A cancer by any other name

Mammogram
In this photo taken in 2010, radiologist Dr. Gerald Iba checked mammograms at The Elizabeth Center for Cancer Detection in Los Angeles.
AP Photo/Damian Dovarganes

The good news is that awareness of cancer has increased and screening technology has become more sensitive. The bad news is that this has led to what the National Cancer Institute calls "overdiagnosis" of cancer.

In recommendations made this week, the National Cancer Institute argues that we need to redefine what we call cancer. "Many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for 'indolent lesions of epithelial origin,'" the institute's working group wrote in the Journal of the American Medical Association.

In addition to changing how we classify different lesions, the National Cancer Institute wants to change the way physicians think about cancer.

"Our investigators are not just looking for ways to detect cancer early, they are thinking about this question of when you find a cancer, what are the factors that might determine how aggressively it will behave," Dr. Harold E. Varmus, director of the National Cancer Institute, told The New York Times. "This is a long way from the thinking 20 years ago, when you found a cancer cell and felt you had a tremendous risk of dying."

LEARN MORE ABOUT CANCER OVERDIAGNOSIS:

Overdiagnosis and Overtreatment in Cancer
Read the recommendations from the National Cancer Institute's working group.

Scientists Seek to Rein In Diagnoses of Cancer
The concern, however, is that since doctors do not yet have a clear way to tell the difference between benign or slow-growing tumors and aggressive diseases with many of these conditions, they treat everything as if it might become aggressive. As a result, doctors are finding and treating scores of seemingly precancerous lesions and early-stage cancers — like ductal carcinoma in situ, a condition called Barrett's esophagus, small thyroid tumors and early prostate cancer. (The New York Times)

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