History
In 1868 Adolf Kussmaul passed a straight metal tube into a sword swallower to look inside the stomach (Haubrich, 2001). Rudolf Schindler's semi-flexible scope followed in 1932, Japan produced a gastrocamera in 1950, and in 1957 Basil Hirschowitz demonstrated the flexible fiberoptic gastroscope, reporting clinical results in 1961. High gastric cancer rates help explain why Korea and Japan became endoscopy leaders.
Screening in Korea
Korea screens everyone 40 and over for stomach cancer every two years, mainly by gastroscopy. A national study found screened people had 47% lower odds of dying from gastric cancer, with greater benefit after repeated exams, while barium studies showed no clear effect (Jun et al., 2017). Patients usually pay 10% (free for lower-premium households); biopsies are covered, but sedation and H. pylori testing cost extra.
Before and after
- Fast from the evening before and review blood thinners or diabetes medicines with your doctor.
- After sedation, avoid driving, alcohol and big decisions that day.
- Seek care for black stools, severe pain or fever after a biopsy.
- The exam also detects gastritis, peptic ulcers, reflux esophagitis and H. pylori infection; the lower bowel needs a colonoscopy.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- How often should I have one?
- Korea's program offers it every two years from 40; your doctor may advise more often if you have risk findings.
- Is sedation covered?
- The exam is covered, but sedation is an extra out-of-pocket cost.
Sources reviewed: 2026-11-09
References
- Haubrich, W. S. (2001). Kussmaul who pioneered gastroscopy. Gastroenterology, 121(5), 1038. Short history of Adolf Kussmaul's 1868 rigid gastroscopy on a sword swallower.
- Hirschowitz, B. I. (1961). Endoscopic examination of the stomach and duodenal cap with the fiberscope. The Lancet, 277(7186), 1074–1078. Landmark clinical report of the flexible fiberoptic gastroscope.
- Fujishiro, M., & Matsumoto, T. (2021). History of endoscopes: Contribution of the Japan Gastroenterological Endoscopy Society. Digestive Endoscopy, 34(S2), 13–14. Brief history of endoscopes from Japan's 1950 gastrocamera onward.
- Jun, J. K., Choi, K. S., Lee, H. Y., Suh, M., Park, B., Song, S. H., Jung, K. W., Lee, C. W., Choi, I. J., Park, E. C., & Lee, D. (2017). Effectiveness of the Korean National Cancer Screening Program in reducing gastric cancer mortality. Gastroenterology, 152(6), 1319–1328.e7. Korean study linking screening endoscopy to 47% lower odds of gastric cancer death.
- Hamashima, C. (2015). Impact of endoscopic screening on mortality reduction from gastric cancer. World Journal of Gastroenterology, 21(8), 2460–2466. Review of evidence that endoscopic screening reduces gastric cancer mortality in East Asia.
- 국립암센터 국가암정보센터. (2026). 국가암검진 사업. National Cancer Center page on screening methods and which extra costs patients pay.
- 국민건강보험공단. (n.d.). 암검진 제도소개. NHIS page on eligibility, intervals and cost-sharing for cancer screening.