Risk Factors for Unresected Gastric Adenocarcinoma in South Africa: A National Cancer Registry Analysis.

Abstract

To describe the proportion of biopsy-proven gastric adenocarcinoma (GAC) that was surgically resected in South Africa (SA) and explore contributory factors for nonresection. This was a national retrospective study of GAC from 2015 to 2020 in SA using data available from the National Cancer Registry. Risk factors for nonresection were modeled using logistic regression. 3,919 individuals had biopsy-proven GAC, and of these, 560 (13.4%) had a surgical resection. Black race (odds ratio [OR], 2.3; <i>P</i> < .001), female sex (OR, 1.3, <i>P</i> = .020), and being uninsured (OR, 3.7, <i>P</i> < .001) were associated with nonresection. Resection rates showed a nonlinear increasing trend over time. The majority of GACs in SA were not resected, and race, sex, and health insurance status were associated with nonresection. Additional research to understand ways to mitigate barriers related to social determinants of health are needed to make cancer care more equitable in SA.