To the Editor,
Gastric cancer is the fifth most common cancer and the leading cause of cancer-related deaths worldwide.(1) Despite global declines in incidence rates of gastric cancer, there are emerging data to suggest that incidence rates of non-cardia gastric cancer among persons 50 years or younger (hereafter early-onset non-cardia gastric cancer [EOGC]) are increasing, with markedly higher rates among Hispanic persons as compared to non-Hispanic persons.(2,3) In a recent issue of Cancer Epidemiology, Biomarkers, and Prevention, Alagesan et al. review non-modifiable risk factors for gastric cancer, including race, ethnicity, and age.(4) We appreciate the authors drawing attention to the changing gastric cancer burden worldwide, progress made to address this global burden, and remaining gaps. However, we believe that this review missed an opportunity to highlight emerging disparities in EOGC among Hispanic persons, the largest ethnic minority group in the United States. We hope that this letter brings awareness to journal readership on the changing landscape of EOGC in the US.
Several studies now report higher incidence rates of EOGC among Hispanics compared to non-Hispanic persons. For example, a 2019 study using Surveillance, Epidemiology, and End Results (SEER) data from 2007 to 2015 found that Hispanics were more likely to be diagnosed with EOGC at younger ages, have higher grade tumors, and were less likely to receive surgery as compared to non-Hispanic Whites.(5) We also recently used population-based data from the California and Texas Cancer Registries and found that of 3,047 White persons diagnosed with EOGC from 1995 to 2016, 73.2% were Hispanic White.(3) In addition, we found that incidence rates of EOGC were higher among Hispanic White persons as compared to non-Hispanic White persons (1.29 vs. 0.31 cases per 100,000 persons) and that higher incidence rates among Hispanic Whites persisted across multiple domains, including age, year, sex, stage, county type, census tract poverty level, and state of residence.
In conclusion, Alagesan et al. wrote an important review on the progress and priorities of gastric cancer. However, we hope that this letter demonstrates a small fraction of the data currently published on important ethnic disparities in EOGC and encourages further research to understand why young Hispanics face such elevated risks of this aggressive disease.
Funding:
Anna Tavakkoli’s effort was supported by the UTSW ACS-IRG (IRG-17–174-13) and Cancer Center Support Grant (P30CA142543)
Footnotes
Conflicts of Interest:
Anna Tavakkoli and Sandi Pruitt disclose no pertinent conflicts of interest.
Caitlin Murphy discloses consulting for Freenome.
References
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