Various racial and ethnic disparities affect disease presentation, treatment delivery and outcomes among young patients with gastric cancer, according to data presented at the Gastrointestinal Cancers Symposium.
In particular, Asian and Hispanic ethnicity were independently associated with favorable survival.
Because the characteristics of patients who present with gastric cancer at a young age (as much as 15%) are not well defined, Ibrahim Nassour, MD, and colleagues from The University of Texas Southwestern Medical Center in Dallas, identified all 5,869 patients with gastric adenocarcinoma aged younger than 45 years within the National Cancer Database between 2006 and 2013, and assessed whether race and ethnicity were associated with certain clinical and pathologic characteristics. These included patient-, tumor-, and treatment-related factors and overall survival.
Overall, 40.6% of patients were non-Hispanic white, 27.7% were Hispanic, 16.9% were black and 9% were Asian.
The investigators found that Hispanic patients presented with gastric cancer at a younger age compared with the other groups (P < .01), and they presented with metastatic disease more often (59.2%) compared with blacks (50.2%), non-Hispanic whites (49.6%) and Asians (49.8%; P < .01).
Non-Hispanic whites presented with tumors in the cardia more often (45.7%) compared with blacks (12.7%), Hispanics (12.5%) and Asians (9.6%; P < .01).
In addition, Hispanics (28.4%) and blacks (14.2%) lacked health insurance more often than Asians (12%) and non-Hispanic whites (7.1%; P < .01), and blacks (60.5%) and Hispanics (49.1%) more often made less than the median income vs. non-Hispanic whites (35.8%) and Asians (24.2%; P < .01).
Notably, Asians had better overall outcomes compared with other groups. Their median overall survival was 22.7 months vs. 15.2 months for non-Hispanic whites, 14 months for Hispanics and 13.6 months for blacks (P < .01).
Finally, being Asian or Hispanic, having a cardia tumor, being treated at an academic center, having higher income, and having a low Charlson Comorbidity Index were independently associated with favorable survival.
The investigators concluded that there are indeed racial and ethnic disparities among young gastric cancer patients, and that future research should evaluate whether these differences are caused by disparities in access to health care or inherent biological differences. – by Adam Leitenberger
Nassour I, et al. Abstract 25. Presented at: Gastrointestinal Cancers Symposium; Jan. 19-21, 2017; San Francisco.
Disclosures: The researchers report no relevant financial disclosures.