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Clinicopathological Characteristics of Asymptomatic Young Patients with Gastric Cancer Detected during a Health Checkup

대한소화기학회지 2019년 74권 5호 p.281 ~ 290
 ( Moon Hyoung-Ho ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Internal Medicine

 ( Kang Hyoun-Woo ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Internal Medicine
 ( Koh Seong-Joon ) - Seoul National University College of Medicine Seoul National University Boramae Hospital Department of Internal Medicine
 ( Kim Ji-Won ) - Seoul National University College of Medicine Seoul National University Boramae Hospital Department of Internal Medicine
 ( Shin Cheol-Min ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: The Korean National Cancer Screening Program recommends biennial gastric cancer screening for patients aged ≥40 years. This study compared the characteristics of asymptomatic young gastric cancer patients aged <40 years, whose cancer was detected during a health checkup (screening group), with those whose disease was detected because of symptoms (diagnostic group).

Methods: Data were collected retrospectively from 84 subjects who underwent a gastroduodenoscopy before the age of 40 years and who were diagnosed with gastric cancer from January 2006 to February 2017 in three tertiary centers in Korea. The clinicopathological characteristics, including age, sex, stage, location, pathology, and survival, were compared according to the purpose of endoscopy (screening group, n=23 vs. diagnostic group, n=61).

Results: The median age of the screening group was higher than that of the diagnostic group (37 vs. 35 years, p=0.027), as was the proportion of early gastric cancer cases (78.3% vs. 29.5%, p<0.01), curative endoscopic treatment or operation rate (95.7% vs. 52.5%, p<0.01), and the overall survival (p<0.01). Poorly differentiated or signet ring cell carcinoma was less common in the screening group than in the diagnostic group (56.5% vs. 83.6%, p=0.006). The sex ratio, smoking status, family history of gastric cancer, Helicobacter pylori infection status, and tumor location were similar in the two groups.

Conclusions: Screening gastroduodenoscopy may enable the early detection of gastric cancer and prolong survival in patients <40 years of age.

키워드

Gastric cancer; Screening; Endoscopy; Young adult
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