Proposed Terminology and Classification of Pre-Malignant Neoplastic Conditions: A Consensus Proposal

EBioMedicine. 2017 Dec:26:17-24. doi: 10.1016/j.ebiom.2017.11.024. Epub 2017 Nov 26.


Cancer evolution is a step-wise non-linear process that may start early in life or later in adulthood, and includes pre-malignant (indolent) and malignant phases. Early somatic changes may not be detectable or are found by chance in apparently healthy individuals. The same lesions may be detected in pre-malignant clonal conditions. In some patients, these lesions may never become relevant clinically whereas in others, they act together with additional pro-oncogenic hits and thereby contribute to the formation of an overt malignancy. Although some pre-malignant stages of a malignancy have been characterized, no global system to define and to classify these conditions is available. To discuss open issues related to pre-malignant phases of neoplastic disorders, a working conference was organized in Vienna in August 2015. The outcomes of this conference are summarized herein and include a basic proposal for a nomenclature and classification of pre-malignant conditions. This proposal should assist in the communication among patients, physicians and scientists, which is critical as genome-sequencing will soon be offered widely for early cancer-detection.

Keywords: Cancer; Clonal evolution; Neoplastic stem cells; Pre-malignant states.

Publication types

  • Review

MeSH terms

  • Cell Transformation, Neoplastic / genetics*
  • Disease Progression
  • Humans
  • Precancerous Conditions / classification*
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / genetics*
  • Precancerous Conditions / pathology