Disparities in the Receipt of Palliative-intent Treatment Across Disaggregated Hispanic Subgroups With Stage IV Gastric Cancer in the United States

OBJECTIVES: Gastric cancer affects over 30,000 Americans annually and has a 5-year survival rate of roughly 40%. Palliative-intent interventions are critical for symptom relief and quality of life, yet access remains inequitable. We examined disparities in receipt of palliative-intent care among disaggregated Hispanic subgroups with gastric cancer. METHODS: Using the National Cancer Database (2004 to 2021), we identified adults (≥18 y) with AJCC stage IV gastric cancer. The primary outcome was receipt of palliative-intent intervention, defined as treatment for symptom alleviation rather than cure. Patients were stratified into Hispanic subgroups (Mexican, Puerto Rican, Cuban, South/Central American, Dominican, Other Hispanic, Not Otherwise Specified [NOS], and Spanish surname only) and compared with non-Hispanic White patients. Multivariable logistic regression adjusted for demographic, socioeconomic, and clinical covariates. RESULTS: Among 73,990 patients (median age 67 y), 65.2% were non-Hispanic White. Only 19.3% received palliative-intent treatment. Compared with non-Hispanic White patients, odds of receipt were lower for Mexican (AOR 0.74, 95% CI: 0.64-0.87), Cuban (AOR 0.57, 95% CI: 0.34-0.94), South/Central American (AOR 0.73, 95% CI: 0.61-0.88), and NOS Hispanic (AOR 0.82, 95% CI: 0.75-0.89) patients (all P