Survival Disparities in Hispanic/Latino Patients With Gastric Cancer at a High-Volume Cancer Center

For patients with gastric cancer, there is a need to understand and improve disparities in care. We aimed to evaluate the association between race/ethnicity and overall survival for patients with gastric cancer treated at a high-volume, comprehensive cancer center.

We performed a retrospective cohort study of patients diagnosed with gastric cancer between 1/1/2010 and 3/1/2023 who were treated at a single center. Patients were categorized by race/ethnicity: Hispanic/Latino (H/L), non-Hispanic Asian (NHA) and non-Hispanic White (NHW). Overall survival was compared between groups using Cox regression models.

A total of 662 patients were included: 164 (24.8%) H/L, 210 (31.7%) NHA, and 288 (43.5%) non-Hispanic White. There were no significant differences in histologic grade, tumor subtype, lymphovascular invasion, signet ring features, HER2 positivity, or PDL1 expression between groups. However, H/L patients traveled the farthest for care (20.2 versus 18.2 versus 15.8 miles, P < 0.001), had the highest rate of Medicaid insurance (20.7% versus 7.1% versus 4.2%, P < 0.001) and lived in the most socioeconomically disadvantaged neighborhoods (state area deprivation index: 6 versus 3 versus 3, P < 0.001). H/L ethnicity independently predicted worse overall survival (hazards ratio 1.49, [95% confidence interval (CI): 1.06-2.10], P = 0.021).

Despite treatment at a high-volume comprehensive cancer center, H/L ethnicity independently predicts worse survival, suggesting that factors beyond hospital quality contribute to disparities. Identifying and addressing social barriers are essential steps toward improving outcomes for these high-risk populations.