The incidence of gastric carcinoma in Asian migrants to the United States and their descendants

Objectives: We examined the incidence of gastric carcinoma in Chinese, Japanese, and Filipino residents of the United States to obtain additional information about the etiology of this disease. Methods. The age, race, and birthplace of residents of Hawaii, San Francisco/Oakland, and northwestern Washington who were diagnosed with gastric carcinoma during the period 1973-1986 were obtained from population-based registries, and a special tabulation from the 1980 Census was used to estimate the number of person-years at risk for each category of resident. Results: The incidence of gastric carcinoma in Japanese-Americans was three to six times higher than that of US-born whites, with the highest rates occurring in those persons born in Japan. The rate in US-born Chinese and Chinese men who immigrated to the US was similar to that of whites, whereas the rate in Chinese female migrants was twice that of white American women. Filipino men, regardless of birthplace, were only at 60% the risk of US-born white men, while their female counterparts had a rate very similar to that of US-born white women. The high incidence observed among Japanese-Americans and Chinese female immigrants was largely restricted to sites other than the gastric cardia. Conclusions: Our findings suggest that dietary and other lifestyle differences between the different generations of Japanese-Americans, and between Japanese residents of the US and Japan may provide clues regarding the etiologies of stomach cancers that arise beyond the gastric cardia.