{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:14:59Z","timestamp":1789665299790,"version":"4.0.1"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"\n Importance<\/jats:title>\n It has been proposed that grade group (GG) 1 prostate cancer should no longer be defined as cancer but as a precancerous condition. One argument raised by critics is this would decrease adherence with essential monitoring (active surveillance) and therefore lead to increased prostate cancer mortality. However, relabeling GG1 prostate cancer also reduces overdiagnosis and overtreatment, and given that these are the major disincentives to prostate-specific antigen (PSA) screening, it should increase use of prostate cancer screening and thereby reduce deaths from prostate cancer.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To model the effects of relabeling of GG1 prostate cancer on prostate cancer mortality in the US.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n In this decision analytical model created in 2025, the number of men with GG1 cancer and those considering prostate cancer screening with prostate-specific antigen were estimated using US population-based and clinical data published from 2020 to 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Relabeling GG1 as a precancerous condition.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Predicted increase in prostate cancer deaths due to lower adherence with active surveillance vs predicted decrease in prostate cancer deaths due to higher screening rates related to reduced concerns regarding overdiagnosis and overtreatment.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In the base case, which was relatively conservative, relabeling would lead to 6-fold more annual prostate deaths avoided than caused (2835 vs 452). Numerous scenarios modifying model inputs failed to change this conclusion. For instance, even if active surveillance progression rate increased by 50%, nonadherence rate doubled, and there was only a 10% absolute increase in screening, annual deaths would be reduced by close to 500. Under the base case, there would be a net decrease in mortality even if the absolute increase in screening rates was only 3%.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, dropping the cancer label from GG1 prostate disease and redefining GG1 prostate disease as a precancerous lesion led to a net reduction in estimated prostate cancer deaths. Proponents for retaining the cancer label for GG1 prostate disease should argue relabeling would have close to zero effects on screening rates or that other harms outweigh the benefits of reduced prostate cancer mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2026.1391","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T15:00:33Z","timestamp":1779375633000},"page":"767","source":"Crossref","is-referenced-by-count":2,"title":["Prostate Cancer Mortality After Relabeling Low-Grade Prostate Cancer as Precancerous"],"prefix":"10.1001","volume":"12","author":[{"given":"Andrew J.","family":"Vickers","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Cooperberg","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Franscisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian P.","family":"Pavlovich","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Franscisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Eggener","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"27","key":"cbr260006r1","doi-asserted-by":"publisher","first-page":"3110","DOI":"10.1200\/JCO.22.00123","article-title":"Low-grade prostate cancer: time to stop calling it cancer.","volume":"40","author":"Eggener","year":"2022","journal-title":"J Clin Oncol"},{"issue":"4","key":"cbr260006r2","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.eururo.2022.09.015","article-title":"Prostate adenocarcinoma grade group 1: rationale for retaining a cancer label in the 2022 World Health Organization classification.","volume":"83","author":"Netto","year":"2023","journal-title":"Eur Urol"},{"issue":"27","key":"cbr260006r3","doi-asserted-by":"publisher","first-page":"3106","DOI":"10.1200\/JCO.22.00926","article-title":"Renaming Gleason score 6 prostate to noncancer: a flawed idea scientifically and for patient care.","volume":"40","author":"Epstein","year":"2022","journal-title":"J Clin Oncol"},{"issue":"17","key":"cbr260006r4","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1056\/NEJMoa2503223","article-title":"European Study of Prostate Cancer Screening - 23-year follow-up.","volume":"393","author":"Roobol","year":"2025","journal-title":"N Engl J Med"},{"key":"cbr260006r5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-071082","article-title":"Current policies on early detection of prostate cancer create overdiagnosis and inequity with minimal benefit.","volume":"381","author":"Vickers","year":"2023","journal-title":"BMJ"},{"issue":"18","key":"cbr260006r6","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1001\/jama.2018.3710","article-title":"Screening for prostate cancer: US Preventive Services Task Force Recommendation Statement.","volume":"319","author":"Grossman","year":"2018","journal-title":"JAMA"},{"issue":"3","key":"cbr260006r7","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1002\/pon.5832","article-title":"Patient reported factors influencing the decision-making process of men with localised prostate cancer when considering active surveillance-a systematic review and thematic synthesis.","volume":"31","author":"Cunningham","year":"2022","journal-title":"Psychooncology"},{"issue":"11","key":"cbr260006r8","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1093\/jnci\/djad108","article-title":"The influence of the \u201ccancer\u201d label on perceptions and management decisions for low-grade prostate cancer.","volume":"115","author":"Berlin","year":"2023","journal-title":"J Natl Cancer Inst"},{"issue":"6","key":"cbr260006r9","doi-asserted-by":"publisher","first-page":"485","DOI":"10.3322\/caac.70028","article-title":"Prostate cancer statistics, 2025.","volume":"75","author":"Kratzer","year":"2025","journal-title":"CA Cancer J Clin"},{"issue":"7","key":"cbr260006r10","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1093\/jnci\/djac066","article-title":"Grade migration of prostate cancer in the United States during the last decade.","volume":"114","author":"Borregales","year":"2022","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"cbr260006r11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.1439","article-title":"Time trends and variation in the use of active surveillance for management of low-risk prostate cancer in the US.","volume":"6","author":"Cooperberg","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"6","key":"cbr260006r12","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1097\/JU.0000000000000713","article-title":"Long-term outcomes of active surveillance for prostate cancer: the Memorial Sloan Kettering Cancer Center experience.","volume":"203","author":"Carlsson","year":"2020","journal-title":"J Urol"},{"issue":"2","key":"cbr260006r13","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/JU.0000000000004039","article-title":"Estimating the effect of radical prostatectomy: combining data from the SPCG4 and PIVOT randomized trials with contemporary cohorts.","volume":"212","author":"Vickers","year":"2024","journal-title":"J Urol"},{"issue":"6","key":"cbr260006r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2024.102178","article-title":"National trends in PSA cancer screening with parallel investigation of colorectal cancer screening: an analysis of the CDC Behavioral Risk Factor Surveillance System from 2012 to 2022.","volume":"22","author":"Nguyen","year":"2024","journal-title":"Clin Genitourin Cancer"},{"issue":"7","key":"cbr260006r15","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1056\/NEJMoa1201637","article-title":"Quality-of-life effects of prostate-specific antigen screening.","volume":"367","author":"Heijnsdijk","year":"2012","journal-title":"N Engl J Med"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2849438\/jamaoncology_vickers_2026_br_260006_1784081582.87699.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:00:36Z","timestamp":1784214036000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2849438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2026.1391","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}