Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 27, Issue 31, Pages 5126-5151Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v27.i31.5126
Keywords
Gastric cancer; Endoscopy; Endoscopic imaging; Endoscopic mucosal resection; Endoscopic submucosal dissection
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Gastric cancer is a significant global health concern, with effective screening and treatment strategies in high prevalence regions, but challenges remain in lower prevalence areas. Advances in endoscopic imaging and the potential of artificial intelligence are promising for improving detection and treatment of early gastric cancer.
Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality. The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage. In high prevalence regions such as Japan and Korea, this has led to the implementation of population screening programs. However, guidelines remain ambiguous in lower prevalence regions. In recent years, there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions. More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection. In addition, promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging. Data on endoscopic resection (ER) are particularly robust in Japan and Korea, with high rates of curative ER and markedly reduced procedural morbidity. However, there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries. Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER, as both technology and proceduralist expertise continue to grow.
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