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Cancer diagnosis is often missed
Janice Hopkins Tanne, New York
Lethal cancers were not diagnosed or were misdiagnosed before death in 44% of cases, according to a 10 year retrospective study of postmortem examinations at a US academic medical centre.
This discrepancy calls into serious question all public health statistics based on death certificate information, as well as clinical decisions, according to Dr George Lundberg, a pathologist and editor of JAMA.
Dr Elizabeth Burton and colleagues reviewed data on all 1105 men and women in whom postmortem examinations were carried out between 1986 and 1995 at the Medical Center of Louisiana in New Orleans (JAMA 1998;280:1245-8). The medical centre's rate of postmortem examination was unusually high (42%) thanks to cooperation with the local coroner.
Because diagnoses from death certificates are unreliable, Dr Burton gathered clinical diagnoses from surgical pathology reports, cytology reports, and patient charts. She found 250 malignant tumours in
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