The most notable change in this revision is the unification of the stomach cancer screening method. Until now, gastric cancer screening was a method of choosing between gastroscopy and gastrointestinal angiography, but now gastrointestinal angiography has virtually disappeared from the front line. As a result of analyzing extensive clinical data at home and abroad, it was clearly proven that gastroscopy is overwhelmingly superior to gastrointestinal angiography in terms of the preventive effect in lowering the mortality rate of stomach cancer and the accuracy of detecting lesions. Accordingly, gastrointestinal contrast examination is only considered in special exceptional cases where endoscopic procedures are physically impossible, and is no longer recommended for general health checkups. This can be interpreted as a strong will to increase the efficiency of national screening and provide the most standardized, high-quality medical care to the public.

Medical rigor was also emphasized in setting the age range for gastric cancer screening. As before, screening is recommended for asymptomatic adults aged 40 to 74, but a much more cautious approach is being taken for those aged 75 or older. The research committee noted that screening after age 75 may do more harm than good. Considering the risk of complications that may arise during the test process, the life expectancy of the elderly, and the overall health status, we believe that it is more reasonable to make an individual decision through in-depth consultation with medical staff rather than a uniform examination. This suggests that unconditional screening is not a solution, but ‘wise screening’ that takes quality of life into account is the key to cancer prevention.

Meanwhile, in the field of liver cancer screening, the existing solid system is maintained while the latest concerns of modern medicine are reflected. Six-monthly screening for high-risk patients with cirrhosis and chronic hepatitis B and C over 40 years of age has been reaffirmed as still the best strategy for early detection of liver cancer. In particular, it has been proven once again that combining liver ultrasound and serum alpha-fetoprotein testing has a significant effect in reducing mortality. However, the plan to include patients with non-alcoholic steatohepatitis or liver fibrosis, which is rapidly increasing recently, as a new screening target group was also carefully reviewed, but it was concluded that there is currently insufficient medical evidence to make it routine. This shows the academic world's cautious stance to be wary of excessive expansion of screening that is not based on scientific evidence and to remain cautious until data is accumulated.

The core value that runs through this amendment is ‘evidence-based trust.’ The National Cancer Center adopted the international standard ‘GRADE’ methodology and went through a transparent process from literature review to public hearings, and the guidelines derived through this process will serve as strong guidelines in the medical field in the future. Liver cancer screening using CT or MRI was also classified as ‘recommendation pending’ because there was not yet enough data to compare the benefits and harms. This was not simply omitting the test, but maintained the scientific attitude of exploring the optimal method until better evidence was provided. In conclusion, this recommendation will serve as an unwavering compass for medical staff and a guidepost for the public to guide the safest path without unnecessary fear or excessive screening.