Misdiagnosing Cancer is More Common Than We Think

A Boston group's study offers data on cancer misdiagnosis, and how to stop the problem.

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According to a statement issued yesterday by Boston-based Best Doctors, Inc., cancer is commonly misdiagnosed. In a joint study between Best Doctors and the National Coalition on Health Care (NCHC), researchers found that 60.5 percent of doctors surveyed believed cancer misdiagnosis rates to be between zero and 10 percent, a number far lower than the 28 percent estimated by the BMJ Quality and Safety journal. The study also found that doctors believed lymphoma to be the most misdiagnosed cancer, followed by, in order, breast cancer, sarcomas, melanomas, and cancer of an unknown site.

Though 28 percent seems disturbingly high, the release also polled doctors on why they believe misdiagnosis occurs. The top reasons were “fragmented or missing information across medical information systems” (38.5 percent), “inadequate pathology diagnostic resources” (22 percent), and “inadequate genetic/genomic information available at the time of diagnosis” (20.3 percent). What should not be considered a reason, Best Doctors’ David Seligman says in the release, is doctor apathy or ineptitude.

“Does misdiagnosis mean physicians don’t care or aren’t committed?  Of course not,” noted David Seligman, chairman and chief executive officer of Best Doctors. “But doctors today are increasingly time-strapped. Many of them are seeing up to 30 patients a day. They’re working in an overburdened health system with fractured or incomplete medical records. All of these things too often directly impact health outcomes – no matter how dedicated or skilled the physician may be.”

Doctors are also cognizant of what needs to be done to correct the problem. In the study, doctors were asked for possible ways to avoid misdiagnosis, or changes that need to be made the diagnostic system. The most popular answer, chosen by 36 percent of respondents, was “new or improved pathology tools and resources,” followed by “new or more readily accessible resources for tumor genetic testing” with 17.8 percent, and “new or improved radiology tools and resources” with 15 percent. From a research standpoint, 29 percent of surveyed doctors also felt that lawmakers should offer incentives to hospitals that are gathering data and presenting research about misdiagnosis.

One thing the study made clear is that doctors and researchers, as we would hope, are not taking this problem lightly. Along with the goal of avoiding the patient pain and suffering that comes with an incorrect diagnosis, the release quotes John Rother, NCHC president and chief executive officer, about the added cost misdiagnosis brings to the healthcare system:

“According to Thomson Reuters, nearly seven hundred billion dollars are wasted in the U.S. medical system each year, much of which is tied to misdiagnosis or people getting the wrong treatment,” Rother said. “Not enough is being done on the state and federal policy end of things to acknowledge and firmly address this critical issue. Given our current health care climate and challenges, as decision-makers become more aware of the frequency of misdiagnosis and the enormous costs associated with it, they have a sizeable opportunity to make diagnostic accuracy much more of a ‘front and center’ issue in health care.”