1,191	4.11%	310	2	0	5	8	325	4.14%
C16.8-Overlapping lesion of stomach	1,374	401	32	611	4	2,422	8.35%	819	8	0	7	4	838	10.66%
C16.9-Stomach, NOS	3,013	942	64	963	29	5,011	17.28%	1,491	16	5	12	26	1,550	19.73%
SUM	17,351	4840	336	6384	90	29,001	100.00%	7,590	87	16	70	95	7,858	100.00%

Table: Table 1. Frequency of GAC in patients from 17 cancer registries in the United States from 2000-2019 sorted by anatomic distribution of cancer within the stomach, gender, ethnicity, and race.

Disclosures:

Andrew Chen indicated no relevant financial relationships.

Qi Yu indicated no relevant financial relationships.

Andrew Chen, BS¹, Qi Yu, MD². C0689 - Anatomic Distribution of Gastric Adenocarcinoma Varies Among Patients of Different Gender, Ethnicity, and Race in the U.S., ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.