Am J Gastroenterol

Objectives: American Indian and Alaska Native (AI/AN) populations have higher gastric cancer rates than the general U.S. population. This study provides a comprehensive overview of incidence rates among AI/AN persons during 2005–2016 compared with non-Hispanic whites (whites). Methods: Population-based cancer registry data for 2005–2016 were linked with the Indian Health Service (IHS) patient registration databases to address racial misclassification. Age-adjusted gastric cancer incidence rates were expressed per 100,000 per year. Incidence and trend analyses were restricted to purchased/referred care delivery area (PRCDA) counties in 6 geographic regions, comparing gastric cancer incidence rates for AI/AN versus white populations in the U.S. Results: Gastric cancer rates were higher in the AI/AN compared to white populations in nearly every U.S. region. Incidence rates for central/distal portions of the stomach were higher in AI/AN individuals compared to whites. Rates of later stage gastric cancer were higher in AI/AN populations overall and in every region except the Pacific Coast and East. Incidence rates decreased significantly over time in both populations. Declining rates in the AI/AN populations were driven by changes in the Pacific Coast and Northern Plains regions. Conclusions: AI/AN populations have a disproportionately high incidence of gastric cancer, especially in Alaska. High incidence in the central/distal portions of the stomach among AI/AN populations likely reflects a high prevalence of Helicobacter pylori infection in these populations. These data can be used to develop interventions to reduce risk factors and improve access to health services among AI/AN peoples at high risk for gastric cancer.

32740090

PMC7710924

CDC Public Access