HIGH PREVALENCE OF DUODENAL-ULCER AND GASTRIC-CANCER IN DYSPEPTIC PATIENTS IN KOREA

Background: Although gastric cancer and duodenal ulcer are both relate d to Helicobacter pylori infection, they are mutually exclusive diseas es such that patients with a history of duodenal ulcer have a markedly reduced risk of developing gastric cancer. It has been hypothesized t hat different strains of H. pylori may be related to the different dis eases. Our aim was to study the prevalence of duodenal ulcer disease a nd gastric cancer in dyspeptic patients in South Korea, a country with a high incidence of gastric cancer. Methods: The study population con sisted of consecutive patients between the ages of 20 and 81 years ref erred to Guro Hospital's Endoscopic Unit for evaluation of dyspepsia. Patients with a history of peptic ulcer or gastric cancer were exclude d. Each patient underwent endoscopy and completed a detailed questionn aire. Peptic ulcer was defined as the presence of an active ulcer, red scar, or white scar. Results: One thousand patients were evaluated, a nd 867 (43% men and 57% women) met the entry criteria. The prevalence of peptic ulcer and gastric cancer were 24% and 7%, respectively. Amon g peptic ulcer patients, duodenal ulcer was commoner (75%) than gastri c ulcer or coexistent duodenal and gastric ulcer (21% and 4%, respecti vely). The mean age of duodenal and gastric ulcer patients (45 +/- 14 and 48 +/- 12 years, respectively) was significantly lower than that o f gastric cancer patients (59 +/- 11 years) (P < 0.01). Only 44 (7%) o f the 597 remaining patients had definite endoscopic abnormalities (fo r example, erosive esophagitis, duodenitis, or pyloric deformity). Con clusion: Gastric cancer and duodenal ulcer were prevalent diagnoses am ong Korean patients undergoing endoscopy for evaluation of dyspepsia. Korea may be the ideal country to investigate the relation between spe cific H. pylori strains and different H. pylori diseases.