{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:09:47Z","timestamp":1790172587502,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Esophagogastroduodenoscopy (EGD) is widely used for gastric cancer (GC) screening in Japan; however, sedation during EGD is not recommended. We aimed to assess the tolerability of unsedated EGD (USEGD) in the Japanese population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants who underwent GC screening in Japanese urban areas between July 2021 and December 2022 were included in this study. We conducted a real\u2010time questionnaire survey on USEGD invasiveness in 16 clinics and hospitals. Participants completed a self\u2010report questionnaire, including a six\u2010point face scale, immediately after undergoing USEGD with an ultrathin endoscope for GC screening, and were placed into the tolerable (T group) or intolerable groups (I group) based on the scores 1\u20133 and 4\u20136 on the face scale, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 1021 participants (median age, 59 years; interquartile range, 59\u201374 years) consisted of 561 men and 437 women, while 23 preferred not to answer. Of the 777 participants who underwent USEGD using an ultrathin endoscope, 135 (17.4%) were categorized into the intolerable (I) group based on severe distress, and 642 (82.6%) into the tolerable (T) group. Multiple logistic regression analysis revealed that older age (odds ratio [OR]: 0.974;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008) and prior USEGD experience (OR: 0.527;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.006) were associated with higher tolerability. Conversely, females (OR: 2.498;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and first\u2010time EGD experience (OR: 2.202;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003) were associated with lower tolerability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>USEGD was generally well\u2010tolerated; however, some participants found it intolerable, even with transnasal endoscopy. Supportive measures for these individuals are essential for sustaining effective screening programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70179","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T18:00:29Z","timestamp":1754935229000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Endoscopic Sedation is Not an Option: Insights From a Multicenter on\u2010site Survey on Tolerance for Japanese Gastric Cancer Screening"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2703-9509","authenticated-orcid":false,"given":"Kazuya","family":"Inoki","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiya","family":"Chiba","sequence":"additional","affiliation":[{"name":"Chiba Medical Dental Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Miura","sequence":"additional","affiliation":[{"name":"Miura Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Tagawa","sequence":"additional","affiliation":[{"name":"Tagawa Clinic  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Aoyagi","sequence":"additional","affiliation":[{"name":"Aoyaghi Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Takeuchi Gastrointestinal Medicine Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Moriyama Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Kuraoka","sequence":"additional","affiliation":[{"name":"Osaki Gastroenterology Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Aging Research and Geriatric Medicine Institute of Development Aging and Cancer Tohoku University  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Haruhara","sequence":"additional","affiliation":[{"name":"Hatanodai Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Mizuki","sequence":"additional","affiliation":[{"name":"Tokyo Sea Fort Square Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Saito","sequence":"additional","affiliation":[{"name":"Saito Family Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimi","family":"Hagisawa","sequence":"additional","affiliation":[{"name":"Ohi Chuou Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Ono","sequence":"additional","affiliation":[{"name":"Minoyama Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Takayama","sequence":"additional","affiliation":[{"name":"Takayama Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Onishi","sequence":"additional","affiliation":[{"name":"Onishi Clinic  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Mishima","sequence":"additional","affiliation":[{"name":"Mishima Internal Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Katagiri","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuyuhiko","family":"Yamamura","sequence":"additional","affiliation":[{"name":"Endoscopy Center Showa Medical University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Ohde","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health St. Luke's International University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisuke","family":"Inoue","sequence":"additional","affiliation":[{"name":"Showa Medical University Research Administration Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9244-2820","authenticated-orcid":false,"given":"Takahisa","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Toho University Omori Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Showa Medical University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-320234"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20200416"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy077"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14063"},{"key":"e_1_2_11_6_1","first-page":"327","article-title":"Report on the Seventh National Survey on Gastrointestinal Endoscopy\u2010related Adverse Events for Three Years: From 2019 to 2021","volume":"66","author":"Furuta T.","year":"2024","journal-title":"Gastroenterological Endoscopy"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.12.046"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12678"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.07.016"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.07.059"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.12.040"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.07.018"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13882"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-330396"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02549-7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-41513"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.08.034"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.01.025"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2367-4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-022-07432-9"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70092-5"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2009.00840.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i11.1378"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-29284-7"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12804"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v6.i2.41"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2015-100589"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12612"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1900-6004"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.113961"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.2196\/26759"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(63)90117-6"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052580"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:59:01Z","timestamp":1790171941000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/deo2.70179"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70179","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"assertion":[{"value":"2025-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70179"}}