AIM:To compare the differences in the endoscopicclassification of early colorectal carcinoma(CRC)betweenJapan and China.METHODS:Ten cases of early CRC were included in thestudy.After reviewing the color pictures of these cases,5Japanese endoscopists and 5 Chinese endoscopists madetheir classificatory diagnosis individually using the currentJapanese classification,and indicated their findings on whichthe diagnosis was based.RESULTS:Some lesions diagnosed by the Japaneseendoscopists as Ⅱa or Ⅱa plus Ⅱc,were classified as Is orIsp by the Chinese endoscopists.For superficial lesionsconsisting of elevation plus central depression,Ⅱa plusdepression,Ⅱa plus Ⅱc or Ⅱc plus IIa were classifiedaccording to the ratio of elevated area/depressed area.However,international as well as interobserver differencestill existed in the classification of such lesions.In addition,most Chinese endoscopists overlooked slightly depressedpart on the top of a protruded lesion.Laterally spreadingtumor,a special type of IIa,was identified as LST by someJapanese endoscopists.CONCLUSION:Discrepancies on macroscopic classificationfor early CRC do exist between Japanese and Chineseendoscopists,which are found not only in terminology butalso in recognition of some lesions.In order to develop auniversal classification,it needs for internationalcommunication and cooperation. AIM: To compare the differences in the endoscopic classification of early colorectal carcinoma (CRC) between Japan and China. METHODS: Ten cases of early CRC were included in the study. After reviewing the color pictures of these cases, 5 Japanese endoscopists and 5 Chinese endoscopists made the disease classificatory diagnosis individually using the current Japan classification, and indicated their findings on which the diagnosis was based .RESULTS: Some lesions diagnosed by the Japanese endoscopists as Ⅱa or Ⅱa plus Ⅱc, were classified as Is orIsp by the Chinese endoscopists. For superficial lesionsconsisting of elevation plus central depression, Ⅱa plusdepression, Ⅱa plus Ⅱc or Ⅱc plus IIa were classifiedaccording to the ratio of elevated area / depressed area. However, international as well as interobserver differencestill existed in the classification of such lesions.In addition, most Chinese endoscopists overlooked slightly depressedpart on the top of a protruded lesion.Laterally spreading tumor, a special type of IIa, was identified as LST by someJapanese endoscopists. CONCLUSION: Discrepancies on macroscopic classification for early CRC do exist between Japanese and Chinese endoscopists, which are found not only in terminology butalso in recognition of some lesions. In order to develop auniversal classification, it needs for international communication and cooperation.