TABLE 1.

A Cancer-Screening Lexicon

True positive	The screening test gives a positive result, which is subsequently confirmed to be malignant cancer or a precancerous lesion that requires active surveillance, if that is the intended purpose of the test.
False positive	The screening test gives a positive result, which is subsequently confirmed to not be malignant cancer or a precancerous lesion that requires active surveillance, if that is the intended purpose of the test.
True negative	The screening test gives a negative result when no malignant cancer or precancerous lesion requires active surveillance, if that is the intended purpose of the test, is indeed present.
False negative	The screening test gives a negative result, but a malignant cancer or a precancerous lesion that requires active surveillance, if that is the intended purpose of the test, is subsequently confirmed to be present.
Consequential disease	A condition that will cause mortality or significant morbidity within the individual’s expected remaining lifespan.
Overdiagnosis	Making a person into a patient unnecessarily; a screen-positive result that detects an inconsequential condition, which does not require treatment or monitoring.
Sensitivity	The ability of a test to correctly identify those with the disease; a test with high sensitivity will miss fewer cancers (ie, fewer false negatives).
Specificity	The ability of a test to correctly identify those without the disease; a test with high specificity will have fewer instances of saying a cancer is present in error (false positives).
Positive predictive value	The probability that individuals with a positive test result actually have the disease increases with increasing disease prevalence.
Negative predictive value	The probability that individuals with a negative test result do not actually have the disease.
Precancerous lesion	A cellular or gross deviation away from normal that has an elevated risk of, or is on a trajectory toward, transformation into cancer.
indeterminate (lesion/nodule)	An abnormality that has a risk of progressing to become consequential cancer, the extent of which is unknown.
Detection	Identification, by means of a test, of a previously undiagnosed condition.
Diagnosis	Identification and characterization of a specific disease/condition following detection/symptomatic presentation.
Cancer screening	Testing asymptomatic, apparently healthy people for signs of cancer.
Targeted cancer screening	Testing asymptomatic individuals for cancer, within a subset of the population who are at higher risk of cancer (based on genomic risk, family history, behavioral factors, etc, beyond a simple age cutoff that is applied in all screening programs); therefore, finding a higher incidence of disease (synonymous with “surveillance”).
Risk stratification	Using genotypic, phenotypic, environmental, or behavioral information to identify individuals or populations who are at higher risk for developing cancers; can also identify those who are at lower risk and tailor interventions appropriately.