Korean J Gastrointest Endosc > Volume 34(2); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;34(2): 76-82.
장년 대장암 환자와의 비교를 통해 본 노인 대장암 환자의 특성
이형석* · 이석영 · 서지현 · 곽경근 · 정수진 · 이광혁 · 박영수 · 황진혁 · 김진욱 · 정숙향 · 김나영 · 이동호 · 정현채 · 송인성
서울대학교 의과대학 내과학교실 및 간연구소, *서울적십자병원 내과
Characteristics of Colorectal Cancer in Elderly Patients in Comparision with Younger Patients
Hyung Suk Lee, M.D.*, Seokyoung Lee, M.D., Ji-Hyun Seo, M.D., Kyeng Kunn Kwack, M.D., Su Jin Chung, M.D., Kwang Hyuck Lee, M.D., Young-Soo Park, M.D., Jin-Hyeok Hwang, M.D., Jin-Wook Kim, M.D., Sook Hyang Jung, M.D., Nayoung Kim, M.D., Dong Ho Lee, M.D.,
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, *Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea

Considering the increasing age of the general population and the incidence of colorectal cancer (CRC), this study examined the characteristics of CRC in the aged, by comparing the clinical, endoscopic and histologic findings of CRC of younger and old patients.
The records of 232 patients diagnosed with CRC from March 2003 to September 2004 were reviewed retrospectively. Two cohorts based on age, under and over 65 years, were compared for the patient and tumor characteristics.
The bowel habit change was significant (p=0.018) and there was a high prevalence of hematochezia in the older patients. The rate of cancer detection via a routine checkup was higher in the younger patients (p=0.015). The incidence of right colon cancer increased with age, and substantially higher in females. More older patients had Dukes stage C disease (p=0.007), while more younger patients had stage D (p=0.022). The incidence of metastasis was high in those with right colon cancer (p=0.009), and significantly higher in female. In females, high-risk tumor such as mucinous or signet-ring was more common in the older patients. The older patients had significantly low CEA levels in the advanced stage. Synchronous CRC was more common in the older patients (8.1% vs. 3.4%) and was located within the adjacent segment.
CRC must be considered when older patients present with changes in their bowel habits or hematochezia. The right colon must be examined closely in older patients, particularly in females. A metastasis should be checked in right colon cancer, particularly in females. In older patients, advanced disease should be considered even in those with a low CEA level, and synchronous CRC must be searched for in the same or adjacent segment to that of the primary cancer.
Key Words: Colorectal cancer, Old age
주요어: 대장암, 노인
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