PT - JOURNAL ARTICLE AU - Philip Wai Yan Chiu AU - Noriya Uedo AU - Rajvinder Singh AU - Takuji Gotoda AU - Enders Kwok Wai Ng AU - Kenshi Yao AU - Tiing Leong Ang AU - Shiaw Hooi Ho AU - Daisuke Kikuchi AU - Fang Yao AU - Rapat Pittayanon AU - Kenichi Goda AU - James Y W Lau AU - Hisao Tajiri AU - Haruhiro Inoue TI - An Asian consensus on standards of diagnostic upper endoscopy for neoplasia AID - 10.1136/gutjnl-2018-317111 DP - 2019 Feb 01 TA - Gut PG - 186--197 VI - 68 IP - 2 4099 - http://gut.bmj.com/content/68/2/186.short 4100 - http://gut.bmj.com/content/68/2/186.full SO - Gut2019 Feb 01; 68 AB - Background This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers.Method The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement.Results Risk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy.Conclusion This consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.