Gastroscopy is currently the most direct and reliable method for diagnosing esophageal, gastric and duodenal diseases, and no other examination methods, including CT, upper gastrointestinal barium angiography, and color ultrasound of the gastrointestinal tract, can replace it. Because gastroscopy can enter the human body and reach the lesion directly, it is like a camera inside the body, which can help doctors observe the real health status inside the digestive tract at close range, and can further clarify the diagnosis by performing pathological biopsy and cytological examination on the suspected lesion, which is the first choice of examination method for upper gastrointestinal lesions. China is a country with high incidence of gastric cancer, with about 400,000 new cases of gastric cancer and 350,000 deaths per year, accounting for 40% of new cases and deaths of gastric cancer in the world. The situation of gastric cancer diagnosis and treatment in China is serious. With the rapid development of science and technology, medical equipment and medical technology have made amazing progress. In terms of gastroscopy, at present, most hospitals with conditions are applying high-definition and ultra-clear gastroscopes, and there are pigmented endoscopes, magnifying endoscopes and ultrasonic endoscopes specifically for early lesions, which are the necessary conditions for “fine gastroscopy”. Fine gastroscopy can detect the subtle changes of mucosa in the early stage of gastric cancer that can be easily ignored by ordinary gastroscopy, thus greatly improving the diagnosis rate of early cancer. (A) Current situation of domestic gastroscopy diagnosis and treatment Equipment conditions and personnel skills vary At present, domestic electronic gastroscopy has become very popular, and some community hospitals are also equipped with gastroscopy equipment and carry out gastroscopy examination and even some simple endoscopic treatment. However, such popularity inevitably brings uneven examination techniques and the disadvantage of missing some diseases during gastroscopy, especially for the diagnosis of early cancer of the digestive tract, which requires more specialized endoscopists and more advanced examination equipment. According to a professional survey, the detection rate of early gastric cancer is about 70% in Japan, 50% in Korea, and less than 10% in China, which is a huge gap. This gap is mainly brought about by the differences in gastroscopy equipment, examination modes and methods, which is of course also related to the huge number of patients requiring endoscopy and the serious shortage of endoscopists in China, a direct consequence of which is the shortening of examination time, which in turn leads to less careful observation during the examination. (2) Advancement of fine gastroscopy to detect early cancer What exactly is fine gastroscopy? Conventional gastroscopy is usually applied to ordinary white light gastroscopy, and the examination time is usually 5-10 minutes. This examination method is sufficient for detecting common gastritis, gastric ulcer, gastric polyp and middle and late gastric cancer, but it is not sufficient for early cancer diagnosis. Because the mucosal changes of early stage cancer are subtle, it is difficult to distinguish it from ordinary mucosal erosion and inflammation, therefore, more experienced specialized endoscopists are needed to conduct more detailed examinations, or even to conduct inch-by-inch carpet search of the mucosa of esophagus, stomach and duodenum under gastroscopy, and once suspicious lesions are found, then targeted endoscopy will be performed. Once a suspicious lesion is found, then we will perform targeted examinations such as magnification, staining, and ultrasonic endoscopy to see the various tissues in the digestive tract more clearly, and perform pathological biopsy and cytological examination on the lesion. Through these meticulous examinations, combined with the advanced gastroscopy magnification and staining functions, the small mirror becomes a “microscope”, and various early cancers of the digestive tract can be almost invisible. Of course, because it is a “delicate” examination, the examination time is bound to be prolonged, usually more than 10 minutes, or even 20-30 minutes, so patients who are in a position to do so are recommended to undergo painless gastroscopy as much as possible to reduce the discomfort caused by gastroscopy. The hospital has specially introduced the world’s most advanced ultra-clear electronic endoscope, which integrates magnification and electronic staining, to greatly improve the detection rate of early cancer of digestive tract. With the development of gastrointestinal endoscopy technology, early gastric cancer, esophageal cancer, colorectal cancer and other gastrointestinal lesions can be treated minimally invasively through endoscopic ESD and EMR technology, eliminating the pain of open surgery. Most of the GI tumors can be cured by early detection and early treatment. It has been reported that most early gastric cancers can be treated radically by endoscopy, and the 5-year survival rate can be more than 90%, and the treatment cost is low, and the quality of patients’ survival is almost unaffected; even if middle and late gastric cancers are treated by surgery, the 5-year survival rate is still less than 30%, and the cost is expensive, and most patients’ quality of survival is poor. Therefore, the timing of gastric cancer detection sometimes even directly determines whether the patient can still survive. (C) See if you should go for fine gastroscopy Workplace people who are busy, stressed and anxiety-prone are the people with high incidence of gastric cancer. However, because of their busy work, many of them find it difficult to spare time to go to professional hospitals for examination and treatment although they feel sick in their stomach, and many white-collar workers even delay to seek medical treatment because they are afraid of gastroscopy. It is a pity that the best treatment time is delayed. We have recently arranged dedicated staff to carry out fine gastroscopy at fixed times to ensure quality and quantity for patients to implement the examination. Director Xia Junquan suggests that fine gastroscopy is recommended for the following groups: 1) those who suffer from pre-cancerous gastric diseases, such as chronic atrophic gastritis, gastric polyps, gastric ulcer, post-surgical stomach, pernicious anemia, etc.; 2) those who come from areas with high incidence of gastric cancer and esophageal cancer; 3) those who have family history of gastric cancer and esophageal cancer; 4) those who have long-term upper gastrointestinal disorders without regular diagnosis and treatment.