The impact of endoscopy in upper gastrointestinal tract cancer screening programs

Upper gastrointestinal tract cancers, notably esophageal and stomach cancers, continue to pose substantial public health challenges worldwide, despite advancements in diagnostic techniques. Predominantly diagnosed in later stages (III-IV) in over 60% of cases, these cancers have a notably poor prognosis. Early detection through screening programs is critical to improving treatment outcomes and reducing mortality rates. Given the significant regional variations in the incidence and mortality rates of these cancers, a tailored approach to screening is necessary. Objective. This review evaluates the efficacy of prominent endoscopic screening strategies for esophageal and gastric cancer across different global regions. Key points. Endoscopy stands as the cornerstone for early detection of cancer and pre-cancerous states in the upper gastrointestinal tract. Due to varying disease incidence and mortality rates across regions, screening strategies must be adapted to local needs. This article provides a detailed analysis of national screening programs in countries with high incidences, such as Japan, South Korea, and China, evaluating their clinical outcomes and cost-effectiveness. Conclusion. Customizing screening programs for gastric and esophageal cancers to fit the demographic and epidemiological profiles of specific regions can greatly enhance health outcomes and optimize resource use. The ongoing emphasis on early detection through endoscopy is essential for reducing the mortality associated with upper gastrointestinal tract cancers, thereby affirming the value of these targeted screening efforts.