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Objectives This study aimed to explore whether alternative diagnostic labels to communicate a hypothetical low-risk prostate cancer diagnosis influenced management choice and level of anxiety among Australian women with a male partner aged 50 years or older (decreasing harms from overdiagnosis and overtreatment). It further sought to test whether providing absolute risk information about the benefits and harms of different management strategies modified any diagnostic label effects.The alternative labels for low-risk prostate cancer were chosen by our Clinician and Consumer Co-Investigators through a series of iterative online questionnaires. The final two labels that were chosen were: ‘low-risk neoplasm’ and ‘low-risk prostate neoplasm’. These were intended to convey the low, but not zero, risk of disease progression of the prostate lesion.This study complements another in Australian men (accepted for Oral presentation at PODC Abstract #18).Methods The study was designed as a between-subjects factorial (3 x 2) randomised online hypothetical experiment. Participants were randomised 1:1:1 to one of: ‘low-risk prostate cancer, Gleason Group 1’, ‘low-risk prostate neoplasm’, or ‘low-risk prostate lesion’. A second randomisation then allocated them 1:1 to detailed information on the benefits and harms of different management choices (including iconarrays to communicate absolute risks) versus less detailed information about management choices (no iconarrays).The primary outcome was management recommendation for their partner’s low-risk prostate lesion: conservative management (PSA monitoring or active surveillance) vs curative treatment (prostatectomy or radiation therapy). Secondary outcomes were: proportions recommending individual management options, diagnosis anxiety, management choice anxiety, open-text explanation of choice, and whether they would recommend curative treatment after five years of conservative management. We used an intention to treat approach for analysis, using multi-arm analyses across the six randomised groups.Results Recommendations of 1435 people recruited (1428 females, 7 non-females) were 34.5% (495) PSA monitoring, 46.5% (667) active surveillance, 11% (155) prostatectomy, and 8% (118) radiotherapy. Among those who received minimal information about the management options, 27.8% (67/234) of control label, 21.1% (49/236) of ‘low-risk prostate neoplasm’, and 15.8% (39/247) of ‘low-risk prostate lesion’ groups recommended curative treatment (absolute decrease 6.7% and 12.0%, respectively). Among those who received detailed information about the management options, 17.1% (41/235) of control label, 14.8% (34/230) of ‘low risk prostate neoplasm’, and 18.1% (46/248) of ‘low risk prostate lesion’ recommended curative treatment (absolute decrease 2.3% for ‘low-risk prostate neoplasm’ and absolute increase 1.0% for ‘low-risk prostate lesion’). Compared to the low information and control label, ‘low-risk prostate neoplasm’ and ‘low-risk prostate lesion’ + detailed information resulted in absolute decreases in curative treatment recommendations by 13% and 9.7%, respectively.Conclusions A high proportion of women are likely to recommend conservative managment (PSA monitoring alone or active surveillance) to their male partner if he was diagnosed with a low risk prostate lesion, but this is lower than the results for men themselves (See PODC Abstract #18).Compared to current practice where patients are told they have a ‘low risk prostate cancer’ and receive minimal information about the different management options, both alternative diagnostic labels (‘Low risk prostate neoplasm’ or’Low risk prostate lesion’) may increase the probability that their partners recommend they have conservative management instead of curative treatment.Providing detailed information about management options appears to also result in more recommendations for conservative management, and this effect is stronger than for men themselves.Using an alternative diagnostic label and providing detailed information about the different management options appear to be synergistic, increasing the probability of a conservative management recommendation (and preventing overtreatment).