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World J Gastroenterol. Sep 7, 2014; 20(33): 11546-11551
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11546
Racial and ethnic disparities in gastric cancer outcomes: More important than surgical technique?
Shaila J Merchant, Lily Li, Joseph Kim
Shaila J Merchant, Lily Li, Joseph Kim, Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010, United States
Author contributions: Merchant SJ performed the literature review; Merchant SJ, Li L and Kim J wrote the manuscript.
Correspondence to: Joseph Kim, MD, Associate Professor of Surgery, Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, United States. jokim@coh.org
Telephone: +1- 626-4717100 Fax: +1- 626-3018865
Received: October 25, 2013
Revised: February 8, 2014
Accepted: May 28, 2014
Published online: September 7, 2014
Processing time: 317 Days and 11.3 Hours
Abstract

Racial and ethnic disparities in cancer care are major public health concerns and their identification is necessary to develop interventions to eliminate these disparities. We and others have previously observed marked disparities in gastric cancer outcomes between Eastern and Western patients. These disparities have long been attributed to surgical technique and extent of lymphadenectomy. However, more recent evidence suggests that other factors such as tumor biology, environmental factors such as Helicobacter pylori infection and stage migration may also significantly contribute to these observed disparities. We review the literature surrounding disparities in gastric cancer and provide data pertaining to potential contributing factors.

Keywords: Race; Ethnicity; Disparities; Gastric cancer; Gastric adenocarcinoma

Core tip: Our prior investigations and review of the literature suggest that racial and ethnic disparities in gastric cancer outcomes in Eastern and Western patients may not be solely attributed to surgical technique and extent of lymphadenectomy. More recent evidence from the Asian population of Los Angeles County and a broad spectrum of the United States suggests that racial disparities exist independent of the number of lymph nodes harvested. Our data suggests that gastric cancer outcomes are not comparable among different racial and ethnic groups. Therefore, a one size fits all approach to gastric cancer management appears to be inappropriate.