The spread of upper gastrointestinal endoscopy in Japan and the United States. An international comparative analysis of technology diffusion.

The use of upper gastrointestinal (GI) fiberoptic endoscopy has spread at different times and rates in Japan than in the United States. Factors that explain this disparity and its effects on patient outcomes are reported. This essay outlines Japanese data in gastroenterology, giving an account of the resources and time that were spent on the development of upper GI endoscopy in Japan. It also draws implications for the assessment of endoscopy for populations at high risk for gastric cancer.