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Should we rename low risk cancers?

BMJ 2019; 364 doi: (Published 23 January 2019) Cite this as: BMJ 2019;364:k4699

Rapid Response:

Re: Should we rename low risk cancers?

I'm very sympathetic to Laura Esserman's point of view but I don't think she goes far enough. These "low risk cancers" are in most cases, the consequence of screening for breast and prostatic cancers. Surely the simplest solution to the problem is to de-implement these screening programmes. Screening by mammography or by PSA tests have no impact on all cause mortality but can impair quality of life by the over-diagnosis and over-treatment of these lesions that have no capacity to progress to life threatening disease. [1.2] They may look like Snarks down the microscope but behave like Boojums.
[1] Baum M, Harms from breast cancer screening outweigh benefits if
death caused by treatment is included. Br Med J 2013, 346: f385.
[2] MartinRM, DonovanJL, TurnerEL, etal; CAP Trial Group. Effect of a low-intensity PSA-based screening intervention on prostate
cancer mortality: the CAP randomized clinical trial , JAMA March 6, 2018 Volume 319, 883-895

Competing interests: No competing interests

26 January 2019
Michael Baum
Prof emeritus of surgery
4 Corringway