진행성위암의 위험요인을 파악하고 조기검진의 효과를 평가하고자 2007년 6월부터 2011년 12월까지 대전 소재 1개 대학교병원에서 위암으로 최초 진단과 수술을 받은 조기위암 171명과 진행성위암 환자 342명, 총 580명을 대상으로 설문조사와 의무기록 조사를 실시하였다. 두 군간에 카이제곱 검정과 로지스틱 회귀분석으로 교차비를 계산한 결과 진행성위암은 조기위암에 비하여 70세 이상에서(OR 2.393; 95%CI 1.329-4.310), 과거 흡연자(OR 1.612; 95%CI 0.970-2.680), 혈액형 A형(OR 1.784; 95%CI 1.035-3.075) 및 H. pylori균 감염(OR 1.699; 95%CI 0.905-3.191)에서 상대적으로 높았다. 또한 체중감소(OR 2.752; 95%CI 1.333-5.684)와 소화불량(OR 1.574; 95%CI 1.069-2.319)이 중요한 증상과 징후였다. 조기진단의 효과는 파악할 수 없었지만 조기진단이 성공적인 치료의 기회를 높이고 생존율을 향상시킨다는 것을 감안할 때 집단을 대상으로 조기검진을 고취시키는 교육과 선별검사가 요구된다.
To study the risk factors and effect of gastric cancer screening, case-control study was conducted. From June 2007 to December 2011, 580 newly diagnosed gastric cancer (342 advanced gastric cancer, 171 early gastric cancer) patients were enrolled at the department of general surgery in a university hospital. History of gastric examinations and possible risk factors were collected through interviews with structured questionnaire and reviewed medical chart. Comparing advanced cancer and early gastric cancer were analysed by chi-square test and logistic regression. The results showed that aged 70 and over (OR 2.393; 95%CI 1.329-4.310), Ex-smoker (OR 1.612; 95%CI 0.970-2.680), blood type A (OR 1.784; 95%CI 1.035-3.075), and H. pylori infection (OR 1.699; 95%CI 0.905-3.191) were important risk factors for advanced gastric cancer compared to early gastric cancer. Weight loss (OR 2.752; 95%CI 1.333-5.684) and indigestion (OR 1.574; 95%CI 1.069-2.319) were also important sign and symptom. Although the results cannot find effect of screening, national policies on early cancer detection must conduct.
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