It is important to remember that regular endoscopy can prevent cancer and detect cancer early. [인터뷰] : ZUM News

| [인터뷰] Director Kim Seok-won, an internal medicine specialist
| Pre-cancer and early cancer detection possible through stomach and colonoscopy
| Endoscopy should not be avoided because of vague fears.

Although the number of people undergoing gastroscopy is increasing due to the promotion of health examinations and the national cancer screening project, the incidence of stomach cancer and colon cancer per 100,000 people is still among the highest in the the world It is thought that the causes of stomach cancer are the food culture of eating spicy or salty foods often, or the habit of putting spoons in stews (although it has decreased a lot nowadays). Compared to the past, the habit of eating more fried foods is considered a factor that increases the risk of developing colon cancer.

Director Kim Seok-won, a specialist in internal medicine, said, “Today, the number of people undergoing gastroscopy and colonoscopy has increased significantly as a result of the national cancer screening project, but there are still many people who have a vague fear and avoid endoscopy. ” He added, “High-grade adenomas, which are in the pre-cancerous stage, are often found and removed, and are very helpful in early cancer screening.” We spoke to Director Kim about the importance of regular stomach exams and colonoscopies.

Q. What are the common stomach and colon problems found during health checkups?
In gastroscopy, esophagitis, gastric ulcer, duodenal ulcer, and Helicobacter positivity are found, and gastric adenoma and gastric cancer are found, which may become cancer in the future. In colonoscopy, colon polyps are the most common, and colon diverticulum, colon cancer, ulcerative colitis, and Crohn’s disease are not uncommon.
Q. How is the monitoring cycle determined, and can it change depending on the person’s health status?
National exams and gastroscopy are performed every two years, and colonoscopy is usually done every five years if there are no polyps. However, depending on family history, symptoms, and previous polyps, a gastroscopy can be done every year and a colonoscopy can be done every two years.

Q. Can you explain the advantages and disadvantages of endoscopy?
It is important to be able to treat the patient’s symptoms by evaluating and finding the direct cause of the patient’s symptoms and, if present, removing polyps. It is also true that there is a risk of side effects or endoscopic problems (bleeding perforation, etc.) in sleep endoscopy. However, the advantages far outweigh the disadvantages, so it must be done from time to time.

Q. Explain the polyps found during stomach and colonoscopy.
Proliferative polyps, fundic gastric adenomas, low-grade adenomas, and high-grade adenomas are mostly found in the stomach, and can be removed through endoscopic mucosal resection or endoscopic submucosal dissection. Colonoscopy also includes hyperplastic polyps, low-grade adenomas, and high-grade adenomas. Among these, low-grade adenomas and high-grade adenomas are lesions that can later turn into cancer, and in these cases, they can be removed through endoscopic mucosa. resection.

C. (Gastroscopy) During a gastroscopy, something called burning of the intestinal skin is found. What is gastric cancer and what is the risk of stomach cancer in the future? I am also curious about how the treatment will proceed.
Intestinal metaplasia refers to the change of gastric mucosal tissue to the form of intestinal mucosa as chronic gastritis progresses and is one of the risk factors for gastric cancer. Atrophic gastritis and intestinal metaplasia result from chronic gastritis after Helicobacter pylori infection and are factors that increase the risk of gastric cancer. Helicobacter pylori infection is a well-known factor that increases the risk of gastric cancer, and atrophic gastritis and intestinal metaplasia, which are the result of chronic gastritis caused by Helicobacter pylori, are also independent factors that increase the risk of gastric cancer. .

Atrophic gastritis and intestinal metaplasia increase the risk of developing gastric cancer by 6- and 10-fold, respectively. Therefore, it is very important to manage atrophic gastritis and intestinal metaplasia through diagnosis and evaluation.

Q. (Gastroscopy) If Helicobacter pylori is found, does the possibility of stomach cancer increase? So how is elimination treated?
Helicobacter pylori infection is associated with stomach cancer. Not all carriers develop stomach cancer, but it increases the risk of developing it. Ulcers are usually treated using a combination of antibiotics and stomach acid suppressants to eradicate the infection.

Q. (Colonoscopy) You said that among polyps, low-grade and high-grade adenomas are the ones that can cause colon cancer.
Low-grade adenoma and high-grade adenoma are types of colon polyps, and these are adenomas with a high risk of malignant transformation. Low-grade adenomas are in the low-risk group, but high-grade adenomas have obvious cell changes, greatly increasing the risk of developing colon cancer.

Q. (Colonoscopy) Can a high-grade adenoma, which can be cancerous, be treated simply by removing it? What are the preventive measures in the future?
Removing both low-grade and high-grade adenomas will reduce the likelihood that they will develop into cancer. In the future, it can be prevented through regular colonoscopy, healthy eating habits, and exercise.

Q. Can we reduce patients’ vague fear of endoscopy?
I know the biggest fear is about taking bowel preparations during a colonoscopy. However, recently, in order to reduce this inconvenience, there are tablets and tablets with a significantly reduced capacity (1.38L) from the existing 3-4L, making it easier to take .

Q. Is it true that it is safer to undergo a non-sleep endoscopy than a sleep endoscopy?
It is true that non-sleep endoscopy is safer than sleep endoscopy. This is because side effects sometimes occur as a result of administering sleep-inducing drugs, but hospitals and research centers have an adequate patient monitoring system, so sleep endoscopy can be performed safely and effectively. comfortable

Q. What health advice do you usually give to your patients?
There are many cases where advanced adenomas, which are in the pre-cancerous stage, were found and removed through gastroscopy and colonoscopy. I would say that regular health checks are helpful in detecting cancer at an early stage, so it is essential. It is recommended that people over 50 get a colonoscopy, but in many cases, only a fecal test is done and no colonoscopy is done. However, as a doctor, I strongly recommend that you undergo a colonoscopy. If you continue to have regular endoscopy, cancer can be prevented.

Jeong Shin-young, Hidoc Health and Medical Reporter [email protected]

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