Recalibrating low risk lesions
This project aims to engage the international pathology community to consider recalibration of the cancer diagnostic threshold and/or revisions to terminology used for low risk lesions, and 2) test proposed solutions in randomised cross over trials using hypothetical scenarios. This will be done by convening an international pathology symposium. A modified Delphi approach will be used to achieve consensus where we will work with key stakeholders – International Academy of Anatomical Pathologists, the Royal College of Pathologists of Australasia, the WHO Classification of Tumours Group, and others – to convene the symposium. Discussions on benefits and risks of proposed solutions for recalibration of diagnostic thresholds and/or changing terminology of low risk lesions, will be audio recorded and transcribed for thematic analysis. Following the symposium, we will undertake a series of randomised cross over trials using hypothetical scenarios to test the effects of proposed solutions on consumers.
Collaborators: A/Prof Nirmala Pathmanadthan (Westmead breast Cancer Institute), Prof Richard Scolyer (Melanoma Institute Australia), Prof Graham Mann (Melanoma Institute Australia). Dr Peter Ferguson (Melanoma Institute Australia), Prof Peter Soyer (University of Queensland), Prof Sunil Lakhani (University of Queensland), Dr Murali Varma (University Hospital of Wales).
Cancer Relabelling Citizens’ Jury
This project will elicit the views of informed citizens by conducting three citizens juries across Australia on whether low risk lesions that have little chance of causing harm should still be called ‘cancer’. It will use low risk papillary thyroid cancer as an example and pose the question of whether this should also be considered for other forms of low risk cancers.
Collaborators: Dr Patti Shih (University of Wollongong), Prof Stacy Carter (University of Wollongong), Dr Chris Degeling (University of Wollongong), Dr Raw Thomas (Bond University)
Media analysis of calls to rename low risk cancers
The use of more medicalised labels can increase both concern about illness and the desire for more invasive treatment. We wrote an analysis article in The BMJ in 2018 to consider the potential implications of removing the cancer label for low risk lesions where there is evidence of overdiagnosis and previous calls to replace the term cancer. The article generated a large amount of high-profile media coverage, nationally and internationally. This study analyses the media’s coverage of the article and aims to understands how to better communicate the message of low risk cancers and overdiagnosis to the public.
Collaborators: Dr Ray Moynihan (Bond University), A/Prof Juan P Brito (Mayo Clinic)