Editorials

Screening for breast and cervical cancer as a common cause for litigation

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7246.1352 (Published 20 May 2000) Cite this as: BMJ 2000;320:1352

A false negative result may be one of an irreducible minimum of errors

  1. Robin M Wilson, consultant radiologist
  1. City Hospital, Nottingham NG5 1PB

    A delay in the diagnosis of cancer is now one of the commonest reasons for medical litigation. Increasingly women in whom breast or cervical cancers are diagnosed after a “normal” screening test are alleging negligence through a delay in diagnosis and are seeking compensation through the legal system. Medical staff involved in providing screening are highly concerned about this situation.1 How has it arisen?

    The enthusiasm of the health service to promote screening has perhaps given women unrealistic expectations. Women may falsely believe that screening prevents cancer rather than detects it earlier. There is also a perception that cancers arising after a normal screening examination must have been “missed” and that the delays in diagnosis have prognostic significance.

    Population screening is different from health care, which manages individuals with symptoms; most people who are screened are free from disease, and an acceptable balance between the sensitivity and specificity of the screening test must take this …

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