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Early detection of upper GI cancers depends on high-quality endoscopy and recognition of subtle lesion features. Endoscopists conducting surveillance in high-risk patients, including those with Barrett’s oesophagus, prior squamous neoplasia, and chronic atrophic gastritis, should master endoscopic features, classification systems, and sampling techniques. This review summarizes current diagnostic approaches and the latest advanced imaging and diagnostic methods.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/latest-advances-in-endoscopic-detection-of-oesophageal-and-gastric-neoplasia-review/331846/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/latest-advances-in-endoscopic-detection-of-oesophageal-and-gastric-neoplasia-review/331846.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is endoscopy considered the gold standard for oesophageal and gastric cancer diagnosis?","Question",{"text":112,"@type":113},"Endoscopy enables direct visualisation and provides sampling for histological confirmation, supporting accurate diagnosis of both cancers and precursor lesions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What is the role of surveillance in high-risk patients?",{"text":117,"@type":113},"Surveillance aims to detect cancer earlier by recognizing endoscopic features of precursors and applying appropriate classification systems and sampling techniques in patients such as those with Barrett’s oesophagus and chronic atrophic gastritis.",{"name":119,"@type":110,"acceptedAnswer":120},"What factors affect early detection during upper GI endoscopy?",{"text":121,"@type":113},"Detection depends on endoscopist performance and the quality of the procedure; diagnostic limitations can lead to missed cancers and detection rates vary across clinicians.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331846,1790191417,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":36},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","diagnostics  \nReview  \nLatest Advances in Endoscopic Detection of Oesophageal and Gastric Neoplasia  \nWilliam Waddingham 1, David G. Graham 2 and Matthew R. Banks 2, *  \nCitation: Waddingham, W.; Graham, D.G.; Banks, M.R. Latest Advances in Endoscopic Detection of Oesophageal and Gastric Neoplasia. Diagnostics 2024, 14, 301. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/diagnostics14030301](10.3390/diagnostics14030301)  \nAcademic Editor: Hajime Isomoto  \nReceived: 29 October 2023  \nRevised: 23 January 2024  \nAccepted: 24 January 2024  \nPublished: 30 January 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Gastroenterology, Royal Free London NHS Foundation Trust, London NW3 2QG, UK  \n2 Department of Gastroenterology, University College London NHS Foundation Trust, London NW1 2BU, UK  \n* [Correspondence: matthew.banks2@nhs.net](Correspondence: matthew.banks2@nhs.net)  \nAbstract: Endoscopy is the gold standard for the diagnosis of cancers and cancer precursors in the oesophagus and stomach. Early detection of upper GI cancers requires high-quality endoscopy and awareness of the subtle features these lesions carry. Endoscopists performing surveillance of high-risk patients including those with Barrett’s oesophagus, previous squamous neoplasia or chronic atrophic gastritis should be familiar with endoscopic features, classification systems and sampling techniques to maximise the detection of early cancer. In this article, we review the current approach to diagnosis of these conditions and the latest advanced imaging and diagnostic techniques.  \nKeywords: Barrett’s oesophagus; squamous dysplasia; chronic atrophic gastritis; intestinal metaplasia; surveillance  \n1. Introduction  \nOesophageal and gastric cancers remain major worldwide causes of cancer-related deaths, with oesophageal cancer ranking seventh in incidence and sixth for mortality, and gastric cancer ranking fifth for incidence and fourth for mortality globally [1] . There is considerable geographical variation in the occurrence of these cancers. Concerningly, across developed countries, the incidence of oesophageal adenocarcinoma (OAC) is rising and is predicted to continue to do so until at least 2040 [2] . This has been suggested to be related to increasing levels of obesity and gastro-oesophageal reflux, and perhaps reduced prevalence of H. pylori [1] . Notably, despite global declines in H. pylori infection, recent studies have also shown an increase in the incidence of stomach cancer (cardia and non-cardia) among adults aged \u003C50 years in both low-risk countries (including the United States, Canada and the United Kingdom) and high-risk countries. It has been hypothesised that this increase may be accounted for by a rising prevalence of autoimmune chronic gastritis and dysbiosis of the gastric microbiome [1] .  \nLate diagnosis of oesophageal and gastric cancers continues to contribute to the poor outcomes associated with these diseases, with UK ten-year survival figures as low as 12.4% for oesophageal and 16.7% for gastric cancer [3] . Further to this, the COVID-19 pandemic has led to significant delays in diagnosis, with one study estimating these delays have caused a 6% increase in oesophageal cancer deaths [4] . Early diagnosis and treatment is a key determinant in improving outcomes; early gastric cancer (EGC), for example, has a good prognosis, with a five-year survival rate of between 69% and 82%[5] . Furthermore, when these cancers are confined to the mucosa (stage T1a) endoscopic resection (ER) is often curative and associated with excellent outcomes, with 5-year survival has high as 92%[6] .  \nEndoscopy is the ac","cbCaikpsym2LOK0Q","https://ap.wps.com/l/cbCaikpsym2LOK0Q","pdf",3248370,16,"English","# Introduction\n## Upper GI cancers and diagnostic challenges\n## Gold-standard endoscopy and surveillance rationale\n# High-Quality Upper GI Endoscopy\n## Missed cancers and detection variability","[{\"question\":\"Why is endoscopy considered the gold standard for oesophageal and gastric cancer diagnosis?\",\"answer\":\"Endoscopy enables direct visualisation and provides sampling for histological confirmation, supporting accurate diagnosis of both cancers and precursor lesions.\"},{\"question\":\"What is the role of surveillance in high-risk patients?\",\"answer\":\"Surveillance aims to detect cancer earlier by recognizing endoscopic features of precursors and applying appropriate classification systems and sampling techniques in patients such as those with Barrett’s oesophagus and chronic atrophic gastritis.\"},{\"question\":\"What factors affect early detection during upper GI endoscopy?\",\"answer\":\"Detection depends on endoscopist performance and the quality of the procedure; diagnostic limitations can lead to missed cancers and detection rates vary across clinicians.\"}]","Latest Advances in Endoscopic Detection of Oesophageal and Gastric Neoplasia - Review | PDF",1789995458]