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Comparative Study
. 2017 Apr;26(4):587-596.
doi: 10.1158/1055-9965.EPI-16-0573. Epub 2016 Dec 1.

Stomach Cancer Disparity among Korean Americans by Tumor Characteristics: Comparison with Non-Hispanic Whites, Japanese Americans, South Koreans, and Japanese

Eunjung Lee  1 , Lihua Liu  2 , Juanjuan Zhang  2 , Mariana C Stern  2 , Afsaneh Barzi  3 , Amie Hwang  2 , Andre E Kim  2 , Ann S Hamilton  2 , Anna H Wu  2 , Dennis Deapen  2
Affiliations
Comparative Study

Stomach Cancer Disparity among Korean Americans by Tumor Characteristics: Comparison with Non-Hispanic Whites, Japanese Americans, South Koreans, and Japanese

Eunjung Lee et al. Cancer Epidemiol Biomarkers Prev. 2017 Apr.

Abstract

Background: Stomach cancer incidence shows substantial racial-ethnic disparity in the United States, with Korean Americans experiencing by far the highest incidence. We examined stomach cancer incidence trends in Korean Americans by tumor subsite, histology, and stage and compared them with incidence rates in racial-ethnic groups with the second highest rate (Japanese Americans) and the lowest rate (non-Hispanic whites; NHWs) as well as populations in South Korea and Japan.Methods: We calculated age-adjusted incidence rates by racial-ethnic groups, sex, and tumor characteristics, using the 1988-2012 California Cancer Registry data. Data on South Korea and Japan were obtained from the literature and other resources.Results: Between 1988 and 2012 in California, Korean Americans had about five times greater incidence than NHWs and twice that of Japanese Americans. Tumor characteristics differed by ethnic group and gender. The incidence in Korean Americans has declined during recent years, for both cardia and noncardia sites and for both intestinal- and diffuse-type histology. Although Korean Americans were diagnosed at an earlier stage than other Californians, the proportion with localized disease (43%) was much smaller than in South Korea (57%), where population-based screening is available.Conclusions: Stomach cancer incidence declined in the highest risk ethnic groups. However, the persistent disparity between Korean Americans and other racial-ethnic groups warrants additional strategies for prevention and earlier diagnosis.Impact: Analysis of California Cancer Registry data identified a racial-ethnic subgroup with stomach cancer disparity that may benefit from targeted prevention and screening efforts. Cancer Epidemiol Biomarkers Prev; 26(4); 587-96. ©2016 AACR.

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Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1.
Figure 1.
Stomach cancer age-adjusted incidence rates (AAIR) by sex and time period among non-Hispanic whites (NHW), Korean Americans and Japanese Americans in California, South Koreans, and Japanese, 1988–2012. Data for South Korean and Japanese AAIRs were obtained from publically available incidence data (7, 8, 22). A. Men; B. Women. Abbreviation: JA, Japanese American; KA, Korean American; NHW, Non-Hispanic White
Figure 2.
Figure 2.
Subsite distribution by race/ethnicity and diagnosis year time period in California (1988–2012) in comparison with that in South Korea and in Japan (2003–2008). A: Men; B: Women. Source for data for Japan and South Korea: CI5 Vol. X (5). Japan data presented are from Japan, Miyagi Prefecture (5). Abbreviation: JA, Japanese American; KA, Korean American; NHW, Non-Hispanic White
Figure 2.
Figure 2.
Subsite distribution by race/ethnicity and diagnosis year time period in California (1988–2012) in comparison with that in South Korea and in Japan (2003–2008). A: Men; B: Women. Source for data for Japan and South Korea: CI5 Vol. X (5). Japan data presented are from Japan, Miyagi Prefecture (5). Abbreviation: JA, Japanese American; KA, Korean American; NHW, Non-Hispanic White
Figure 3.
Figure 3.
Stage distribution by race/ethnicity and diagnosis year time period in California (1988–2012), South Korea (2006–2010), and Japan (2003–2005)*. * Unknown stage tumors were not included in calculating stage distribution. Proportion of cases with unknown stage was similar across racial/ethnic groups in California (10%−12%); this was also similar to the unknown % in South Korea (11%) and Japan (8%). Stage distribution for South Korea was reconstituted from Table 3 in Jung et al. 2013 (21). Stage distribution for Japan was reconstituted using data presented in Japan Cancer Statistics 2014 (23). Abbreviation: JA, Japanese American; KA, Korean American; NHW, Non-Hispanic White; S. Korea, South Korea.
Figure 4.
Figure 4.
Stomach cancer incidence rate by histologic type, time period, race/ethnicity and sex in California, 1988–2012. A: Intestinal type, men; B: Intestinal type, women; C: Diffuse type, men; D: Diffuse type, women. Abbreviation: JA, Japanese American; KA, Korean American; NHW, Non-Hispanic White
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