{"entity":{"id":"idea-prev-indolent-lesion-nomenclature-body","kind":"idea","name":"An international body to rename indolent lesions so 'cancer' means something","aka":[],"tldr":"Some things called cancer, such as low-grade prostate lesions, almost never spread. An expert body could reclassify them, as cervical precancer was, so fewer people are overtreated.","summary":"Cervical CIN and bladder PUNLMP are precedents for moving low-risk lesions out of the carcinoma category. Propose a WHO/IARC-convened classification group with explicit criteria (lifetime metastatic risk under 1% untreated) and a schedule to review Gleason 6, papillary microcarcinoma, low-grade DCIS, small renal masses, and Barrett's low-grade dysplasia.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Overdiagnosis and false alarms): Welch & Black, Overdiagnosis in cancer (JNCI 2010)","url":"https://doi.org/10.1093/jnci/djq099"}],"tags":[],"related":[],"cancers":["prostate","thyroid"],"sections":["early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["iarc"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-overdiagnosis"],"keyPapers":["paper-welch-j-natl-cancer-inst"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Reclassification reduces active treatment of the reclassified lesions by at least 40% within five years without a measurable increase in cancer-specific mortality.","rationale":"Words drive fear and treatment; PUNLMP shows the profession can do this.","test":"Pre/post analysis after WHO Classification of Tumours reclassification for one lesion type, Gleason 6 first.","maturity":"speculative","actor":"policy","cost":"small","horizonYears":5},"route":"/ideas/idea-prev-indolent-lesion-nomenclature-body/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"},{"id":"thyroid","kind":"cancer","name":"Thyroid cancer","route":"/cancers/thyroid/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"institution":[{"id":"iarc","kind":"institution","name":"International Agency for Research on Cancer (IARC / WHO)","route":"/institutions/iarc/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"}],"paper":[{"id":"paper-welch-j-natl-cancer-inst","kind":"paper","name":"Overdiagnosis in cancer","route":"/key-papers/paper-welch-j-natl-cancer-inst/"},{"id":"paper-welch-albertsen-psa-era-diagnosis-treatment-jnci-2009","kind":"paper","name":"Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005","route":"/key-papers/paper-welch-albertsen-psa-era-diagnosis-treatment-jnci-2009/"}]}}