How to improve the quality of upper gastrointestinal diagnostic endoscopy?

Upper gastrointestinal endoscopy is commonly performed worldwide and is the gold standard for most upper gastrointestinal tract diseases, particularly cancer. This review will use gastric cancer as an example to tackle how providers can improve the quality of endoscopy being delivered to reduce the missing rate, which may reach up to 10% of cases. In brief, endoscopists must consider pre-, intra-, and post-procedural attitudes to achieve this purpose. "Preparing or planning endoscopy," cancer as a possible diagnosis in all procedures should be thought. Fasting of patients and the use of mucosal cleaning solutions help ensure mucosal cleansing, while planned sedation increases comfort. During endoscopy, taking time for complete inspection and photodocumentation to assure completeness. Importantly, training and knowledge of cancer (superficial) endoscopic features, particularly using advanced imaging technologies, are of paramount importance, as they are regular post-endoscopy audits of practice that positively impact quality. Finally, human-machine interaction through artificial intelligence has been shown to improve photodocumentation, detection, and auditing, and it may well assure a more homogenous service, particularly among low-performing deliverers.