China is a country with high incidence of gastric cancer, with 400,000 new cases of gastric cancer and about 350,000 deaths each year. The prognosis of gastric cancer is closely related to the time of diagnosis and treatment. Even if the progressive gastric cancer receives comprehensive treatment mainly by surgery, the 5-year survival rate is still less than 30%, and the quality of life is low, which brings heavy burden to families. In contrast, most early gastric cancers can be treated radically under endoscopy, and the 5-year survival rate is over 90%. Unfortunately, the diagnosis and treatment rate of early gastric cancer in China is less than 10%, which is much lower than 70% in Japan and 50% in Korea, which are also countries with high prevalence of gastric cancer. Early detection, early diagnosis and early treatment of cancer are the main strategies to reduce mortality and increase survival rate. Therefore, endoscopic screening among people with high risk of gastric cancer is an efficient and feasible way to change the serious situation of gastric cancer diagnosis and treatment in China. How to improve the diagnosis of early gastric cancer needs to be done from two aspects. In one aspect, patients should pay attention to alarm symptoms, including gastrointestinal bleeding, vomiting, wasting, upper abdominal discomfort, upper abdominal mass, etc. When these symptoms appear, especially for those who are over 45 years old, they must consult hospitals promptly and perform gastroscopy as early as possible. The aforementioned colleagues, classmates and friends who had stomach cancer, each of them told me that they had the above alarm symptoms, but unfortunately, every time I suggested them to have gastroscopy, they always ignored it because of their busy work schedule, thinking that there would be no big problem in their youth and other reasons and excuses, and as a result, the regrettable results happened. On the other hand, every endoscopist should have a heart that wants to detect early gastric cancer and an eye that can detect early gastric cancer. During my years of doing gastroscopy, I always heard some patients’ complaints every year. Some of them complained about the long operation time, while other doctors did it in just a few minutes, and some complained why he had to go for magnification gastroscopy + staining after the general gastroscopy was done, which added pain and financial burden. Nowadays, there are more and more gastroscopy operations in each hospital every year, and the operation speed of some doctors is also getting faster and faster, fast speed is a symbol of skilled operation, but there is a limit to fast speed, I heard that some doctors finish a gastroscopy in less than 2 minutes, early gastric cancer is often a very small lesion under gastroscopy, can these doctors detect early gastric cancer with such fast operation speed? Very few doctors lack the knowledge of early gastric cancer, even if the lesions are found, they do not pay enough attention to them due to the lack of knowledge, and just biopsy a few pieces of lesions hastily, which can be imagined that this practice seriously affects the detection of early gastric cancer. In the past, for the endoscopic detection of early gastric cancer, we used the method of general gastroscopy and multi-point biopsy after the lesion was found. The disadvantage of this method is that the biopsy site is often not the most valuable one, resulting in deviation of biopsy results from the actual pathological results of the lesion. complications such as bleeding are likely to occur. In the past few years, we have been adhering to this process for endoscopic discovery of early gastric cancer: careful examination by general gastroscopy, replacement of suspicious lesions with magnification endoscopy (ME) + lesion pigment staining + narrow band imaging (NBI), and further ultrasound endoscopy if necessary, through these means, just like targeting, the key parts of the lesions are discovered, so as to achieve the purpose of targeted biopsy, which greatly improves the detection rate of early gastric cancer. The detection rate of early gastric cancer is greatly improved.