P2036 - Gastric Cancer: Epidemiology and Diagnosis in the Black Population at a Tertiary Medical Center

Effie M. Mathew, BS¹, Brady Houtz, ¹, Muyi Li, MD¹, Timothy J. Kuchera, MD¹, Corey O'Brien, MD², Alex Schlachterman, MD^1
1Thomas Jefferson University Hospital, Philadelphia, PA; ²Thomas Jefferson University Hospital, Philadephia, PA

Introduction: Despite low prevalence in the U.S., gastric adenocarcinoma is associated with a high mortality rate. Incidence rates differ amongst demographic groups, with higher rates in Asian and Black populations compared to White. The aim of this study was to assess the prevalence of various types of gastric cancer in adult Black patients. Secondary objectives included symptoms, means of diagnosis, and staging at diagnosis.

Methods: This is a retrospective study of adult patients diagnosed with any primary gastric lesion from 2013-2021 at a tertiary medical center in Philadelphia, PA. Metastatic lesions in the stomach from non-gastric primary cancer were excluded. 572 patients were identified, with 62.9% of the patient population being White, 10% Asian, 24% Black, and 3.1% Hispanic. With a focus on the Black patient population, variables collected included patient demographics, symptoms, gastric lesion diagnosis, stage at diagnosis, and mortality.

Results: In total 135 Black patients with median age of 70 years were included; 45.2% were male (Table 1). The most common malignancy diagnosed was gastric adenocarcinoma at 54.1%. A majority (70.9%) of patients were symptomatic at diagnosis. 63.2% were diagnosed with locally staged disease and 25.6% with metastatic disease. Lesions were first identified via upper endoscopy in 45.1% of patients, and via CT/MRI in 16.5%.

When comparing the Black population to non-Black populations (White, Asian, and Hispanic), there was no significant difference in rates of gastric adenocarcinoma (54.1% vs 52.8%, p=0.803). However, there was a significantly higher prevalence of gastrointestinal stromal tumor (GIST) among the Black population (28.9% vs. 14.7%, p< 0.05) when compared to non-Black populations. Overall, there was also no significant difference in the staging at diagnosis (local disease 63.2% vs 66.9%, p=0.729) between these two populations.

Discussion: The most commonly diagnosed gastric lesion amongst Black patients was gastric adenocarcinoma, but the rates did not differ significantly to that of non-Black populations. However, a higher prevalence of GIST was found in the Black population. This study adds to the literature on differences in the prevalence of various gastric cancers in the United States, particularly in the adult Black population. Larger studies are needed to elucidate cost-effectiveness and mortality benefit to gastric cancer screening in this population.

Median Age, years (range)	70 (35-96)
Male, n (%)	61 (45.2%)
Smoking, n (%)	12 (8.9%)
Gastric Lesion Diagnosis, n (%)
Gastric Adenocarcinoma	73 (54.1%)
GIST	39 (28.9%)
Carcinoid	9 (6.7%)
Linitis Plastica	1 (0.7%)
Other	3 (2.2%)
Unknown	4 (3.0%)
GE Junction	5 (3.0%)
Lymphoma	1 (0.7%)
Symptomatic Disease at Diagnosis, n (%)	95 (70.9%)
Unknown if Symptomatic at Diagnosis, n (%)	28 (20.9%)
Stage at Diagnosis, n (%)
Local	84 (63.2%)
Metastatic	34 (25.6%)
Unknown	17 (12.6%)
Median Age at Diagnosis, years (range)	63 (34-90)
First Identification of Lesion, n (%)
CT/MRI	22 (16.5%)
UGIS	1 (0.8%)
EGD	60 (45.1%)
Surgery	7 (5.3%)
Unknown	41 (30.8%)
Ultrasound	2 (1.5%)

Table: Table 1: Baseline Characteristics and Diagnoses. GIST - gastrointestinal stromal tumor. GE - gastroesophageal. CT/MRI - computed tomography/magnetic resonance imaging. UGIS - upper gastrointestinal series. EGD - esophagogastroduodenoscopy.



Disclosures:
Effie Mathew indicated no relevant financial relationships.
Brady Houtz indicated no relevant financial relationships.
Muyi Li indicated no relevant financial relationships.
Timothy Kuchera indicated no relevant financial relationships.
Corey O''Brien indicated no relevant financial relationships.
Alex Schlachterman indicated no relevant financial relationships.


Effie M. Mathew, BS¹, Brady Houtz, ¹, Muyi Li, MD¹, Timothy J. Kuchera, MD¹, Corey O'Brien, MD², Alex Schlachterman, MD¹. P2036 - Gastric Cancer: Epidemiology and Diagnosis in the Black Population at a Tertiary Medical Center, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.