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Malignant cancer goes undetected

It seems you may have to be dead before you can get an accurate diagnosis of malignant cancer.

Findings from a new US study reveal an alarming 44 per cent discrepancy between diagnosis of malignancies and confirmation of these diagnosis at autopsy.

In studying 1,105 autopsies done between 1986 and 1996, Elizabeth Burton and her colleagues at Louisiana State University Medical Centre identified 433 tumours, of which 250 were malignant.

Of those malignant tumours, 111 cancers were either undiagnosed or misdiagnosed; 57 of the deaths in individuals with undiagnosed cancer were directly related to the previously undetected malignancy.

The study was potentially skewed by the fact that the population studied had a low socio economic status and thus were more likely to be at risk of discrepancy.

Putting a cheerful slant on the findings, the authors suggest that autopsy remains an important diagnostic tool. However, autopsy rates have declined dramatically in the last 40 years, and the inability of doctors to interpret data and make an accurate diagnosis is unlikely to be much of a comfort to living individuals at risk of cancer (JAMA, 1998; 280: 1245-8).



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