Abstract
BACKGROUND: Stomach cancer is the fourth leading cause of cancer-related deaths globally, but its late-stage detection and its lack of early symptoms are still the main challenges ahead. Limited research has focused on detailed racial and ethnic disparities in stomach cancer incidence within the United States. This study aims to address these gaps by analyzing age-adjusted stomach cancer incidence rates from 2000 to 2021. METHODS: Using data from the US Surveillance, Epidemiology, and End Results (SEER) program (2000-2021), we identified a cohort of 138,628 individuals diagnosed with incident stomach cancer at age ≥ 20. Both crude and age-adjusted models were employed and incidence rates were adjusted by age to the 2000 US population. RESULTS: This cohort comprised 73,410 non-Hispanic Whites, 18,006 non-Hispanic Blacks, 1,210 American Indians and Alaska Natives, 19,497 non-Hispanic Asians/Pacific Islanders, and 26,015 Hispanics. Overall total age-adjusted incidence rate of stomach cancer across all groups is 10.4 per 100,000. While all racial groups show a gradual overall decline in stomach cancer incidence from 2000 to 2021, NH-Whites consistently have the lowest rates across all stages and periods. Overall, significant racial disparities were observed, with NH-A/PIs and NH-Blacks showing the highest rate ratio of 1.94 compared to NH-Whites from 2000 to 2021. In the age subgroup analysis, the most significant racial disparity was identified among individuals aged 75 years and older during 2000-2006, with NH-A/PIs experiencing a stomach cancer incidence rate 2.63 times higher (95% CI: 2.51-2.76) than NH-Whites. Similarly, in the tumor stage subgroup analysis, we found the largest disparity in the regional stage group during the same period, whereas NH-A/PIs had a stomach cancer incidence rate 2.71 times higher (95% CI: 2.57-2.85) than NH-Whites. CONCLUSIONS: The overall trend in stomach cancer incidence shows a gradual decline. However, racial disparities persist consistently between 2000 and 2021. During the earlier years, NH-A/PIs had the highest stomach incidence rates. Nonetheless, in more recent years, attention is also needed for Non-Hispanic Blacks and Hispanics, as their incidence rates have shown an upward trend. These study results underscore the importance of targeted public health interventions to address these enduring racial disparities.