title: Differences in routine esophagogastroduodenoscopy between Japanese and international facilities: A questionnaire survey.
abstract: OBJECTIVE
  The mortality rate of gastric cancer (GC) is close to the incidence rate worldwide. However, in Korea and Japan, the mortality rate of GC is less than half of the incidence rate. We hypothesized that good-quality routine esophagogastroduodenoscopy (EGD) contributes to a high detection rate for early GC (EGC) and improves mortality in these countries.
  
  
  METHODS
  To clarify the differences in routine EGD, a questionnaire survey was conducted in 98 Japanese and 53 international institutions.
  
  
  RESULTS
  Prevalence of screening examination among routine EGD was higher in Japanese than in international institutions. Japanese endoscopists noted that endoscopic mucosal atrophy was the most significant risk factor for GC, whereas international endoscopists paid more attention to clinical information such as age, symptoms and family history. Antispasmodics, mucolytics and defoaming agents were used more frequently in Japanese institutions. The examination time was similar (mostly 5-10 min) between Japanese and international institutions. Japanese endoscopists took more pictures (>20 in almost all institutions) than international endoscopists (≤20 in two-thirds of institutions). In Japanese institutions, biopsy specimens were more frequently taken from areas of mucosal discoloration, unevenness or spontaneous bleeding rather than from obvious endoscopic lesions such as ulceration or polyps. In most Japanese institutions, one or two biopsy specimens were taken per lesion, compared with ≥three in international institutions.
  
  
  CONCLUSIONS
  There were some discrepancies between Japanese and international institutions for routine EGD. Thus, standardization is required for adequate risk assessment, proper techniques, and knowledge of endoscopic diagnosis of EGC.
authors: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
authors: Noriya
authors: N
authors: Uedo
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors: Takuji
authors: T
authors: Gotoda
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Shigetaka
authors: S
authors: Yoshinaga
authors: Department of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors: Tokuma
authors: T
authors: Tanuma
authors: Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Yoshinori
authors: Y
authors: Morita
authors: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors: Hisashi
authors: H
authors: Doyama
authors: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Fukuoka, Japan.
authors: Akira
authors: A
authors: Aso
authors: Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
authors: Toshiaki
authors: T
authors: Hirasawa
authors: Endoscopy Division, Department of Gastroenterology, National Cancer Center Hospital East, Kashiwa, Japan.
authors: Tomonori
authors: T
authors: Yano
authors: Department of Gastroenterology, Kochi Red Cross Hospital, Kochi, Japan.
authors: Norihisa
authors: N
authors: Uchita
authors: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Shiaw-Hooi
authors: SH
authors: Ho
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chimei Medical Center, Tainan, Taiwan.
authors: Ping-Hsin
authors: PH
authors: Hsieh
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D014943:Global Health; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: biopsy; early diagnosis; esophagogastroduodenoscopy; gastric cancer; gastrointestinal endoscopy