Disparities and trends in gastric cancer: Incidence, mortality, and stage-specific trends.

e16063 Background: Gastric cancer remains a significant global health burden. This study aims to provide a comprehensive analysis of gastric cancer incidence and mortality trends, with a focus on sex, race/ethnicity and stage at diagnosis. Methods: Surveillance, Epidemiology, and End Results Program (SEER) database is used to identify the incidence and survival rates of gastric cancer from 1992 to 2021. Multivariable Poisson regression was used to estimate incidence and mortality rates. Results: Males had higher rates than females (incidence: 7.4 vs. 3.9; mortality: 5.6 vs. 2.5 per 100,000) across all racial/ethnic groups. Non-Hispanic Black (NHB)and Non-Hispanic Asian (NHA)/Pacific Islander (PI) males exhibited the highest rates, while Non-Hispanic Whites (NHW) had the lowest. Incidence and mortality increased with disease stage, with distant-stage cancers showing the highest rates (incidence: 2.1; mortality: 1.9). Localized-stage cancers had the lowest rates (incidence: 0.9; mortality: 0.9), followed by regional-stage cancers. Temporal trends showed annual declines in regional-stage incidence (APC = -2.82%; p < 0.001) and increases in localized-stage incidence (APC = 1.16%; p = 0.013), with a sharp rise from 2019 to 2021 (APC = 14.6%; p < 0.001). Distant-stage incidence consistently declined across most groups. Localized-stage mortality increased (APC = 3.17%; p < 0.001), while regional-stage mortality decreased (APC = -0.68%; p < 0.001). Distant-stage mortality stabilized, with a brief rise of 17.5% (2004–2006) before leveling off. NHB populations had the highest localized-stage incidence (2.9) and mortality (1.6). Hispanics experienced the highest distant-stage incidence (3.3) and mortality (3.0). Conclusions: Males exhibit significantly higher rates of incidence and mortality compared to females. Racial minorities, particularly NHB and NHA/PI populations, experience the highest disease burden. Localized-stage cancers have shown recent increases in incidence, while distant-stage cancers continue to account for the highest mortality. Age-adjusted rates and stage at diagnosis. Mortality Overall Non-Hispanic White Non-Hispanic Black Non-Hispanic AI/AN Non-Hispanic Asian/PI Hispanic Rate (95% CI)per 100,000 Rate (95% CI)per 100,000 Rate (95% CI)per 100,000 Rate (95% CI)per 100,000 Rate (95% CI)per 100,000 Rate (95% CI)per 100,000 SexMaleFemale 5.6 (5.5, 5.6)2.5 (2.5, 2.6) 4.6 (4.5, 4.6)1.7 (1.7, 1.8) 8.8 (5.8, 6.0)4.0 (8.5, 9.0) 8.3 (7.5, 9.2)4.2 (3.7, 4.7) 7.4 (7.2, 7.6)4.1 (3.9, 4.2) 7.8 (7.7, 8.0)4.3 (4.2, 4.4) StagingIn SituLocalizedRegionalDistant 0.0 (0.0, 0.0)0.9 (0.8, 0.9)1.1 (1.1, 1.1)1.9 (1.8, 1.9) 0.0 (0.0, 0.0)0.7 (0.7, 0.7)0.9 (0.9, 0.9)1.4 (1.4, 1.5) 0.0 (0.0, 0.0)1.6 (1.5, 1.6)1.7 (1.6, 1.7)2.7 (2.6, 2.8) 0.0 (0.0, 0.0)1.5 (1.2. 1.7)1.6 (1.3, 1.8)3.0 (2.7, 3.3) 0.0 (0.0, 0.0)1.2 (1.1, 1.2)1.8 (1.8, 1.9)2.5 (2.4, 2.5) 0.0 (0.0, 0.0)1.2 (1.1, 1.2)1.7 (1.6, 1.8)2.9 (2.8, 3.0)