High prevalence of duodenal ulcer and gastric cancer in dyspeptic patients in Korea.
BACKGROUND
Although gastric cancer and duodenal ulcer are both related to Helicobacter pylori infection, they are mutually exclusive diseases such that patients with a history of duodenal ulcer have a markedly reduced risk of developing gastric cancer. It has been hypothesized that different strains of H. pylori may be related to the different diseases. Our aim was to study the prevalence of duodenal ulcer disease and gastric cancer in dyspeptic patients in South Korea, a country with a high incidence of gastric cancer.


METHODS
The study population consisted of consecutive patients between the ages of 20 and 81 years referred to Guro Hospital's Endoscopic Unit for evaluation of dyspepsia. Patients with a history of peptic ulcer or gastric cancer were excluded. Each patient underwent endoscopy and completed a detailed questionnaire. Peptic ulcer was defined as the presence of an active ulcer, red scar, or white scar.


RESULTS
One thousand patients were evaluated, and 867 (43% men and 57% women) met the entry criteria. The prevalence of peptic ulcer and gastric cancer were 24% and 7%, respectively. Among peptic ulcer patients, duodenal ulcer was commoner (75%) than gastric ulcer or coexistent duodenal and gastric ulcer (21% and 4%, respectively). The mean age of duodenal and gastric ulcer patients (45 +/- 14 and 48 +/- 12 years, respectively) was significantly lower than that of gastric cancer patients (59 +/- 11 years) (P < 0.01). Only 44 (7%) of the 597 remaining patients had definite endoscopic abnormalities (for example, erosive esophagitis, duodenitis, or pyloric deformity).


CONCLUSIONS
Gastric cancer and duodenal ulcer were prevalent diagnoses among Korean patients undergoing endoscopy for evaluation of dyspepsia. Korea may be the ideal country to investigate the relation between specific H. pylori strains and different H. pylori diseases.
Malaty
H M
HM
Dept. of Medicine, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Kim
J G
JG
El-Zimaity
H M
HM
Graham
D Y
DY
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004384:Duodenoscopy; D004415:Dyspepsia / Q000150:complications*; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology