FUNDAMENTALS OF GASTROINTESTINAL ENDOSCOPIC SCREENING AND ISSUES CONCERNING THE ACCURACY MANAGEMENT OF POPULATION-BASED AND WORKPLACE CANCER SCREENING

Abstract

The gastrointestinal endoscopic screening was recently approved for implementation as a population-based gastric cancer screening in 2016. However, in the case of population-based gastric endoscopic screening, forceps biopsy, which is conducted subsequently while screening, is treated as a precision examination and double-checking of recorded images is mandatory. This causes significant confusion for clinicians participating in the screening. The complexity of the screening algorithm compared to other screening methods is a major problem for accuracy control. Concerning workplace-cancer screening, which plays a central role in cancer screening for the working age population, standardization of screening programs, equalization of testing accuracy, and development of an accuracy management infrastructure have not progressed. For gastrointestinal endoscopic screening, the accuracy management infrastructure should be developed to enable unified data management in the future, aiming to realize organized gastric cancer screening that combines regional and occupational cancer screening. Screening-certified physicians who know the difference between medical treatment and screening are expected to play a key role in making gastric endoscopic screening more accurate and precise in general.