Adams Alexandra, Gandhi Atish, Friedmann Patricia, Sarkar Srawani, Rana Brijesh, Epplein Meira, Wilkens Lynne, Huang Brian Z, In Haejin
Division of Surgical Oncology, Rutgers Cancer Institute, New Brunswick, NJ, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
Cancer Causes Control. 2025 Mar;36(3):255-263. doi: 10.1007/s10552-024-01934-9. Epub 2024 Nov 7.
Gastric cancer (GC) incidence rates show notable differences by racial/ethnic groups in the US. We sought to determine whether stratification by race/ethnicity would reveal unique risk factors for development of non-cardia gastric cancer (NCGC) for US population.
Analysis included 1,112 incident cases of NCGC and 190,883 controls from the Multiethnic Cohort Study, a prospective US cohort study that recruited individuals living in Hawaii and California, aged 45-75 years from 5 races/ethnicities. Descriptive analysis and Cox regression models examined the association of risk factors for GC and calculate hazard ratios for each race/ethnicity, adjusting for sociodemographic and dietary variables.
Increasing age and male sex were risk factors for NCGC for most race/ethnicities. Higher risk was associated with: GC family history for Latino and Japanese American individuals [HRs range from 1.75 to 1.98]; foreign-born for Japanese American individuals [HR: 1.52, 95% CI 1.11-2.09]; lower education for African American, Japanese American, and Native Hawaiian individuals [HRs range from 1.30 to 1.74]; daily alcohol consumption for African American individuals[HR: 1.56, 95% CI 1.04-2.35]; current smoking for Latino and Japanese American individuals [HRs range from 1.89 to 1.94]; sodium consumption in the highest quartile for White individuals [HR: 2.55, 95% CI 1.23-5.26] compared to the lowest quartile; fruit consumption in the 2nd, 3rd, and 4th highest quartile for Native Hawaiian individuals [HRs range from 2.19 to 2.60] compared to the lowest quartile; diabetes for African American individuals [HR: 1.79, 95% CI 1.21-2.64]; and gastric/duodenal ulcers for Native Hawaiian individuals [HR: 1.82, 95% CI 1.04-3.18].
Analyses by racial/ethnic group revealed differing risk factors for NCGC. Increased knowledge of the varying pathways to GC can support personalized GC prevention strategies and risk stratification tools for early detection.
在美国，胃癌（GC）发病率在不同种族/族裔群体中存在显著差异。我们试图确定按种族/族裔分层是否会揭示美国人群非贲门胃癌（NCGC）发生的独特风险因素。
分析纳入了多民族队列研究中的1112例NCGC新发病例和190883例对照，该研究是一项前瞻性美国队列研究，招募了居住在夏威夷和加利福尼亚、年龄在45 - 75岁的5个种族/族裔的个体。描述性分析和Cox回归模型检验了GC风险因素的关联，并计算每个种族/族裔的风险比，对社会人口统计学和饮食变量进行了调整。
对于大多数种族/族裔而言，年龄增长和男性是NCGC的风险因素。较高风险与以下因素相关：拉丁裔和日裔美国人的GC家族史[风险比范围为1.75至1.98]；日裔美国人中出生在国外的[风险比：1.52，95%置信区间1.11 - 2.09]；非裔美国人、日裔美国人和夏威夷原住民中教育程度较低的[风险比范围为1.30至1.74]；非裔美国人每日饮酒[风险比：1.56，95%置信区间1.04 - 2.35]；拉丁裔和日裔美国人当前吸烟[风险比范围为1.89至1.94]；与最低四分位数相比，白人中钠摄入量处于最高四分位数的[风险比：2.55，95%置信区间1.23 - 5.26]；与最低四分位数相比，夏威夷原住民中水果摄入量处于第二、第三和第四最高四分位数的[风险比范围为2.19至2.60]；非裔美国人患糖尿病的[风险比：1.79，95%置信区间1.21 - 2.64]；以及夏威夷原住民患胃/十二指肠溃疡的[风险比：1.82，95%置信区间1.04 - 3.18]。
按种族/族裔群体进行的分析揭示了NCGC不同的风险因素。对GC不同发病途径的更多了解可为个性化的GC预防策略和早期检测的风险分层工具提供支持。
