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Effect of endoscopic screening at 1‐year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea
Author(s) -
Yoon Hyuk,
Kim Nayoung,
Lee Hye Seung,
Shin Cheol Min,
Park Young Soo,
Lee Dong Ho,
Park Do Joong,
Kim Hyung Ho,
Jung Hyun Chae
Publication year - 2012
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.07038.x
Subject(s) - medicine , cancer , intestinal metaplasia , population , helicobacter pylori , gastritis , gastroenterology , environmental health
Background and Aim: The recommended interval of endoscopic screening for gastric cancer (GC) in a general population is 2 years in Korea. However, it has not been determined whether endoscopic screening with a shorter interval is beneficial, especially for high‐risk groups. Methods: A total of 415 patients with GC were categorized according to whether they had (vigilant screening group) or not (non‐vigilant screening group) undergone endoscopic screening within 1 year before being diagnosed with GC. Clinicopathologic GC characteristics of the two groups were compared. Next, the same analyses were conducted in subgroups of patients with high risk for GC including males, current smokers, first‐degree relatives of GC; and patients with Helicobacter pylori infection, gastric atrophy, or intestinal metaplasia (IM). Results: The proportion of vigilant screening patients was 36.1%. Early gastric cancer (EGC) was more frequently observed in the vigilant screening group than the non‐vigilant screening group (62.7% vs 49.4%, P = 0.009). In the high‐risk factor analyses, EGC was more frequently detected among patients with severe IM in the vigilant screening group than the non‐vigilant screening group (66.7% vs 35.5%, P = 0.047). In addition, more patients in the vigilant screening group had undergone endoscopic submucosal dissection (ESD; 26.7% vs 0%, P = 0.008) and had stage I (84.6% vs 41.7%, P = 0.012) than in the non‐vigilant screening group. Conclusions: Endoscopic screening for GC at 1‐year intervals would be beneficial for patients with severe IM in South Korea; this method could detect EGC for which the curative modality would be ESD.