Should we rename low risk cancers?BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k4699 (Published 23 January 2019) Cite this as: BMJ 2019;364:k4699
All rapid responses
Renaming low risk cancers would be a cosmetic exercise and would not solve the underlying problem. The exponential rise in diagnosis of low risk cancers is due to over-diagnosis resulting from over-investigation. 
Judicious use of investigations and not diagnosing the low risk cancers is probably the way forward. For instance, the proposed update to NICE prostate guidance advocates use of MRI scan as the first line investigation for people with suspected localised prostate cancer and it further recommends omission of prostate biopsy, after informed consent, in people who are likely to have low risk cancers.
A mere change in nomenclature would seem like hoodwinking the patient. Honest patient engagement and education is critical in management of low risk cancers.
1 Esserman LJ, Varma M. Should we rename low risk cancers? BMJ 2019;364:k4699. doi:10.1136/bmj.k4699
2 Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst 2010;102:605–13. doi:10.1093/jnci/djq099
3 Prostate cancer: diagnosis and management (update) | Guidance and guidelines | NICE. https://www.nice.org.uk/guidance/indevelopment/gid-ng10057/documents (accessed 24 Jan 2019).
Competing interests: No competing interests