Gastric carcinoma in African Americans: a 10 year single center analysis

The occurrence of gastric cancer (GCa) has been declining in the U.S. over the past years. The reasons for this decline, though unclear, may not hold true for minorities. In fact, data on the occurrence, presentation and determinants of survival in African Americans still remains sketchy. In an attempt to rectify this problem, we retrospectively analyzed accumulated data at the Howard University Cancer Center between 1985 and 1994. There were 115 patients with GCa, 53 females and 62 males. The age range was 26-88 years, with most patients being over 50 years of age (84%). Eighty seven out of the 115 patients were completely staged and thus formed the population base for the analysis. There was a progressive decline in the frequency of diagnosis of GCa between the 1985-1989: 63% cases (55/87) and 1990-1994: 37% cases (32/87). In analyzing this group, we found no gender difference on presentation. Seventy percent of the patients (61/87) presented with the advanced disease (stages III & IV). Eighty eight percent (77/87) underwent surgery: 50/77 surgery alone; 9/77 surgery and chemo; 18/77 surgery and other forms of therapy (radiotherapy and chemotherapy). Seventy one percent of the patients who presented with late stage disease, died within 12 months. The predominant histologic type was adenocarcinoma (85%), while lymphoma and leiomyosarcoma accounted for five and three percent respectively. In conclusion, our data suggest that most patients in our minority population presented at a late stage of GCa, and stage was an important determinant of survival. Also, our findings are in agreement with the declining trend of GCa in the U.S.