Early gastric cancer is a curable disease regardless of its location, histologic type, genetic changes, or the ethnicity of the patient. To improve the detection rate of early gastric cancer, intensive training of endoscopists and the use of novel endoscopic techniques have been introduced into routine examinations in Japan. In the United States, where most gastric cancer is found in advanced stages, a similar approach should be advocated. Endoscopic resection of high-grade dysplasia is also encouraged in the United States not only for proper diagnosis but also for achieving cure without surgical intervention.