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

Hyoung Ho Moon; Hyoun Woo Kang; Seong-Joon Koh; Ji Won Kim and Cheol Min Shin

doi:10.4166/kjg.2019.74.5.281

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Korean J Gastroenterol < Volume 74(5); 2019 < Articles

Korean J Gastroenterol 2019; 74(5): 281-290 https://doi.org/10.4166/kjg.2019.74.5.281

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

Hyoung Ho Moon, Hyoun Woo Kang

, Seong-Joon Koh¹, Ji Won Kim¹ and Cheol Min Shin²

Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang; Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine¹, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine², Seongnam, Korea

Correspondence to: Hyoun Woo Kang, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea. Tel: +82-31-961-7128, Fax: +82-31-961-9309, E-mail: gangmali@naver.com, ORCID: https://orcid.org/0000-0003-3431-0827

Received: July 10, 2019; Revised: October 10, 2019; Accepted: October 10, 2019; Published online: November 25, 2019.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.; Keywords: Gastric cancer; Screening; Endoscopy; Young adult