Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11546
Revised: February 8, 2014
Accepted: May 28, 2014
Published online: September 7, 2014
Processing time: 317 Days and 11.3 Hours
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.
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.