Gastric cancer, or stomach cancer, is the fifth most common cancer and the third leading cause of cancer death globally. In the United States, there are disparities in stomach cancer incidence and mortality, with Black and Hispanic Americans having a nearly two-fold greater risk of developing or dying from stomach cancer than white people. And while the U.S. does not have screening guidelines in place for stomach cancer, as it does for colorectal or breast, some clinicians are investigating whether a shift should be made.
Awarded a new five-year grant by the National Institutes of Health (NIH), Chin Hur, MD, MPH, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and member of the Herbert Irving Comprehensive Cancer Center (HICCC), is conducting comparative modeling to provide critical evidence aimed to improve the prevention and early detection of stomach cancer and cancer control policy. Targeting the most vulnerable, high-risk populations that bear the greatest burden of stomach cancer in the U.S., Dr. Hur and his collaborators hope to bring about change in prevention and screening guidelines via this data modeling approach.
"In countries like Korea and Japan there are national screening guidelines, partially because their rates of stomach cancer are so much higher than in the U.S. But if you look at groups of higher risk individuals in the U.S., those people could benefit from regular screenings," says Dr. Hur, who specializes in cancer screening and prevention for gastrointestinal cancers and directs the Columbia Stomach Cancer Screening Center.
"Right now, we don't have national guidelines for stomach cancer screening and if you're at high-risk, we want to be able to have a guideline or program to turn to that says you should be screened. That's our goal."
Each year in the U.S., an estimated 26,500 new cases of stomach cancer are diagnosed and 11,000 deaths occur from the disease. Stomach cancer disproportionately impacts certain racial/ethnic groups, immigrant communities, and high poverty areas. A 2020 American Association for Cancer Research Cancer Disparities Progress Report noted that stomach cancer is the top-ranking cancer in terms of disparities in deaths between Hispanics and whites and is the number two cancer between Blacks and whites.
"Stomach cancer is preventable and curable especially if it is diagnosed early," says Dr. Hur, who also is a member of the HICCC's Cancer Population Science research program and directs the Healthcare Innovation Research and Evaluation (HIRE) unit. "But if people don't know the risk factors or the signs and symptoms for stomach cancer, they don't necessarily know what to watch for. There is a critical need to assess screening and prevention strategies for stomach cancer that make sense, particularly for minority communities bearing much of the disease burden."
The study, which kicked off this fall with a global team of collaborators, is focusing on developing stomach cancer simulation models to estimate disease outcomes for subgroups of race and ethnicity in the U.S. The models would assess the impact of primary prevention strategies and risk factors, such as high-salt and high-fat diets, family history, and H. pylori bacterial infection which attacks the stomach lining and is known to lead to cancer, and adapt these models to evaluate stomach cancer prevention on a global scale.
