Basic principles and practice of gastric cancer screening using high-definition white-light gastroscopy: Eyes can only see what the brain knows.

Abstract Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: 1) detection, 2) differential diagnosis, and 3) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an early-stage " superficial lesion" looks like. In recent years, image-enhanced endoscopy (IEE) has become common, but white light endoscopy is still the first step for detection and characterization of lesions in general clinical practice. Settings and practice of routine esophagogastroduodenoscopy (EGD) such as use of antispasmodics, number of endoscopic images taken, and observational procedure are customary decided in each facility in each country and are not well-standardize. Therefore, in this paper, we attempted to outline currently available evidence and actual Japanese practice about gastric cancer screening using white light endoscopy, and provide knacks for detecting EGC during routine EGD which would become a basis of future research.