Section of Gastroenterology and Hepatology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Michael E DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.
Dig Dis Sci. 2018 Jun;63(6):1613-1619. doi: 10.1007/s10620-018-5012-9. Epub 2018 Mar 15.
The USA has among the lowest gastric cancer incidence rates worldwide.
To investigate whether increasing immigration from high cancer incidence countries has altered the GC incidence in a large US metropolitan area.
This was a retrospective cohort study among an underprivileged, multiethnic population in Texas. Gastric cancer cases diagnosed during 2005-2015 were identified using the cancer registry of the public medical care system for Harris County. All cases were histologically confirmed; demographic and clinical data were obtained from review of electronic medical records. Census data were used to determine the distribution of the adult county population by race/ethnicity and age. Two time periods (2005-2009 and 2010-2015) were studied to correspond with census reporting intervals.
In total, 299 cases were included: average age 55 years, 59% males and 63% Hispanics (predominantly recent immigrants of Central-American origin). The gastric cancer incidence remained stable among non-Hispanic Whites and Blacks but increased significantly among Hispanics (from 10 to 17 cases/100,000 persons/year, RR = 2.0, 95% CI 1.4-2.5, p = 0.001). Among Hispanics, gastric cancer incidence rose significantly among persons aged 40-59 years and ≥ 60 years and was likely to be at advanced stage at the time of diagnosis even in the younger age population.
Gastric cancer incidence significantly increased among Hispanics residing in Houston resulting in changes in gastric cancer incidence becoming more unevenly experienced across the US population. Consideration should be given to gastric cancer preventive efforts, especially among immigrant populations from high gastric cancer risk countries.
美国的胃癌发病率是全球最低的国家之一。
研究从高癌症发病率国家不断增加的移民是否改变了美国一个大城市的胃癌发病率。
这是德克萨斯州一个贫困、多种族人群中进行的回顾性队列研究。使用哈里斯县公共医疗保健系统的癌症登记处，确定了 2005-2015 年间诊断出的胃癌病例。所有病例均经组织学证实；人口统计学和临床数据来自电子病历审查。人口普查数据用于确定县成年人口按种族/族裔和年龄的分布情况。研究了两个时期（2005-2009 年和 2010-2015 年），以与人口普查报告间隔相对应。
共纳入 299 例病例：平均年龄 55 岁，男性占 59%，西班牙裔占 63%（主要是中美洲原籍的新移民）。非西班牙裔白人和黑人间的胃癌发病率保持稳定，但西班牙裔人群的发病率显著增加（从 10 例/10 万人/年增加到 17 例/10 万人/年，RR=2.0，95%CI1.4-2.5，p=0.001）。在西班牙裔人群中，40-59 岁和≥60 岁人群的胃癌发病率显著上升，即使在年轻人群中，诊断时也可能处于晚期。
居住在休斯顿的西班牙裔人群的胃癌发病率显著增加，导致美国人群的胃癌发病率分布更加不均匀。应考虑针对胃癌的预防措施，特别是针对来自高胃癌风险国家的移民人群。
