간암의 조기 진단을 위한 검진대상

Despite the lack of evidence that screening for hepatocellular carcinoma (HCC) is of benefit in reducing mortality, it has widely accepted by gastroenterologist in the area where the prevalence of HCC is high. We reviewed the articles related to the epidemiology of HCC which had been reported in the 1990s in Korea. We also tried to select the patients in whom screening may be effective. Liver cirrhosis increases the risk of HCC about 6 folds. Among cirrhotics, HBV and HCV-related cirrhosis and alcoholic cirrhosis comprised more than 95% of patients with HCC in the 1990s in Korea. In chronic hepatitis B, the risk of HCC increases over the age of 30 in male and the age of 40 in female. In chronic hepatitis C, the risk of HCC is mainly limited to those who have established cirrhosis, but there is minimum risk under the age of 40 in both sex. Although ethanol is not considered as a carcinogen, cirrhotic change caused by chronic alcohol ingestion can be a risk of HCC. (Korean J Gastroenterol 2001;38:313-318)