title: Basic principles and practice of gastric cancer screening using high-definition white-light gastroscopy: Eyes can only see what the brain knows.
abstract: Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: (i) detection; (ii) differential diagnosis; and (iii) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make a diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an early-stage 'superficial lesion' looks like. In recent years, image-enhanced endoscopy has become common, but white-light endoscopy (WLI) is still the first step for detection and characterization of lesions in general clinical practice. Settings and practice of routine esophagogastroduodenoscopy (EGD) such as use of antispasmodics, number of endoscopic images taken, and observational procedure are customarily decided in each facility in each country and are not well standardized. Therefore, in the present article, we attempted to outline currently available evidence and actual Japanese practice on gastric cancer screening using WLI, and provide tips for detecting EGC during routine EGD which could become the basis of future research.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.affiliation: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
authors.forename: Noriya
authors.initials: N
authors.lastname: Uedo
authors.affiliation: Endoscopy Division, National Cancer Center Central Hospital, Tokyo, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yoshinaga
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Kobe Hospital, Sapporo, Japan.
authors.forename: Tokuma
authors.initials: T
authors.lastname: Tanuma
authors.affiliation: Department of Gastroenterology, Kobe University School of Medicine, Kobe, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.affiliation: Depatment of Medicine and Bioregulatory Science, Graduate School of Science, Kyushu University, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Aso
authors.affiliation: Cancer Institute Hospital of the Japanese Foundation of Cancer Research, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hirasawa
authors.affiliation: Endoscopy division, Department of Gastroterology, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.affiliation: Department of Gastroenterology, Kochi Red Cross Hospital, Kochi, Japan.
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Uchita
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Shiaw-Hooi
authors.initials: SH
authors.lastname: Ho
authors.affiliation: Department of Gastroenterology and Hepatology, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Ping-Hsin
authors.initials: PH
authors.lastname: Hsieh
mesh_terms: D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D013274:Stomach Neoplasms / Q000175:diagnosis*
keywords: Helicobacter pylori; Kimura-Takemoto classification; gastric atrophy; gastric cancer; screening gastroscopy