RT Journal Article SR Electronic T1 An Asian consensus on standards of diagnostic upper endoscopy for neoplasia JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 186 OP 197 DO 10.1136/gutjnl-2018-317111 VO 68 IS 2 A1 Philip Wai Yan Chiu A1 Noriya Uedo A1 Rajvinder Singh A1 Takuji Gotoda A1 Enders Kwok Wai Ng A1 Kenshi Yao A1 Tiing Leong Ang A1 Shiaw Hooi Ho A1 Daisuke Kikuchi A1 Fang Yao A1 Rapat Pittayanon A1 Kenichi Goda A1 James Y W Lau A1 Hisao Tajiri A1 Haruhiro Inoue YR 2019 UL http://gut.bmj.com/content/68/2/186.abstract 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.