Abstract Gastric cancer remains a major global health concern, with Asia bearing the highest disease burden. India ranks third in new gastric cancer cases after China and Japan and second in gastric cancer–related mortality in the region. Early detection markedly improves survival and enables minimally invasive, organ-preserving treatment; however, the identification of early gastric cancer (EGC) is technically challenging. Accurate detection requires a high-quality endoscopic examination following a structured, stepwise approach that includes risk assessment, thorough mucosal cleansing, systematic inspection of the stomach, and targeted biopsy of suspicious areas. Once detected, lesions should be evaluated for histologic type, depth of invasion, and ulceration to guide management, including its suitability for endoscopic resection. In Indian clinical practice, early detection remains difficult due to wide regional variation in disease prevalence, high patient volume, unequal access to quality endoscopy, and low public and physician awareness. Nevertheless, improved training and adoption of standardized endoscopic practices can enhance detection rates even in resource-limited settings. This review highlights practical strategies for EGC detection and diagnosis while addressing India-specific challenges, underscoring the importance of structured training, quality assurance, and targeted screening to improve EGC outcomes nationwide.
Mohapatra et al. (Fri,) studied this question.