Optimizing early upper gastrointestinal cancer detection at endoscopy

Nat Rev Gastroenterol Hepatol. 2015 Nov;12(11):660-7. doi: 10.1038/nrgastro.2015.128. Epub 2015 Aug 11.


Survival rates for upper gastrointestinal cancers are poor and oesophageal cancer incidence is increasing. Upper gastrointestinal cancer is also often missed during examinations; a predicament that has not yet been sufficiently addressed. Improvements in the detection of premalignant lesions, early oesophageal and gastric cancers will enable organ-preserving endoscopic therapy, potentially reducing the number of advanced upper gastrointestinal cancers and resulting in improved prognosis. Japan is a world leader in high-quality diagnostic upper gastrointestinal endoscopy and the clinical routine in this country differs substantially from Western practice. In this Perspectives article, we review lessons learnt from Japanese gastroscopy technique, training and screening for risk stratification. We suggest a key performance indicator for upper gastrointestinal endoscopy with a minimum total procedure time of 8 min, and examine how quality assurance concepts in bowel cancer screening in the UK could be applied to upper gastrointestinal endoscopy and improve clinical practice.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Early Detection of Cancer / methods*
  • Endoscopy, Digestive System* / methods
  • Endoscopy, Digestive System* / standards
  • Gastrointestinal Neoplasms / pathology*
  • Humans
  • Practice Guidelines as Topic
  • Risk Assessment
  • Upper Gastrointestinal Tract*