<p>Cancer education traditionally focuses on prevention, screening, diagnosis, treatment, survivorship and palliative care. However, primary care trainees frequently encounter patients with premalignant, indeterminate or risk-bearing findings that require surveillance despite the absence of cancer. These “almost-cancer” encounters demand skills in risk communication, uncertainty management and continuity of care. This article proposes an Almost-Cancer Curriculum for general practice and family medicine trainees, centred on avoiding binary reassurance, developing risk grammar, clarifying surveillance ownership and supporting patient understanding beyond the consultation. By teaching trainees to manage cancer-related uncertainty before diagnosis, the curriculum aims to improve communication, equity, follow-up safety and patient-centred care.</p>