Characterizing gastric cancer and time-to-first treatment among non-Hispanic American Indian Alaska Native and white patients in North Carolina

Purpose This study aimed to characterize the gastric cancer burden among non-Hispanic American Indian Alaska Native (NHAIAN) and White (NHW) individuals in North Carolina to provide a baseline assessment of the gastric cancer burden in North Carolina.Methods Data from the North Carolina Central Cancer Registry (2003-2021) were used to construct gastric cancer diagnosis (NHAIAN n = 111; NHW n = 7,685) and treatment (NHAIAN n = 97; NHW n = 6,040) cohorts. Race-stratified patient characteristics were summarized. We evaluated unadjusted associations between patient characteristics and receipt of no treatment and the multivariable-adjusted association risk ratio (RR) between race and no treatment using modified Poisson regression. Race-specific cumulative incidence functions (CIFs) for treatment initiation were estimated with bootstrapped 95% confidence intervals (CI) and adjusted for key covariates using inverse probability weighting.Results NHAIANs were diagnosed at a younger age (65 vs 68 years; p = 0.006), with non-cardia cancer (80 vs 62%; p Conclusion NHAIAN gastric cancer patients in North Carolina were diagnosed younger, at more advanced stages, and had a lower cumulative probability of initiating treatment within the first year after diagnosis compared to NHWs.