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As survival improves, these survivors face elevated risks of second primary cancers (SPCs). We evaluated SPC risk and post-SPC survival by race\/ethnicity and between the U.S. and South Korea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed patients with stage I\u2013III stomach cancer (2012\u20132020) from the U.S. SEER-17 and Korea Cancer Public-Library Database. SPCs were defined as non-gastric cancers diagnosed\u2009&gt;\u20091 year post initial diagnosis. Cumulative SPC incidence was estimated using Aalen-Johansen method to account for competing death. Cox regression assessed survival impact of SPC development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 19,595 U.S. and 204,240 Korean patients, 1,050 and 6,908 developed SPCs, respectively. In the U.S., 5-year SPC incidence was highest in Black (7.4% [6.1\u20138.6]) and lowest in Pacific Islanders (4.5% [2.3\u20136.7]). Notable heterogeneity in SPC incidence was observed across Asian subgroups, with Korean Americans showing the highest (6.9% [4.7\u20139.1]) and Filipinos the lowest (4.4% [1.9\u20137.2]). In contrast, Korean survivors in South Korea had the lowest SPC incidence (3.8% [3.7\u20133.9]). SPC development was associated with higher mortality (HR\u2009=\u20092.22 [1.96\u20132.52]), with a stronger effect in Asians (HR\u2009=\u20093.12) than Whites (HR\u2009=\u20091.96; interaction\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.1). Among Asian subgroups, SPC development was associated with the highest mortality in Vietnamese (HR\u2009=\u200913.6) and the lowest in Filipino survivors (HR\u2009=\u20091.54; interaction\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). Among Korean survivors in South Korea, SPC development conferred a modest increase in mortality risk (HR\u2009=\u20091.68 [1.61\u20131.75]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SPC risk and outcomes in stomach cancer survivors vary by race\/ethnicity and country, particularly within Asian subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10120-026-01728-9","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:27:35Z","timestamp":1773041255000},"page":"506-518","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Racial\/ethnic and geographic differences in second primary cancers in stomach cancer survivors: a comparative study of U.S. and South Korea"],"prefix":"10.1007","volume":"29","author":[{"given":"Yuntong","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Woo","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangwon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jialin","family":"Mao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Art","family":"Sedrakyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Shu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kui Son","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heejung","family":"Chae","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1315-1433","authenticated-orcid":false,"given":"Eunji","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"3","key":"1728_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, et al. 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