Expert Q&A on Stomach Cancer Risk in Asian Americans

Expert Q&A on Stomach Cancer Risk in Asian Americans

Managing Stomach Cancer Risk: Insights for East Asian Americans

Stomach Cancer

This year, approximately 26,500 people in the U.S. will receive the distressing news that they have stomach cancer, also known as gastric cancer [^1^]. Unlike countries such as Japan, China, Chile, and Iceland, which have screening programs for stomach cancer, the U.S. statistics reveal an alarming discrepancy. Americans of East Asian descent face unusually high risks for stomach cancer [^1^]. But what exactly contributes to this heightened risk? And how can people of East Asian heritage manage it effectively?

Dr. Haejin In, a surgical oncologist at Rutgers Cancer Institute of New Jersey specializing in upper gastrointestinal cancers, including stomach cancer, sheds light on these important questions [^1^]. She shares valuable insights into the increased risk faced by East Asian Americans, the role of Helicobacter pylori (H. pylori) infection, the need for screening, and the importance of raising awareness among healthcare professionals.

Higher Risk for East Asian Americans

Q: In the U.S., how much of a greater risk for stomach cancer do people of East Asian descent face?

A: Koreans are 13 times more at risk compared to White Americans, while Vietnamese are at seven times the risk. The risk is five times higher for Japanese and Chinese individuals [^1^]. The pattern observed in the United States mirrors the global statistics, indicating that certain countries have significantly higher rates of gastric cancer [^1^]. Gastric cancer also disproportionately affects minority populations, with higher mortality rates among Blacks, Hispanics, and Asians compared to Whites [^1^]. It is crucial to emphasize that gastric cancer within the Asian and minority groups is a significantly understudied area that requires further research [^1^].

Role of H. pylori Infection

Q: Higher rates of Helicobacter pylori (H. pylori) infection in some Asian American groups seem to play a role. How can this infection lead to stomach cancer?

A: Helicobacter pylori is a bacterium that resides in the stomach. Initially, it does not cause any problems, but over time, it can lead to gastritis, erosion of the stomach’s lining (mucosa), and atrophic gastritis (chronic inflammation and thinning of the stomach lining), ultimately progressing to gastric cancer [^1^]. Research suggests that the risk of gastric cancer is higher when Helicobacter pylori infection is coupled with a high-salt diet, rather than either factor alone [^1^]. However, it is important to note that not all individuals with Helicobacter pylori infection develop gastric cancer. Various other conditions, such as peptic ulcer disease and gastritis, can also result from this infection [^1^].

Q: Should Asian Americans ask their doctors about getting tested for H. pylori?

A: While there are screening guidelines for many other cancers with similarly high rates, guidelines for Helicobacter pylori screening are lacking [^1^]. Given that a considerable number of Asians in the U.S. are first-generation immigrants, and that even second-generation individuals remain at higher risk, it is reasonable for people of East Asian descent to request testing for Helicobacter pylori infection [^1^]. This can be done through a stool or breath test. If the test is positive, a two-week course of antibiotics is prescribed [^1^].

The Importance of Screening

Q: Stomach cancer screening programs in Japan and Korea have improved survival rates. Currently, the U.S. has no screening guidelines. What symptoms should prompt Asian Americans to get screened for stomach cancer?

Haejin In, MD, MPH

A: The key idea behind screening is to detect cancer before symptoms become evident. Stomach cancer tends to exhibit vague signs during its early stages, making early detection crucial. Symptoms such as a general feeling of discomfort or indigestion may be subtle indicators. However, by the time weight loss occurs, the cancer is often at an advanced stage. It is essential not to wait for symptoms to arise. Individuals with a family history of gastric cancer or those from minority populations, particularly East Asian descent, should consider screening for gastric cancer. The most effective screening method, as practiced in Japan and Korea, is an endoscopy, which involves the insertion of a flexible tube through the mouth to examine the stomach lining. Unlike colonoscopies, endoscopies are less invasive and require only overnight fasting [^1^].

The Role of Healthcare Professionals

Q: Is there a takeaway message for doctors?

A: Healthcare professionals who treat minority populations should maintain a high level of suspicion for gastric cancer, considering the elevated rates of Helicobacter pylori infection and gastric cancer among these groups. It is crucial to develop health policies that address these concerns and allocate resources accordingly [^1^].

In conclusion, East Asian Americans face significantly higher risks of stomach cancer compared to their White counterparts. While the exact reasons for this disparity are yet to be fully understood, research suggests that Helicobacter pylori infection and dietary factors contribute to the heightened risk. Although the U.S. lacks formal screening guidelines, Asian Americans, especially those at higher risk, should consider discussing Helicobacter pylori testing with their healthcare providers. Screening for stomach cancer, following the example set by Japan and Korea, can play a key role in early detection and improving survival rates for this silent but dangerous disease.

References: [^1^]: WebMD. (n.d.). Managing and Understanding Stomach Cancer Risk for East Asian Americans. Retrieved from source