Published online Apr 7, 2022. doi: 10.3748/wjg.v28.i13.1377
Peer-review started: September 25, 2021
First decision: November 7, 2021
Revised: November 23, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: April 7, 2022
Gastric cancer is widespread globally, and disease diagnosis is accompanied by high mortality and morbidity rates. However, prognoses and survivability have improved following implementation of surveillance and screening programs, which have led to earlier diagnoses. Indeed, early diagnosis itself supports increased surgical curability, which is the main treatment goal and guides therapeutic choice. The most recent Japanese guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer consider the degree of endoscopic curability in relation to the characteristics of the gastric lesions. In clinical practice, the management approach for both prevention and treatment should be similar to that of colon lesions; however, unlike the established practices for colorectal cancer, the diagnostic and therapeutic pathways are not shared nor widespread for gastric cancer. Ultimately, this negatively impacts the opportunity to perform an endoscopic resection with curative intent.
Core Tip: Gastric cancer accounted for 5.6% of all new global cancer cases in 2020 and 7.7% of all cancer deaths. It’s generally high mortality and morbidity rates highlight the need for early detection, to increase the curability of surgical treatment. In countries where gastric cancer screening programs exist, endoscopic curability is possible because gastroscopy with magnification and chromoendoscopy can detect gastric lesions at an early stage. It is necessary to support screening programs more widely to achieve the successful implementation of the common strategies of prevention, diagnosis and treatment, thereby reducing the incidence of advanced gastric cancer around the world.