{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.pre-malignant-neoplasm","code":"thing-q1088163","url":"https://ver.cy/models/thing/q1088163/","name":"pre-malignant neoplasm","alternateNames":["glandular cell intraepithelial neoplasm","transitional cell intraepithelial neoplasm","prostatic intraepithelial neoplasia","squamous intraepithelial lesion of the cervix","precancerous lesion of palpebral epidermis","conjunctival intraepithelial neoplasm","corneal intraepithelial neoplasm","intraepithelial neoplasia","In situ lymphoid neoplasia","preleukemia","erythroplakia"],"kind":"thing","status":"published","version":"0.2.0-wave.4","language":"en","classifiers":{"family":"Thing Registry","category":"Cross-cutting context","entryKind":"thing","plane":"XCT","domain":["XCT.QLT"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"An abnormal growth of cells that is not cancer but has an increased risk of becoming cancer, also called a precancerous lesion, often graded by dysplasia or intraepithelial neoplasia, with examples the registry aliases name such as squamous intraepithelial lesions of the cervix, prostatic intraepithelial neoplasia, glandular and transitional cell intraepithelial neoplasms, conjunctival intraepithelial neoplasia and precancerous lesions of the eyelid skin; others include actinic keratosis, Barrett oesophagus and colorectal adenomas. The registry parent neoplastic malignancy contradicts the concept, since these lesions are by definition not malignant. Screening programmes detect many precancers so they can be monitored or treated, and people should follow screening guidance and discuss results with clinicians.","purpose":"Let an agent explain pre-malignant neoplasms in general terms, relay grading, examples, screening and management approaches from pathology and cancer prevention sources, describe the named lesions and flag the contradictory registry parent, and distinguish precancers from cancer in situ as defined by staging systems, invasive cancer, benign tumours and risk factors, without diagnosing or interpreting individual results.","scope":{"in":[],"out":[],"boundaries":[]},"distinguishingFeatures":["Increased cancer risk","Graded dysplasia","Found by screening","Often treatable"],"structure":{"bundles":[{"id":"understand","name":"Understand","description":"What a precancer is.","layers":[{"id":"definition","name":"Definition","description":"Definition.","findings":[{"id":"definition-finding","name":"Definition","description":"Definition.","questions":[{"text":"What is a pre-malignant neoplasm, and how does it differ from carcinoma in situ, invasive cancer, benign tumours and risk factors?","kind":"definition"},{"text":"Has someone received an abnormal screening result, in which case their clinician should explain it and follow-up should not be skipped?","kind":"boundary"}]}]},{"id":"lesions","name":"Lesions","description":"Named lesions.","findings":[{"id":"lesions-finding","name":"Lesions","description":"Lesions.","questions":[{"text":"What are cervical SIL, PIN, glandular and transitional cell intraepithelial neoplasms and conjunctival and eyelid precancers?","kind":"definition"},{"text":"Which entry fits the specific lesion?","kind":"action"}]}]}]},{"id":"pathology","name":"Pathology","description":"Pathology.","layers":[{"id":"dysplasia","name":"Dysplasia","description":"Grading.","findings":[{"id":"dysplasia-finding","name":"Dysplasia","description":"Dysplasia.","questions":[{"text":"How are low-grade and high-grade lesions graded?","kind":"provenance"},{"text":"Which references are standard?","kind":"provenance"}]}]},{"id":"progression","name":"Progression","description":"Progression risk.","findings":[{"id":"progression-finding","name":"Progression","description":"Progression.","questions":[{"text":"Why do many precancers regress while some progress, as studies report?","kind":"provenance"},{"text":"Which sources are cited?","kind":"provenance"}]}]}]},{"id":"prevention","name":"Prevention","description":"Screening and prevention.","layers":[{"id":"screening","name":"Screening","description":"Screening.","findings":[{"id":"screening-finding","name":"Screening","description":"Screening.","questions":[{"text":"How do cervical and colorectal screening programmes find precancers, with guidance checked against current sources?","kind":"provenance"},{"text":"Is the information current?","kind":"boundary"}]}]},{"id":"hpv","name":"HPV","description":"HPV vaccination.","findings":[{"id":"hpv-finding","name":"HPV","description":"HPV.","questions":[{"text":"What do health agencies report about HPV vaccination and cervical precancer rates?","kind":"provenance"},{"text":"Is the presentation neutral and attributed?","kind":"boundary"}]}]}]},{"id":"context","name":"Context","description":"Management.","layers":[{"id":"management","name":"Management","description":"Management approaches.","findings":[{"id":"management-finding","name":"Management","description":"Management.","questions":[{"text":"What general approaches such as surveillance or excision do guidelines describe?","kind":"provenance"},{"text":"Which entry fits colposcopy?","kind":"action"}]}]},{"id":"overdiagnosis","name":"Overdiagnosis","description":"Overdiagnosis debate.","findings":[{"id":"overdiagnosis-finding","name":"Overdiagnosis","description":"Overdiagnosis.","questions":[{"text":"What do researchers argue about overdiagnosis and overtreatment of precancers, with positions attributed?","kind":"provenance"},{"text":"Is the presentation neutral and attributed?","kind":"boundary"}]}]}]}]},"agentConduct":{"may":["Explain in general terms what a precancerous lesion is and why follow-up matters.","Remind people with abnormal screening results to keep their follow-up appointments.","Summarise screening guidance from named health authorities with dates."],"mustNot":["Tell a person their lesion is harmless or certainly cancer.","Advise skipping, delaying or replacing recommended follow-up or treatment.","Recommend unproven remedies as a way to reverse a precancerous lesion.","Disclose a person's screening or biopsy results without consent."],"requiresHuman":["Any decision to treat, remove or watch a particular lesion.","Delivering an abnormal result to a patient."]},"ethics":{"considerations":["Missed follow-up lets preventable cancers develop, while overtreatment causes avoidable harm.","Abnormal results cause anxiety, and some lesions carry stigma, such as those linked to infections."],"affectedParties":["Patients with abnormal results","Their families","Screening programmes"]},"owners":{"steward":"The treating clinician answers for each patient; screening programmes run the call and recall systems.","roles":[],"masterSystems":["Cancer screening registries"]},"relations":[{"target":"Q17321238","type":"parent","note":"registry parent class"},{"target":"Q18554796","type":"parent","note":"registry parent class"},{"target":"disease of cellular proliferation","type":"related","note":"in registry terms"},{"target":"cervical intraepithelial neoplasia","type":"related"},{"target":"cancer screening","type":"related"},{"target":"cancer","type":"related","note":"registry parent contradictory"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.pre-malignant-neoplasm","Wikidata: Q1088163 (https://www.wikidata.org/wiki/Q1088163)"]},"properties":{"applicability":"not-applicable","items":["Bethesda System: 1988 year - cervical cytology, revised","HPV vaccination: prevents many cervical precancers note - attributed to trials","registry parent: neoplastic malignancy note - contradictory"]},"recognition":{"applicability":"optional","items":["Non-cancerous lesion with increased cancer risk","Glandular cell intraepithelial neoplasm, transitional cell intraepithelial neoplasm, prostatic intraepithelial neoplasia, cervical squamous intraepithelial lesion, precancerous eyelid lesion, conjunctival intraepithelial neoplasm","Carcinoma in situ is classed differently by systems; invasive cancer spreads into tissue; benign tumours lack malignant potential; risk factors are exposures","Varies; often invisible, found by screening tests, biopsies or as skin patches."]},"capabilities":{"applicability":"required","items":["explain the concept and grading","relay examples","relay screening","flag the contradictory registry parent"]},"hazards":{"applicability":"required","items":["Missed follow-up after abnormal results","Overtreatment of low-grade lesions","Anxiety from misunderstanding results"]},"interfaces":{"applicability":"required","items":["WHO Classification of Tumours","National screening programmes","Bethesda and LAST terminology"]},"context":{"applicability":"required","items":["Not applicable; a category of lesions with cancer risk.","cervical precancers","skin precancers","gastrointestinal precancers","prostatic and urothelial intraepithelial neoplasia","ocular surface precancers"]}},"sources":[{"title":"Wikidata item Q1088163: pre-malignant neoplasm","url":"https://www.wikidata.org/wiki/Q1088163","note":"identity and sense of the item"},{"title":"Wikipedia: Precancerous condition","url":"https://en.wikipedia.org/wiki/Precancerous_condition","note":"general description of the item"}],"openQuestions":["The registry parent neoplastic malignancy should be corrected","Should each named lesion be a separate entry?","How should screening guidelines be linked and kept current?"],"resources":{"spec":"/models/things/publications/thing-q1088163/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q1088163/spec.json"],"providers":["Claude"],"researchStatus":"unreviewed","generatedAt":"2026-09-14T01:02:47Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-06T19:51:53+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane XCT: no invented physical properties."},"score":1.0}}