We have investigated whether the incidence of early gastric cancer continues to increase. During the last 16 years, from January 1, 1974, through December 31, 1989, 842 patients with primary carcinoma of the stomach were admitted. Of these 842, 676 (80%) underwent gastric resections. During the first 8 years of this study, 391 patients were admitted, and during the second 8 years, 451 patients were admitted. Early cancer in the first 8 years accounted for 28% of the resected cases and 22% of the total cases of gastric cancer. In the second 8 years, early gastric cancer accounted for 38% of the resected cases and 32% of the total number of cases of gastric cancer. The number of early gastric cancers as a proportion of resected cases increased significantly in the second 8 years. Approximately 50% of early gastric cancers were detected as a result of routine upper gastrointestinal examinations which were performed on patients with no clinical features suggestive of a malignant underlying process. We emphasize that gastroenterologists are unlikely to witness a significant increase in the rate of detection of gastric cancer in the early stage as long as both double-contrast radiographic techniques and endoscopic biopsies are performed predominantly only on patients with symptoms that are apparently suggestive of gastric malignancies.