Temporal Trends and Burden of Gastric Cancer in the United States: A SEER-Based Analysis

Calvin Ghimire, Jerry Kenmoe, Pujan Kandel, Sajana Poudel, Sajan Acharya, Alex Rabadi, Matthew Jankowski, Bibek Karki, Manoj Ghimire, Karun Shrestha, Ujwala Koduru, Arvind Kunadi.

Abstract

Background: Gastric cancer is the third leading cause of cancer death worldwide and is diagnosed in 27,000 Americans each year. It accounts for about 1.5% of all new cancers diagnosed in the US each year. We investigated the burden of gastric cancer in United States and temporal trends in cancer-specific incidence and mortality.

Methods: Using data from Surveillance, Epidemiology, and End Results (SEER) areas, we assessed gastric-cancer mortality and linked deaths from gastric cancer to incident cases in SEER cancer registries. This allowed us to evaluate population-level mortality trends attributed to specific subtypes (incidence-based mortality). We also evaluated gastric-cancer incidence and survival according to cancer subtype, sex, and calendar year. Joinpoint software was used to assess changes in incidence and trends in incidence-based mortality.

Results: The overall trend of incidence and mortality of gastric cancer is decreasing from 2000-2019. The incidence rate of gastric carcinoma has been steadily declining at 1.4% and 0.5% annually among males and females respectively. Among males, the incidence-based mortality rate of gastric carcinoma increased from 2001 to 2003 with an Annual Percentage Change (APC) of 7.2 and decreased from 2003 through 2019 with an APC of 1 while in females trend increased from 2001 to 2005 with APC of 3.8 and then trended down through 2019 with APC of 0.9. This decrease in incidence and improvement in survival was found across all races and ethnic groups. This result correlates with an increase in awareness regarding risk factors, early screening and treatment advances for gastric cancer in the time frame we examined.

Conclusions: Population-level mortality from gastric cancer in the United States decreases from 2003 to 2016, and survival after diagnosis improved substantially. Our analysis suggests that a reduction in incidence along with increased screening with esophagogastroduodenoscopy, H. pylori eradication therapy and treatment advances — is likely to explain the reduction in mortality observed during this period.