This research is aimed to improve detectable rate of early oesophageal cancer and precancerous lesion with opportunistic screening and indicative biopsies guided by different doses of iodine staining/NBI (Narrow Band Imaging) in high risk population of oesophageal cancer. Local patients aged 40 to 69 treated in our digestive system department were screened. Following randomized grouping, high-risk patients were stained with different does of iodine (low: 5~7 ml; high: 10~15 ml) for endoscopy and NBI endoscopy, and indicative biopsies was conducted in suspicious esophageal lesions; Pathology results were considered as the final diagnosis. Diagnostic criteria are divided into: mild dysplasia, moderate dysplasia, severe dysplasia and (or) carcinoma in situ, intramucosal carcinoma, submucosal carcinoma and invasive cancer. The results indicated that in first stage: In 2014, a total of 1624 people attended opportunistic screening for esophageal cancer. Among them, detectable rate of early esophageal cancer was 1.23%, accounting for 20.41% of all esophageal cancer, improved significantly compared with that in 2013 (χ2=5.511, P=0.019). The second stage: in 2015, a total of 1948 people participated in esophageal opportunistic screening. There was no significant difference between detectable rates of early esophageal cancer and precancerous lesion with different esophageal endoscopies (P>0.05), a higher incidence of adverse reactions can be seen in low-dose iodine staining group compared with high-dose group (χ2=6.566, P=0.01). In conclusion, the combination of opportunistic screening and indicative biopsies guided by different doses of iodine staining/NBI can effectively improve the detectable rate of early esophageal cancer and precancerous lesion, wherein the low-dose iodine staining endoscopy is more suitable for mass screening.