Cancer May be Misdiagnosed in More Than 10% of Cases

A new study finds that the procedures used to obtain and examine tissue for a cancer diagnosis may lead to a misdiagnosis in up to 12% of patients. 

The study is published in the November 15, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

The frequency and cause of errors in cancer diagnosis has not been well studied due to the lack of national standards for error detection.  Dr. Stephen S. Raab, M.D. of the University of Pittsburgh School of Medicine and his colleagues decided to look at the frequency, cause, and impact of errors in cancer diagnosis.  They reviewed tissue specimens, pathologist’s findings, and medical records from four medical institutions in the mid-Atlantic and Midwestern regions of the country.

Patients often have multiple tests in order to diagnose cancer, and the researchers reviewed patient material when the diagnoses differed on multiple tests from the same patient.

The majority of errors were a result of poor specimen collection, while the proportion of errors caused my pathologist’s misinterpretation ranged from 5 to 50 %.  When pathologists reviewed specimens from other institutions they frequently disagreed with the assignment of error cause or the type of patient harm that the error was determined to have provoked.

According to HealthDay, the study’s author, Dr. Stephen Raab, issued a note of caution about patient harm.  “I want to make clear that the major consequence is not that patients unnecessarily have organs removed or have a false diagnosis of cancer.  Fortunately, patient symptoms almost always lead clinicians to do the right thing and retest, and this will lead to finding the cancer and a proper diagnosis.”

Based on their research, Dr. Raab and his colleagues found that the potential number of Americans who encounter diagnostic errors is large, in the range of 300,000 cancer patients annually.

The researchers say that the variation in clinical environments impairs the ability to truly understand the error causes.  To that end, “the standardization and uniform reporting of errors in cancer diagnosis is a first step in improving safety,” conclude the authors.

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