Kim Jin-Jo
Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
J Gastric Cancer. 2018 Dec;18(4):328-338. doi: 10.5230/jgc.2018.18.e38. Epub 2018 Dec 13.
The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Although similar trends in the prevalence of GERD, obesity, and HP infection are observed in Asian countries after a time lag from Western countries, it is still uncertain if the prevalence of GEJAC in Asian countries is increasing, especially in Korea. The incidence of GERD in Korea is currently increasing; it was below 3% in the 1990s. The incidence of obesity in the Korean population is increasing owing to the adoption of westernized lifestyles, including food preferences, and the HP infection rate in Korea is known to be decreasing. Therefore, based on logical extrapolation of observations of Western countries, the incidence of GEJAC will increase in Korea. However, the proportion of GEJAC among other upper gastrointestinal malignancies in Korea appears to be currently unchanged compared with that in the 1990s. Presently, there is a lack of epidemiologic studies on this issue in this region; therefore, more studies are needed to clarify the characteristics of these tumors and to improve clinical outcomes for patients with these tumors.
近几十年来，西方国家胃食管交界腺癌（GEJAC）的发病率有所上升，同时食管腺癌（EAC）的发病率也在增加。胃食管反流病（GERD）、肥胖、吸烟、饮酒和幽门螺杆菌（HP）低感染率被认为是此类癌症的危险因素。在这些危险因素中，GERD和肥胖患病率的增加以及HP感染率的降低尤其值得关注，因为目前西方国家GEJAC的患病率正在上升。尽管在亚洲国家观察到GERD、肥胖和HP感染患病率的类似趋势，但比西方国家有一定滞后，目前仍不确定亚洲国家GEJAC的患病率是否在增加，尤其是在韩国。韩国GERD的发病率目前正在上升；在20世纪90年代低于3%。由于包括食物偏好在内的西方化生活方式的采用，韩国人群肥胖的发病率正在增加，并且已知韩国的HP感染率正在下降。因此，基于对西方国家观察结果的合理推断，韩国GEJAC的发病率将会增加。然而，与20世纪90年代相比，目前韩国GEJAC在其他上消化道恶性肿瘤中所占的比例似乎没有变化。目前，该地区缺乏关于这个问题的流行病学研究；因此，需要更多的研究来阐明这些肿瘤的特征，并改善这些肿瘤患者的临床结局。
