Abstract: Objective: To estimate the sensitivity and the rate of incorrect diagnosis of endoscopic screening using iodine staining in the high risk area of esophageal cancer. Methods: In May 2002,there were 2013 cases between 40 and 65 years old who were examined endoscopically in the Hebei province. From January to March of 2006, follow- up confirmed occurrences of esophageal squamous cancer, adenocarcinoma of gastric cardia and stomach gland cancer. These data were used to determine sensitivity and rate of incorrect diagnosis. Results: Follow- up lasted 6 to 36 months, and it confirmed the presence of esophageal squamous carcinoma in 2 cases, adenocarcinoma of gastric cardia in 4 cases, gastric antrum adenoma in 1 case. The cause of death was unclear in 1 case. Eleven cases were lost to follow- up, providing an overall follow- up rate of 99.4%. Sensitivity of endoscopic screening with iodine staining for detection of esophageal squamous carcinoma was 97.1%, and the rate of missed diagnosis 2.9%. Sensitivity of the method for detecting adenocarcinoma of gastric cardia was 80%, and the rate of missed diagnosis was 20%. Conclusions: The sensitivity of endoscopic screening with iodine staining in detecting adenocarcinoma or gastric cardia was lower than that for detection of esophageal squamous carcinoma.