Renaming Low-Risk Prostate Cancer May Save Lives Each Year
Author: University of California - Los Angeles Health Sciences
Published: 1 Jul 2026 - Updated: 27 Oct 2026
Publication Details: Peer-Reviewed | Findings
Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content
Synopsis
This research, published in the peer-reviewed journal JAMA Oncology, uses a decision-analytical model built on U.S. population data to test what would happen if Grade Group 1 prostate cancer - the slowest-growing, lowest-risk form, diagnosed in roughly 100,000 American men each year - were renamed a precancerous condition. Senior author Dr. Scott Eggener of UCLA and colleagues from Memorial Sloan Kettering, UCSF and Johns Hopkins weighed the possible harm of some men drifting away from active surveillance against the likely gain of more men agreeing to PSA screening once the fear of overdiagnosis eased, and the model came out ahead in every scenario they tried, with a net drop of nearly 2,400 prostate cancer deaths a year in the main analysis. The work matters most to older men, who make up the bulk of prostate cancer diagnoses and who often face a frightening label, pressure toward surgery or radiation, and side effects that can affect continence, mobility and quality of life, and it gives patients, families and clinicians a clear, evidence-based way to think about how much risk a low-grade diagnosis really carries, though the authors stress the results come from a model and still need real-world confirmation.*
At a Glance
- 1 - A Grade Group 1 diagnosis can cost men access to life insurance because of the word cancer.
- 2 - Surgery and radiation for these tumors can leave lasting urinary, bowel and sexual problems.
- 3 - Bladder, cervical and thyroid cancers have all seen low-risk conditions renamed to reflect their true risk.
- 4 - Even if added screening cut metastatic prostate cancer by only 3%, the model still predicted fewer deaths overall.
Topic Definition
- Grade Group 1 Prostate Cancer
Grade Group 1 prostate cancer, also called Gleason 6 or Gleason 3+3 prostate cancer, is the lowest grade on the five-tier system pathologists use to describe how abnormal prostate tumor cells look under the microscope. Its cells closely resemble normal prostate tissue, it tends to grow very slowly or not at all, and on its own it is not known to spread beyond the prostate or cause symptoms. For that reason, major medical guidelines recommend active surveillance - scheduled PSA blood tests, MRI scans and periodic biopsies - for nearly all men with this diagnosis instead of immediate surgery or radiation, with treatment considered only if a higher-grade cancer is later found.
Overview
Should Lowest-Risk Prostate "Cancer" Still Be Called Cancer? Study Suggests Changing the Name Could Save Lives
A growing number of prostate cancer experts argue that calling the lowest-risk prostate cancer "cancer" does more harm than good. A new UCLA-led study found removing the cancer label could dramatically reduce overtreatment and encourage more men to get screened, potentially leading to significantly fewer deaths from aggressive prostate cancer.
Using a model based on U.S. population data, the researchers estimated that relabeling Grade Group 1 (GG1) prostate cancer - the earliest and lowest-risk form of the disease - as a precancerous condition could reduce unnecessary treatment and prevent nearly 2,400 prostate cancer deaths annually. The researchers found this benefit would largely come from more men choosing PSA screening, as relabeling GG1 could reduce concerns about over-diagnosis and unnecessary treatment among patients and clinicians.
A large body of research has shown that a pure GG1 cannot cause symptoms or metastasize. Guidelines therefore recommend active surveillance (including PSA testing, MRI and periodic biopsies) rather than treatment for nearly all men diagnosed with GG1. Nevertheless, up to 40% of men in the United States with GG1 continue to get treatment.
The findings, published in JAMA Oncology, challenge the long-held assumption that keeping the "cancer" label is necessary to ensure patients continue monitoring their disease.
"Medicine has a history of appropriately redefining conditions when terminology no longer accurately reflects risk," said Dr. Scott Eggener, Chair of the Department of Urology at the David Geffen School of Medicine at UCLA and senior author of the study. "Similar changes have occurred in other cancers, including bladder, cervical, and thyroid cancers, where some conditions once classified as cancer have been redefined to better reflect their extremely low likelihood of causing harm. It has even happened before in prostate cancer. For the lowest-risk prostate tumors, removing the cancer label could help patients avoid unnecessary treatment and encourage screening approaches that can further reduce deaths from aggressive prostate cancer."
Unlike aggressive prostate cancers that can spread throughout the body, GG1 prostate cancer, also known as Gleason 6 prostate cancer, typically grows slowly over years or decades, or not at all. These tumors do not cause symptoms or become life-threatening unless a higher-grade cancer develops in the prostate.
But the diagnosis itself can be difficult for patients to process.
Research has shown that men diagnosed with GG1 typically experience stress and anxiety, and many choose surgery or radiation even when active surveillance would be the most appropriate option. Those treatments can cause long-term complications, including urinary, bowel, and sexual dysfunction. In addition, patients unnecessarily lose access to life insurance because of the cancer diagnosis.
The authors also note that calling these tumors "cancer" contributes to overtreatment because patients may assume the disease is more dangerous than it is.
"Changing the terminology does not mean ignoring these tumors or eliminating follow-up care," said Eggener, who is also a member of the UCLA Health Jonsson Comprehensive Cancer Center. "It means recognizing that not all prostate cancer carries the same risk and language should better reflect the biology of the disease."
Not all experts, however, agree that the cancer label should be removed. Critics argue that relabeling GG1 disease as a precancerous condition could cause some patients to underestimate the importance of ongoing monitoring and become less likely to follow active surveillance recommendations.
If fewer patients continue surveillance, some tumors might later become more aggressive and go undetected, potentially leading to more advanced disease and deaths.
To examine this concern, the researchers built a decision-analytical model to predict both the potential harms and benefits of relabeling GG1 prostate disease. The model incorporated U.S. population data and findings from previously published studies to estimate how changes in patient behavior could affect prostate cancer mortality.
Using this data, the researchers estimated that about 100,000 men each year are diagnosed with GG1 prostate disease and modeled the potential impact if some patients became less likely to follow active surveillance after the terminology was changed. They then compared those potential deaths with the number of deaths that could be prevented if relabeling encouraged more men to undergo PSA screening by significantly reducing concerns about overdiagnosis and overtreatment.
Using a range of scenarios, including cases where adherence to active surveillance declined more than expected and screening rates increased only modestly, the model consistently predicted a net reduction in prostate cancer deaths.
In their primary analysis, the researchers estimated that relabeling GG1 would prevent approximately 2,835 prostate cancer deaths annually through increased screening, while potentially causing about 452 additional deaths if some patients did not continue active surveillance. Overall, the model predicted a net reduction of nearly 2,400 prostate cancer deaths each year.
The findings remained consistent across multiple sensitivity analyses that tested more extreme assumptions, including higher rates of patients discontinuing surveillance, greater disease progression risks and smaller increases in screening. The researchers found that even a modest improvement in screening that reduced metastatic prostate cancer by only 3% would still result in fewer prostate cancer deaths overall.
Because the study used a mathematical model rather than following patients over time, the findings depend on assumptions about how patients and physicians would respond to a change in terminology.
The researchers noted that future studies will be needed to understand how relabeling would affect real-world screening decisions, patient behavior and long-term outcomes.
Still, the researchers said the findings highlight the need to reconsider how low-risk prostate cancer is classified and communicated to patients.
"Patients deserve information that reflects the actual risk of their disease, not just a label that may create fear or confusion," said Eggener. "Our hope is that this work encourages a more thoughtful approach to how we define and communicate low-risk prostate cancer."
The study's first author is Dr. Andrew Vickers from Memorial Sloan Kettering Cancer Center. Other authors include Dr. Matthew Cooperberg and Dr. Peter Carroll from the University of California, San Francisco, and Dr. Christian Pavlovich from the Johns Hopkins University School of Medicine.
Frequently Asked Questions
NOTE: Researched FAQs by Disabled World (DW)
What is the difference between Grade Group 1 and Grade Group 2 prostate cancer?
Grade Group 1 contains only low-grade Gleason pattern 3 cells, while Grade Group 2 includes a small amount of more aggressive pattern 4 cells alongside mostly pattern 3. That small shift matters, because Grade Group 2 can spread and is more likely to need treatment, although some men with low-volume Grade Group 2 disease may still be offered active surveillance.
How is a Gleason score calculated?
A pathologist examines biopsy tissue and assigns a pattern number to the most common cell pattern and to the second most common one, usually on a scale of 3 to 5. The two numbers are added together, so 3 plus 3 gives a Gleason score of 6, which corresponds to Grade Group 1.
Is active surveillance the same as watchful waiting?
No. Active surveillance involves regular PSA tests, MRI scans and repeat biopsies with the goal of offering curative treatment if the cancer changes. Watchful waiting is usually less intensive, is often used for older men or those with serious health problems, and focuses on managing symptoms if they appear rather than curing the disease.
Can a Grade Group 1 diagnosis be upgraded later?
Yes. A biopsy samples only small parts of the prostate, so a follow-up biopsy or MRI-guided biopsy sometimes finds higher-grade cells that were missed the first time. This is one of the main reasons ongoing monitoring remains important even for the lowest-risk diagnosis.
What role does MRI play in active surveillance?
Prostate MRI can identify suspicious areas that need a closer look and help guide targeted biopsies to those spots. It can also help some men space out or avoid repeat biopsies when scans remain stable over time.
What is PSA density and why does it matter?
PSA density is the PSA level divided by the volume of the prostate, usually measured by MRI or ultrasound. Because a larger prostate naturally produces more PSA, this measure helps doctors judge whether a raised PSA is more likely due to gland size or to a tumor, and a higher density can signal greater risk.
When should men start talking with a doctor about PSA screening?
The American Cancer Society suggests men at average risk discuss screening with their doctor starting at age 50, while Black men and those with a father or brother diagnosed before 65 should begin the conversation at 45. Men with several close relatives diagnosed at an early age may start at 40.
Are some men with Grade Group 1 prostate cancer not good candidates for active surveillance?
Some men may be steered toward closer evaluation or treatment if they have a high PSA density, a large amount of tumor across many biopsy cores, suspicious MRI findings, or certain genetic risk factors. A urologist will usually weigh these features, along with age and overall health, before recommending a plan.
Insights, Analysis, and Developments
Editorial Note: The question at the heart of this study is less about medicine than about language, and that is exactly why it deserves attention. A model estimating about 2,835 lives saved through wider screening against roughly 452 lost to lapses in follow-up will not settle the argument by itself, and critics are right that a softer label must never become an excuse to skip monitoring. Still, the balance of the evidence points in one direction: when a diagnosis frightens men into treatment they do not need, or keeps them away from the PSA test altogether, the word itself becomes part of the problem. For older men, men already managing other health conditions, and anyone for whom incontinence or erectile dysfunction would add to an existing disability, getting the terminology right could shape some of the most important health decisions they ever make.*
Attribution/Source(s): This peer-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally issued as a press release by University of California - Los Angeles Health Sciences and published on 1 Jul 2026. Last updated on 27 Oct 2026. This content may have been edited for style, clarity, or brevity.
* Editorial additions by Ian C. Langtree.