Samia Asif, MD1, Lyla Saeed, MD1, Yousaf Zafar, MD2
1University of Missouri Kansas City School of Medicine, Kansas City, MO; 2University of Missouri, Kansas City, MO
Introduction: Using Surveillance, Epidemiology, and End Results (SEER) data, we examined epidemiological associations between patient characteristics and the incidence and survival in gastric cancer in the US.
Methods: Patients diagnosed with stomach cancer between 1975-2016 were identified in SEER registries. We incorporated SEER 9 and 18 registries to calculate incidence, race/ethnicity and disease characteristics. Cox regression was used to estimate survival from SEER follow up data.
Results: Males(M) had higher incidence rates (IR) than females(F): 10.0/105 vs 5.3/105. Observed IR have been decreasing on average 1.5%/year over last 10 years. IR increases with age; for any age group, it is higher for: M than F; black M than white M and black F than white F.
IR are highest in ages 65years and above compared to ages below 65 (36.7/105 vs 3.1/105) and highest in Asian-Pacific Islander (API) populations, Blacks (B), Hispanics (H), American Indian/Alaskan Native, non-Hispanic white (NHW) and Whites (W) in decreasing order. For each ethnicity, IR is higher in M than F. In 2016, W constituted 69.2% of prevalent cases, while B, H and API constituted 12.6, 11.3 and 7.1% respectively.
Mortality rates (MR) decreased from 8.51/105 to 3.02/105 between 1975-2016. MR increases with age for both M and F; between 2012-16 it is highest in B (5.5/105), API (5.3/105), H (5.1/105), American Indian/Alaskan Native (3.4/105), W (2.7/105) and NHW (2.4/105) in decreasing order.
5-year survival improved from 15% in 1975-77 to 32% in 2009-2015. For F, 5-year survival is 36%, higher in BF than WF (39.5% vs 35%). In M, 5-year survival is 30%, lower for BM compared to WM (27%vs 29%).
Adenocarcinoma comprised 80% of all cases reported; others included epidermoid and squamous cell carcinoma and sarcoma/soft tissue tumors (0.8, 0.8 and 0.2% respectively). Rest were documented as other specific or unspecified tumors.
Distant disease comprised (36%) of reported cases, compared to localized (26%), regional (26%) and unknown/un-staged (10%) disease. 5-year survival rates were highest for localized (69%) compared to regional (31%), distant (5%) and unknown/un-staged (23.0 %) disease.
Discussion: Epidemiological trends show improved 5-year survival in gastric cancer among all ethnicities. Advance age and distant disease portend poor outcome. Since black women have better outcome than black men, we postulate that the disease pathogenesis varies by gender and races without considering confounding factors.
Citation: Samia Asif, MD; Lyla Saeed, MD; Yousaf Zafar, MD. P1755 - TRENDS IN INCIDENCE, SURVIVAL, AND MORTALITY OF GASTRIC CANCER IN THE UNITED STATES: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS (SEER) DATABASE STUDY 1975-2016. Program No. P1755. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.