Preferred labels and language to discuss low-risk lesions that may be cancer precursors: A review

Abstract

Objectives: Patients diagnosed with low-risk lesions are confused about whether they have cancer, and experience similar anxiety to those with invasive cancer, which affects quality of life. Current labels for low-risk lesions were chosen by clinicians and lack meaning to patients.

Methods: We reviewed published research on preferred labels and language for low-risk lesions, and the rationale for those preferences.

Results: Of 6569 titles screened, we included 13 studies. Among healthy adults with cervix or prostate lesions, use of the term "cancer" rather than "nodule" or "lesion" resulted in greater anxiety, higher perceived disease severity, and selection of more invasive treatment. Physicians asked about removing "carcinoma" from thyroid lesion labels to reduce patient anxiety and discourage over-treatment did not support this change, instead preferring a term that included "neoplasm".

Conclusions: This review revealed a startling paucity of research on preferences for low-risk lesion labels and language, and associated rationale. Future research is needed to understand how to improve communication about low-risk lesions.

Practice implications: To reduce anxiety and improve the overall well-being of patients, it is crucial to gain a deeper understanding of how to improve patient-provider conversations regarding screen-detected lesions with a low risk of developing into invasive cancer.

Keywords: Indolent lesion of epithelial origin; Low- grade squamous intraepithelial lesion; Low-risk cancer; Low-risk lesion; Papillary thyroid micro-carcinoma; Patient centred care; Patient communication; Review; Urothelial neoplasia of low malignant potential.