Abstract
Aims. Gastric cancer is the second most prevalent cancer and the third leading cause of cancer-related deaths in Korea. The National Cancer Screening Program (NCSP) has implemented esophagogastroduodenoscopy (EGD) biennially for all Koreans starting in their 40s. This study was conducted to estimate the clinical relevance of NCSP through identifying the prevalence of gastric disease, including cancer. Materials and Methods. Data from 40,821 subjects who received the screening EGD in the single center for 7 years were retrospectively investigated. Results. The overall prevalence of nonatrophic/atrophic/metaplastic gastritis, peptic ulcer, adenoma, early gastric cancer (EGC), and advanced gastric cancer (AGC) was 44.28%, 27.97%, 14.95%, 0.59%, 0.43%, 0.21%, and 0.09%, respectively. The prevalence of metaplastic gastritis, peptic ulcer, adenoma, EGC, and AGC was significantly higher in men than in women. The prevalence of preneoplastic/neoplastic disease significantly increased with age. Judged from the ratio of EGC to AGC, the proportion of EGC made up to 70% of all cancers. Conclusions. Screening endoscopy starting for people in their 40s should be strongly recommended for the elderly. Through the NCSP, the early detection of gastric cancer might contribute to the decreased mortality rate due to gastric cancer in Korea.
Highlights
Gastric cancer is the second most common cancer in Korea [1]
Progression of gastric cancer is influenced by environmental factors, such as Helicobacter pylori (H. pylori) infection, smoking, alcohol consumption, salt intake, and consumption of smoked or burnt food, all of which affect the progression of atrophic gastritis, intestinal metaplasia, dysplasia, and adenocarcinoma [6, 7]
Gastric diseases were categorized as nonatrophic gastritis, atrophic gastritis, metaplastic gastritis, adenoma, Early gastric cancer (EGC), advanced gastric cancer (AGC), peptic ulcer, and others
Summary
Gastric cancer is the second most common cancer in Korea [1]. With the introduction of the National Cancer Screening Program (NCSP), all Koreans receive an esophagogastroduodenoscopy (EGD) or an upper gastrointestinal series biennially, starting at 40 years old. The idea behind the NCSP was that early detection of gastric cancer at a curable stage could eventually reduce mortality rates in Korea due to the disease. Gastric cancer (EGC) can be completely cured with endoscopic submucosal dissection (ESD) and laparoscopic gastrectomy [2,3,4]. Progression of gastric cancer is influenced by environmental factors, such as Helicobacter pylori (H. pylori) infection, smoking, alcohol consumption, salt intake, and consumption of smoked or burnt food, all of which affect the progression of atrophic gastritis, intestinal metaplasia, dysplasia, and adenocarcinoma [6, 7]. The aim of this study was to investigate the distribution of gastric diseases (atrophic gastritis, intestinal metaplasia, dysplasia, and gastric cancer) and the prevalence of EGC and AGC
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