Characteristics of Gastric Cancer in Korea - with an Emphasis on the Increase of the Early Gastric Cancer (EGC)

Article information

J Korean Med Assoc. 2010;53(4):283-289
Publication date (electronic) : 2010 April 30
doi : https://doi.org/10.5124/jkma.2010.53.4.283
Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. stomachlee@skku.edu

Abstract

Gastric cancer is the most common malignancy and the second leading cause of cancer-related death in Korea. Age-adjusted annual incidence of gastric cancer per 100,000 persons is 62.8 for male and 25.7 for female. The proportion of early gastric cancer among surgically treated gastric cancer patients was 28.6% in 1995, 32.8% in 1999, and 47.4% in 2004. Screening upper endoscopy is quite commonly performed in Korea, and the proportion of early gastric cancer in the screened population is almost 75%. Gastric adenoma is considered to be a very important precancerous lesion. Gastric adenomas are actively treated in Korea, and at least 1/3 of the gastric adenomas with high grade dysplasia show cancerous focus when endoscopically resected. The prevalence of Helicobacter pylori is decreasing in Korean population, which may lead to the decreased incidence of gastric cancer in the near future. Paradigms of the diagnosis and treatment of gastric cancer are rapidly changing in Korea. Efforts to establish robust scientific data for new approaches are strongly required. The proportion of early gastric cancer among all gastric cancers has been and will be more increased in Korea.

References

1. Park IS, LEE YC, Kim WH, Noh SH, Lee KS, Kim H. Clinicopathologic characteristics of early gastric cancer in Korea. Yonsei Med J 2000. 41607–614.
2. Seo J, Kim N, Lee D, Kim J, Hwang J, Park YS, Seo J, Kim N, Lee D, Kim J, Hwang J, Park YS, Kim SM, Kim HH, Park RY, Lee KS, Jung HC, Song IS. Clinical features and recent treatment trend of gastric cancer. Korean J Med 2006. 71149–157.
3. Park JI, Jin SH, Bang HY, Paik NS, Moon NM, Lee JI. Survival rates after operation for gastric cancer: fifteen-year experience at a Korea cancer center hospital. J Korean Gastric Cancer Assoc 2008. 89–19.
4. Cho J, Jang Y, Kim J, Park S, Park S, Mok Y. Results of surgical treatment for primary gastric adenocarcinoma-single institute experience for 14 Years. J Korean Gastric Cancer Assoc 2009. 9193–199.
5. Kong SH, Park DJ, Lee HJ, Jung HC, Lee KU, Choe KJ, Yang HK. Clinicopathologic features of asymptomatic gastric adenocarcinoma patients in Korea. Jpn J Clin Oncol 2004. 341–7.
6. Korean Gastric Cancer Association. 2004 nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2007. 747–54.
7. Lee HJ, Chung JM, Seo EH, Jeon SW. Clinicopathologic characteristics of gastric cancer diagnosed at health screening. Korean J Med 2008. 75665–672.
8. Jung HC. Gastric cancer screening. Korean J Gastroenterol 2003. 4172–78.
9. Hisamichi S, Sugawara N, Fukao A. Effectiveness of gastric mass screening in Japan. Cancer Detect Prev 1988. 11323–329.
10. Kim JJ, Lee JH, Jung HY, Lee GH, Cho JY, Ryu CB, Chun HJ, Park JJ, Lee WS, Kim WS, Kim HS, Chung MG, Moon JS, Choi SR, Song GA, Jeong HY, Lee SR, Seol SY, Yoon YB. EMR for early gastric cancer in Korea: a multicenter retrospective study. Gastrointest Endosc 2007. 66693–700.
11. Choi IJ. Gastric cancer screening and diagnosis. Korean J Gastroenterol 2009. 5467–76.
12. Kim N, Lee SW, Cho SI, Park CG, Yang CH, Kim HS, Rew JS, Moon JS, Kim S, Park SH, Jung HC, Chung IS. The prevalence of and risk factors for erosive oesophagitis and non-erosive reflux disease: a nationwide multicentre prospective study in Korea. Aliment Pharmacol Ther 2008. 27173–185.
13. Oshima A, Hanai A, Fujimoto I. Evaluation of a mass screening program for stomach cancer. Natl Cancer Inst Monogr 1979. 53181–186.
14. Hisamichi S, Sugawara N. Mass screening for gastric cancer by X-ray examination. Jpn J Clin Oncol 1984. 14211–223.
15. Matsumoto S, Yamasaki K, Tsuji K, Shirahama S. Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital, Nagasaki Prefecture. World J Gastroenterol 2007. 134316–4320.
16. Hansson LE, Lindgren A, Nyren O. Can endoscopic biopsy specimens be used for reliable Lauren classification of gastric cancer? Scand J Gastroenterol 1996. 31711–715.
17. Palli D, Bianchi S, Cipriani F, Duca P, Amorosi A, Avellini C, Russo A, Saragoni A, Todde P, Valdes E. Reproducibility of histologic classification of gastric cancer. Br J Cancer 1991. 63765–768.
18. Park DI, Rhee PL, Kim JE, Hyun JG, Kim YH, Son HJ, Kim JJ, Paik SW, Rhee JC, Choi KW, Oh YL. Risk factors suggesting malignant transformation of gastric adenoma: univariate and multivariate analysis. Endoscopy 2001. 33501–506.
19. Parsonnet J. The incidence of Helicobacter pylori infection. Aliment Pharmacol Ther 1995. 9S2. 45–51.
20. Pounder RE, Ng D. The prevalence of Helicobacter pylori infection in different countries. Aliment Pharmacol Ther 1995. 9S2. 33–39.
21. Kim JH, Kim HY, Kim NY, Kim SW, Kim JG, Kim JJ, Roe IH, Seo JK, Sim JG, Ahn H, Yoon BC, Lee SE, Lee YC, Chung IS, Jung HY, Hong WS, Choi KW. Seroepidemiological study of Helicobacter pylori infection in asymptomatic people in South Korea. J Gastroenterol Hepatol 2001. 16969–975.
22. Yim JY, Kim N, Choi SH, Kim YS, Cho KR, Kim SS, Seo GS, Kim HU, Baik GH, Sin CS, Cho SH, Oh BH. Seroprevalence of Helicobacter pylori in South Korea. Helicobacter 2007. 12333–340.
23. International Agency for Research on Cancer Working Group on the evaluation of carcinogenic risks to humans. Infection with Helicobacter pylori. In Schistosomes. Liver Flukes and Helicobactor pylori 1994. Lyon: International Agency for Research on Cancer;
24. Miwa H, Go MF, Sato N. H. pylori and gastric cancer: the Asian enigma. Am J Gastroenterol 2002. 971106–1112.
25. Tajima K. Challenging epidemiological strategy for paradoxical evidence on the risk of gastric cancer from Helicobacter pylori infection. Jpn J Clin Oncol 2002. 32275–276.
26. Lee MS, Oh HT, Hwang EC, Roe IH, Chin YJ, Lim CY, Kim JW, Lee HS, Lee JH, Song IH, Cho CH. Helicobacter pylori and expression of p53 protein in gastric cancer. Korean J Gastroenterol 1999. 33615–623.
27. Kim HY, Cho BD, Chang WK, Kim DJ, Kim YB, Park CK, Shin HS, Yoo JY. Helicobacter pylori infection and the risk of gastric cancer among the Korean population. J Gastroenterol Hepatol 1997. 12100–103.
28. Sung JW, YooK EJ, Im EH, Kim BH, Lee KC, Heo SS, Jeong HY, Lee HY, Kim YK. Prevalence of helicobacter pylori infection in peptic ulcer and gastric Cancer. Korean J Med 1993. 4577–82.
29. Yoon BC, Bae YH, Lim JH, Song CS, Park SJ, Ku JY. Serum pepsiongen I, II and antibody of H. pylori in gastric cancer. Korean J Med 1996. 51S2. 9.
30. Chang JD, Lee SM. Helicobacter pylori infection and gastric carcinoma in Korean. J Cathol Med Coll 1994. 47495–504.
31. Kang HJ, Jung IS. Helicobacter pylori infection and gastric adenocarcionma in Korean; prevalence and distribution of H.pylori in resected specimen of gastric cancer. J Cathol Med Coll 1992. 45849–863.
32. Chang KH, Park HJ, Lee SI, Kang JK, Park IS, Moon YM, Lee YC, Kim HK. P53 immunoexpression on relation to Helicobacter pylori infection in gastric adenocarcinoma. Korean J Gastroenterol 1996. 28S2. 156.
33. Park SH, Jun IS, Chae HS. H. pylori infection and gastric distribution in gastric adenocarcinoma. Korean J Med 1992. 44S1. 145.
34. Cho KS, Lee OY, Han DS. Prevalence of H. pylori IgG antibody. Korean J Med 1996. 51S1. 167.
35. Lee JH, Chun SY, Ham HY, Yoon JI, Whang SB, Woon TJ, Shin WC, Kim KY. The influence of Helicobacter pylori on the development of gastric cancer. Korean J Med 1993. 45187–193.
36. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991. 2651287–1289.
37. Brown LM, Devesa SS. Epidemiologic trends in esophageal and gastric cancer in the United States. Surg Oncol Clin N Am 2002. 11235–256.
38. Lee JY, Kim HY, Kim KH, Jang HJ, Kim JB, Lee JH, Kim DJ, Kim YB, Kim WJ, Yoo JY. No changing trends in incidence of gastric cardia cancer in Korea. J Korean Med Sci 2003. 1853–57.
39. Sim YK, Kim CY, Jeong YJ, Kim JH, Hwang Y, Yang DH. Changes of the clinicopathological characteristics and survival rates of gastric cancer with gastrectomy-1990s vs early 2000s. J Korean Gastric Cancer Assoc 2009. 9200–206.
40. Lee CH, Lee SI, Ryu KW, Mok YJ. Chronological changes in the clinical features of gastric cancer. J Korean Surg Soc 2002. 63298–304.
41. Park MW, Bae JM, Kim SW, Kim SW, Song SK. Annual change of clinicopathologic characteristics after radical gastrectomy due to gastric cancer. J Korean Surg Soc 2009. 7788–95.
42. Henson DE, Dittus C, Younes M, Nguyen H, Albores-Saavedra J. Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. Arch Pathol Lab Med 2004. 128765–770.
43. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol 2006. 12354–362.
44. Kim YJ, Lee CH, Paik WH, Kim N, Park YS, Jung SH, Hwang JH, Lee KH, Jung HC, Song IS, Kim HH, Lee HS, Lee DH. Clinical and pathologic characteristics of gastric cancer in elderly Korean patients. Korean J Med 2007. 72256–265.
45. Park JI, Jin SH, Bang HY, Paik NS, Moon NM, Lee JI. Survival rates after operation for gastric cancer: fifteen-year experience at a Korea Cancer Center Hospital. J Korean Gastric Cancer Assoc 2008. 89–19.
46. Jung IM, Kong SH, Suh JS, Kim YC, Heo SC, Ahn YJ, Kim SJ, Kwon OJ, Chung JK. Chronological changes of gastric cancer in community hospital. J Korean Surg Soc 2004. 6736–40.
47. Inoue M, Tsugane S. Epidemiology of gastric cancer in Japan. Postgrad Med J 2005. 81419–424.
48. Korean Gastric Cancer Association. Nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2002. 2105–114.
49. Seo SH, Kim CK, Park BH, Hwang KC, Min KS. 5 survival rate after gastrectomy of gastric cancer. J Korean Surg Soc 1963. 5447–478.
50. Noh SH, Yoo CH, Kim YI, Kim CB, Min JS, Lee KS. Results after a gastrectomy of 2,603 patients with gastric cancer: analysis of survival rate and prognostic factor. J Korean Surg Soc 1998. 55206–213.
51. Kim JP, Lee JH, Kim SJ, Yu HJ, Yang HK. Clinicopathologic characteristics and prognostic factors in 10,783 patients with gastric cancer. Gastric Cancer 1998. 1125–133.
52. Yamamoto M, Yamanaka T, Baba H, Kakeji Y, Maehara Y. The postoperative recurrence and the occurrence of second primary carcinomas in patients with early gastric carcinoma. J Surg Oncol 2008. 97231–235.
53. Lundegardh G, Hansson LE, Nyren O, Adami HO, Krusemo UB. The risk of gastrointestinal and other primary malignant diseases following gastric cancer. Acta Oncol 1991. 301–6.
54. Yoshino K, Asanuma F, Hanatani Y, Otani Y, Kumai K, Ishibiki K. Multiple primary cancers in the stomach and another organ: frequency and the effects on prognosis. Jpn J Clin Oncol 1985. 15S1. 183–190.
55. Bearzi I, Ranaldi R. Multifocal early gastric cancer: morphology and histogenesis. Pathol Res Pract 1986. 181144–147.
56. Kosaka T, Miwa K, Yonemura Y, Urade M, Ishida T, Takegawa S, Kamata T, Ooyama S, Maeda K, Sugiyama K. A clinicopathologic study on multiple gastric cancers with special reference to distal gastrectomy. Cancer 1990. 652602–2605.
57. Morita M, Kuwano H, Baba H, Taketomi A, Kohnoe S, Tomoda H, Araki K, Saeki H, Kitamura K, Sugimachi K. Multifocal occurrence of gastric carcinoma in patients with a family history of gastric carcinoma. Cancer 1998. 831307–1311.
58. Kim HJ, Lee JH, Lee JS, Moon TG, Kim JJ, Rhee JC, Noh JH, Sohn TS, Kim S. Clinicopathologic characteristics of multiple synchronous early gastric cancers. Korean J Med 2007. 72360–367.
59. Ryu DD, Um JW, Son GS, Cho MY, Song TJ, Kim CS, Mok YJ, Kim SJ. Multiple primary malignant tumors in patients with gastric cancer. J Korean Gastric Cancer Assoc 2003. 3139–144.
60. Eom BW, Lee HJ, Yoo MW, Cho JJ, Kim WH, Yang HK, Lee KU. Synchronous and metachronous cancers in patients with gastric cancer. J Surg Oncol 2008. 98106–110.
61. Kim SJ, Baik GH, Youn KH, Song SW, Kim DJ, Kim JB, Min SK, Baek IH, Park CH, Jang HJ, Kae SH, Kim HY, Kim KH, Choi YH, Lee SJ, Jeong HJ. The crude incidence rate of stomach cancer in Chuncheon-si during 2000-2002. Korean J Med 2007. 73368–374.
62. Shin MH, Oh HK, Ahn YO. Ten year trend of cancer incidence in Seoul, Korea: 1993-2002. J Prev Med Public Health 2008. 4192–99.
63. Yang YJ, Bae JM. Survival Rates of the 5 major cancers in Jeju island residents, 2000-2001. J Prev Med Public Health 2007. 40213–217.
64. Lee SJ, Shin MH, Choi JS. A Study on the incidence of cancer and evaluationg the quality of the community-based cancer registry in Gwangju Metropolitan City during the first five years of implementation (1998-2002). J Prev Med Public Health 2006. 39255–262.

Article information Continued