Noriya Uedo1, Takuji Gotoda2, Shigetaka Yoshinaga3, Tokuma Tanuma4, Yoshinori Morita5, Hisashi Doyama6, Akira Aso7, Toshiaki Hirasawa8, Tomonori Yano9, Norihisa Uchita10, Shiaw-Hooi Ho11, Ping-Hsin Hsieh12. 1. Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan. 2. Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. 3. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. 4. Department of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan. 5. Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 6. Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan. 7. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Fukuoka, Japan. 8. Division of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan. 9. Endoscopy Division, Department of Gastroenterology, National Cancer Center Hospital East, Kashiwa, Japan. 10. Department of Gastroenterology, Kochi Red Cross Hospital, Kochi, Japan. 11. Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 12. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chimei Medical Center, Tainan, Taiwan.
Abstract
BACKGROUND AND AIM: 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. CONCLUSION: 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.
BACKGROUND AND AIM: 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. CONCLUSION: 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: Duc T Quach; Quy-Dung D Ho; Khien V Vu; Khanh T Vu; Huy V Tran; Nhan Q Le; Nguyen-Phuong N Tran; Thai H Duong; Minh C Dinh; Phuong K Bo; Xung V Nguyen; Quy N Bui; Canh D Tran; Tien T Dao; Huong M Duong Journal: Biomed Res Int Date: 2020-04-26 Impact factor: 3.411