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Introduction <p>Racial disparities in gastric cancer (GC) outcomes have gained increasing attention in the United States, particularly given the large immigrant population from high-incidence regions.</p> Methods <p>We analyzed a nationally representative hospital database (2003–2022) to identify patients with a primary diagnosis of gastric cancer. Outcomes included in-hospital mortality, surgical receipt, perioperative complications, length of stay, and home discharge. Multivariate logistic regression adjusting for sociodemographic and hospital factors estimated odds ratios (ORs) with 95% confidence intervals. Temporal trends and race–period interactions were analyzed to assess in-hospital mortality changes, with regional subgroup analyses evaluating geographic variation.</p> Results <p>A total of 137,951 patients were included. GC admissions and in-hospital mortality declined by 82% and 60% over two decades; however, racial disparities persisted. Compared with White patients, Black (OR 1.17, 95% CI 1.11–1.25) and Native American patients (OR 1.14, 95% CI 1.04–1.26) had higher odds of in-hospital mortality. The Black–White mortality gap narrowed during 2013–2018 but widened after 2019, indicating temporal heterogeneity (P for interaction = 0.026). Black patients underwent surgery less frequently (OR 0.85), experienced more perioperative complications (OR 1.11), and were less often discharged home (OR 0.86). Regionally, mortality was higher among Black patients in the Northeast (OR 1.36) and South (OR 1.14), and among Asian (OR 1.35) and Native American patients (OR 1.47) in the West.</p> Conclusions <p>Despite improvements in GC admissions and in-hospital mortality, clinically relevant racial and regional disparities in hospital-based outcomes persist, highlighting the need for targeted public health and health system strategies to achieve equitable care.</p>

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Hospital-based gastric cancer outcomes in the United States (2003–2022): racial and regional disparities

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Yasutoshi Shiratori,
  • Neha Sharma,
  • Syed Matthew Kodilinye,
  • Carla Barberan Parraga,
  • Fatima Khan,
  • Ahmed E. Salem,
  • Sarah Meribout,
  • Diana Cheung,
  • Aaron Tokayer,
  • Anthony Kalloo,
  • Linda A. Lee

摘要

Introduction

Racial disparities in gastric cancer (GC) outcomes have gained increasing attention in the United States, particularly given the large immigrant population from high-incidence regions.

Methods

We analyzed a nationally representative hospital database (2003–2022) to identify patients with a primary diagnosis of gastric cancer. Outcomes included in-hospital mortality, surgical receipt, perioperative complications, length of stay, and home discharge. Multivariate logistic regression adjusting for sociodemographic and hospital factors estimated odds ratios (ORs) with 95% confidence intervals. Temporal trends and race–period interactions were analyzed to assess in-hospital mortality changes, with regional subgroup analyses evaluating geographic variation.

Results

A total of 137,951 patients were included. GC admissions and in-hospital mortality declined by 82% and 60% over two decades; however, racial disparities persisted. Compared with White patients, Black (OR 1.17, 95% CI 1.11–1.25) and Native American patients (OR 1.14, 95% CI 1.04–1.26) had higher odds of in-hospital mortality. The Black–White mortality gap narrowed during 2013–2018 but widened after 2019, indicating temporal heterogeneity (P for interaction = 0.026). Black patients underwent surgery less frequently (OR 0.85), experienced more perioperative complications (OR 1.11), and were less often discharged home (OR 0.86). Regionally, mortality was higher among Black patients in the Northeast (OR 1.36) and South (OR 1.14), and among Asian (OR 1.35) and Native American patients (OR 1.47) in the West.

Conclusions

Despite improvements in GC admissions and in-hospital mortality, clinically relevant racial and regional disparities in hospital-based outcomes persist, highlighting the need for targeted public health and health system strategies to achieve equitable care.