Current Status of ESD in Taiwan

During the past 10 years, ESD has became a widely accepted procedure for treating early GI tract cancers and precancerous lesions in Taiwan. Because the population of early gastric cancer is relatively small, endoscopists in Taiwan perform esophageal ESD and colorectal ESD more often. The national wide colorectal cancer screening program also has a great impact on the growing number of colorectal ESD. Despite the increasing number of ESD performed each year, there is still no structured training for ESD until recent 2 years. "Learning ESD by doing ESD" is a common phenomenon for most endoscopists. Given the little number of gastric ESD, most doctors have to perform esophageal ESD and colorectal ESD before they are familiar with gastric ESD, which is technically easier. Thus the quality of ESD is also not well controlled in Taiwan. The success rate and complication rate varied widely between endoscopists and institutions. Besides, ESD is still not considered as standard of care for early cancer patients in some medical centers and most regional hospitals. "Quality controlled ESD" should be the next step to do in Taiwan.