Early diagnosis of gastric cancer: Endoscopy and artificial intelligence

Early diagnosis of gastric cancer enables effective, minimally invasive and organ-sparing treatment throughout endoscopic resection. This technique offers low rates of adverse events, improved quality of life compared to surgery, and excellent disease-free survival when curative criteria are met.

Upper gastrointestinal endoscopy with biopsies is the gold standard for diagnosing either pre-malignant conditions or gastric cancer but high-quality endoscopy is paramount to avoid missing lesions. Also, adequate endoscopic assessment of a gastric lesion is crucial to select patients for endoscopic resection and remains the best predictor for curative resection. However, curative resection rates have been stable at around 80–85 % in recent years, so there is room for improvement in patient/lesion selection for endoscopic resection.

This review intends to address strategies that can be pursued to optimize upper gastrointestinal endoscopy quality, improve gastric lesion detection and characterization, and unveil how Artificial Intelligence can contribute to this process in the near future.