Failure to Diagnose Cancer and Misdiagnosis of Cancer
This is an excerpt from an article on ConsumerSafety.org. To read the full article, please use this link.
Common Cancers for Late Diagnosis
To help keep you and your family educated, we’ve provided research on the most commonly misdiagnosed cancers...
Cervical Cancer
Cervical cancer screening is done via a pap smear, which you should receive every 3 years from ages 21-65. There are two main reasons why cervical cancer is missed. First is that the woman did not receive regular pap smears, either by choice, or because her physician failed to recommend them. Second is that sometimes the pap smear doesn’t “catch” the cancerous cells; it isn’t a perfect test.
Symptoms of the cancer include vaginal bleeding or discharge, or pain during sex. All of these can be misattributed to a woman’s menstrual cycle, especially if she has a history of irregularity. Discharge can have many causes, and pain during sex is an unfortunately common complaint among women. Sadly, if a doctor fails to put the pieces together, cervical cancer may go unnoticed until later stages.
Breast Cancer
Breast Cancer is usually discovered either during a clinical breast exam or routine mammogram. An abnormal result may be followed by an MRI and/or a tissue biopsy. In clinical exams, a doctor might miss a tumor that is too small to be felt. Or, the physician may see a woman with dense breast tissue or a mass difference between breasts and mistakenly think the breasts are normal, especially since many women do have slight size differences. A doctor who fails to recommend or perform routine mammograms for women over 40 would also be at fault for a missed diagnosis.
Unfortunately, diagnosing breast cancer is tricky. Most people trust biopsies as the gold standard, but these are often misread by pathologists who don’t specialize in breast cancer. The result is an astounding number of false positive diagnoses, which may lead to surgery like a mastectomy, that wasn’t truly needed.
Colorectal Cancer
Colorectal (colon) cancer is usually missed due to a lack of screening, or the wrong type of screening. Colonoscopy guidelines are clear and well-known, so if your physician isn’t following those provided by multiple national organizations, it is possible for them to miss your cancer. Even with screening, it is possible to miss subtle cancers, which may not be clinically visible during testing.
Though there are several screening types available today, colonoscopies remain the #1 way to detect polyps and colon cancer. Though the test isn’t perfect, it’s the best we have right now, in comparison. For example, a sigmoidoscopy uses a flexible tube to enter the lower colon, and may be less stressful for a patient, because it requires less preparation, and the patient is not “put out” during the procedure. However, a sigmoidoscopy only checks the lower colon. If a cancer is growing in the upper region of your colon, a sigmoidoscopy might miss it completely.
Endometrial Cancer
There is no standard screening for endometrial cancer at this time, though sometimes pap smears can show endometrial abnormalities. Most endometrial cancers are diagnosed first clinically, by symptoms, and then confirmed by a transvaginal ultrasound or endometrial biopsy.
In many cases, endometrial cancer is caught early; in its beginning stages, the cancer is highly curable. However, a physician might miss the signs of endometrial cancer if they are not paying attention to their patient’s complaints. Many of the symptoms, like abnormal bleeding, pelvic pain and weight gain, are also easily associated with menopause– which is when endometrial cancer is most likely to develop.
Lung Cancer
For people with a history of significant smoking, annual screening is recommended, using a technique called low-dose computed tomography (LDCT). Otherwise, there is no recommended or standard screening for lung cancer.
First, LDCT is not without risks for misdiagnosis. The test can have false positive results, possibly leading to unnecessary surgeries or further tests. LDCT can also lead to overdiagnosis, or diagnosis of a problem that may never have worsened on its own. Finally, repeated radiation from LDCT can in some cases cause cancer in healthy people.
Most lung cancer is found first clinically. Unfortunately, many of the symptoms (cough, wheezing, shortness of breath and headache) can be easily mistaken for other conditions, or even viral infections. If lung cancer is suspected, most people have a chest x-ray to confirm. Again, there is a huge potential here for human error. In fact, nearly 90% of lung cancer misdiagnosis is attributed to a misread radiograph (x-ray).
Prostate Cancer
Prostate cancer is the second leading cause of death from cancer for men, affecting nearly 16% of all men during their lifetime. Still, the disease can be difficult to diagnose, both clinically and via testing.
Clinically, the symptoms of prostate cancer are often confused with the signs of aging, especially since the majority of prostate cancer cases occur in men over age 65. Symptoms like back pain, trouble urinating and erectile dysfunction are considered by many to be a natural part of aging, which means men might not mention them to their doctors– or that their physician will wave away concerns.
Even testing for prostate cancer is difficult. Many many are asymptomatic in the early stages, and the cancer may not be palpable during a digital rectal exam. A prostate specific antigen test (PSA test) can be indicative– but antigen levels can be caused by multiple conditions, as well as some medications. Biopsies are difficult to get in the right spot, and can have false results. Plus, in older men, there is a chance that the tumor won’t affect their lives, which makes some doctors opt not to treat it. If a tumor is treated aggressively without true need, it might cause the patient more harm than simply leaving it alone.
Skin Cancer (Melanoma)
Especially in the early stages, skin cancer has very few symptoms, and may be completely asymptomatic. Most diagnoses of skin cancer come from visual suspicion, followed by a biopsy.
Because of the visual aspect, most missed skin cancers are the result of a lack of experience. An internist who sees a suspicious mole or skin lesion may not be specialized enough to recognize the abnormality. Or, with a rough or scaly patch of skin, the physician may think the patient has another type of rash or eczema, and treat for that instead of pushing for testing or sending the patient to a dermatologist.
