There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the United States. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost effective for non-white individuals age 50 years or older. However, a lack of precise, contemporary information on gastric adenocarcinoma incidence in specific anatomic sites for this age group has impeded prevention and early detection programs in the United States. We aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals age 50 years or older.