Evolution of Endoscopic Submucosal Dissection (ESD)
Endoscopic submucosal dissection is a well-established procedure of endoscopic resection that enables the removal of gastrointestinal epithelial lesions. Endoscopic submucosal dissection was first developed in Japan in the 1990s. Endoscopic submucosal dissection is not so popular in North America and Europe due low incidence rate of gastrointestinal cancer compared to Japan. Besides, the rate of early diagnosis of gastrointestinal cancer is low in the western countries. In addition, there are differences between western and Japanese pathologists in their histopathologic criteria for the diagnosis of early cancer, as a result of which early diagnosis by Japanese pathologists might not meet the histopathologic criteria of the western pathologists. Despite the differences, endoscopic submucosal dissection is still being developed and its adoption and use is growing. This is true for the North American and European regions, where the morbidity and mortality rates of conventional surgery is higher than that of Japan. Like Japan, many countries have implemented mass screening programs for cancer. These programs have brought the percentage of cancer cases, which can be diagnosed and treated endoscopically in the early stages, to over 40%.
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Increasing Prevalence of Gastro-intestinal Cancer and Colorectal Cancer
Gastro-intestinal cancer is the fourth most common cancer and the second most leading cause of cancer deaths globally. The death rate due to cancer is high throughout the world as most of the cases are diagnosed in the advanced stages. Less than 25% of the patients diagnosed with gastro-intestinal cancer survive for 5 years. There is an increase in the number of inflammatory bowel disease globally, especially in Asia Pacific. Inflammatory bowels lead to an increase risk of colorectal cancer. The mortality and incidence rate of colorectal cancer are high in Asia Pacific. In Japan, despite the presence of colorectal cancer screening systems the incidence rate is persistently high. In the recent years, Endoscopic submucosal dissection has emerged as one of the most innovative and advanced procedures for therapeutic endoscopy management of gastric, colorectal and esophageal cancers. Endoscopic submucosal dissection is widespread in Asia Pacific, particularly in Japan, and the training model is relatively well established.
Factors Driving and Restraining the Endoscopic Submucosal Dissection Market
The global market for endoscopic submucosal dissection is driven by the increase in the geriatric population and increase in prevalence of gastrointestinal, colorectal and stomach cancers. Since endoscopic submucosal dissection is an ideal technique for early diagnosis and prognosis of cancer, which can be treated endoscopically, the growing awareness regarding the procedure has led to a shift towards early detection of cancer by patients and doctors. The establishments of screening modals globally is another important driving factor for endoscopic submucosal dissection.
However, endoscopic submucosal dissection is ideal only if the cancer is detected in its early stages and not ideal for the patients who are in the malignant stage of gastrointestinal, colorectal or stomach cancers.
The Asia Pacific endoscopic submucosal dissection market is expected to grow at a significant CAGR over the forecast period. The adoption of ESD is high in Asia Pacific, particularly in countries such as Japan and South Korea, due to high prevalence rate of gastrointestinal, colorectal and stomach cancers. In North America, comparative, there are fewer cases for endoscopic submucosal dissection. In Europe, and the MEA regions, the number of endoscopically treatable cancer cases are very few owing to which the endoscopic submucosal dissection market in these regions is expected to grow at a sluggish rate over the forecast period.
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Examples of some of the key players identified in the global endoscopic submucosal dissection market are HOYA Group PENTAX Medical, FUJIFILM Medical Systems U.S.A., Inc. Olympus America Inc., Erbe USA. CREATE MEDIC CO. LTD., etc, Covidien, Ethicon EndoSurgery Inc., Stryker, Karl Storz., Boston Scientific Corporation, Cook Medical Inc, Interscope Inc., Conmed Corporation, Steris Plc.
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