Background: Chronic infection with Helicobacter pylori with non-Hispanic whites (NHW), Hispanics, and blacks (H. pylori) is the strongest risk factor for distal gastric cancer. (with 64.4%, 33.9%, and 72.9% U.S.-born, respectively). Although gastric cancer incidence has decreased, variation by For NHWs, the most frequently diagnosed gastric cancer site race and ethnicity is observed. This study describes gastric was the cardia (35.6%) compared with <15% (P < 0.001) for cancer presentation and screening services among Medicare APIs, Hispanics, and blacks. Although more than 57% of all patients by race/ethnicity, place of birth, and history of gastric cases had a history of gastric cancer–related conditions, cancer–related conditions. H. pylori testing was reported in only 11.6% of those cases. Methods: Using demographic, location, and disease staging H. pylori testing was highest for APIs (22.8%) and lowest for information, extracted from the Surveillance, Epidemiology blacks (6.5%). and End Results-Medicare gastric cancer database (1997–Conclusions: Noncardia gastric cancer, associated with 2010), we compared frequencies of gastric cancer–related H. pylori infection, was diagnosed more frequently among conditions (e.g., peptic ulcer, gastric ulcer, gastritis) and APIs, blacks, and Hispanics than NHWs. Testing for H. pylori screening (H. pylori testing and endoscopy) from inpatient was low among all gastric cancer cases despite evidence of risk and outpatient services claims by selected race/ethnicity and factors for which screening is recommended. Studies are place of birth. needed to increase appropriate testing for H. pylori among Results: Data included 47,994 incident gastric cancer higher risk populations. cases with Medicare claims. The majority (48.0%) of Impact: This study sheds light on poor screening practices Asian/Pacific Islanders (API) were foreign-born, compared despite presence of gastric cancer-related conditions.
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