title: Precancer: a conceptual working definition -- results of a Consensus Conference.
abstract: BACKGROUND
  Precancers are lesions that precede the appearance of invasive cancers. The successful prevention or treatment of precancers has the potential to eliminate deaths due to cancer.
  
  
  METHODS
  A National Cancer Institute-sponsored Conference on Precancer was convened on November 8-9, 2004, at The George Washington University Medical Center, Washington, DC. A definition of precancers was developed over 2 days of Conference discussions.
  
  
  RESULTS
  The following five criteria define a precancer: (1) evidence must exist that the precancer is associated with an increased risk of cancer; (2) when a precancer progresses to cancer, the resulting cancer arises from cells within the precancer; (3) a precancer differs from the normal tissue from which it arises; (4) a precancer differs from the cancer into which it develops, although it has some, but not all, of the molecular and phenotypic properties that characterize the cancer; (5) there is a method by which the precancer can be diagnosed.
  
  
  CONCLUSIONS
  The Conference participants developed a general definition for precancers that would provide a consistent and clinically useful way of distinguishing precancers from all other types of lesions. It was recognized that many precancerous lesions may not meet this strict definition, but the group felt it was necessary to define criteria that will help standardize clinical and biological studies. Furthermore, a set of defining criteria for putative precancer lesions will permit pathologists to build a diagnostically useful taxonomy of precancers based on specified clinical and biological properties. Precancers thus characterized can be classified into clinically relevant sub-groups based on shared properties (i.e. biomarkers, oncogenes, common metabolic pathways, responses to therapy, etc.). Publications that introduce newly described precancer entities should describe how each of the five defining criteria apply. This manuscript reviews the proposed definition of precancers and suggests how pathologists, oncologists and cancer researchers may determine when these criteria are satisfied.
authors.affiliation: Cancer Diagnosis Program, National Cancer Institute, NIH, Bethesda, MD, USA.
authors.forename: Jules J
authors.initials: JJ
authors.lastname: Berman
authors.forename: Jorge
authors.initials: J
authors.lastname: Albores-Saavedra
authors.forename: David
authors.initials: D
authors.lastname: Bostwick
authors.forename: Ronald
authors.initials: R
authors.lastname: Delellis
authors.forename: John
authors.initials: J
authors.lastname: Eble
authors.forename: Stanley R
authors.initials: SR
authors.lastname: Hamilton
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: George L
authors.initials: GL
authors.lastname: Mutter
authors.forename: David
authors.initials: D
authors.lastname: Page
authors.forename: Thomas
authors.initials: T
authors.lastname: Rohan
authors.forename: William
authors.initials: W
authors.lastname: Travis
authors.forename: Donald E
authors.initials: DE
authors.lastname: Henson
mesh_terms: D006801:Humans; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology*; D014481:United States