Migration-associated variation in gastric cancer risk in the United States

Mid-20^th-century migrant studies demonstrated that gastric cancer risk declines after migration from Asia to the United States, but does not fully converge to host-country levels, implicating early-life exposures and long disease latency. Whether these migration-associated risk gradients remain detectable in contemporary low-incidence settings has not been systematically evaluated. Analysis of SEER and state cancer registry data linked to US Census-derived population denominators investigated crude and age-adjusted gastric cancer incidence from 2010 to 2022 in California and New York. Gastric cancer incidence remained consistently higher among Asian populations than among non-Hispanic Whites (NHW), with age-adjusted incidence ranging form 3.6-4.7 per 100,000 in NHW versus 12-26 per 100,000 in Korean populations. Disaggregated analyses showed persistent differences across subgroups, with Korean population consistently exhibiting higher incidence than Chinese, Japanese, and Vietnamese populations. Incidence declined significantly over time in California (annual percen change -1% to -3%) but not in New York. Extrapolations suggest that a clinically meaningful burden will persist among high-risk subgroups through 2035. The authors conclude that these findings demonstrate that migration-associated variation in gastric cancer risk remains detectable and prevention-relevant in contemporary US populations (graphical abstract).