University Times

Study reveals errors in cancer diagnosis

A new study led by pathologist Stephen Raab of Pitt’s School of Medicine finds that the procedures used to obtain and examine tissue for cancer diagnosis are prone to errors that can harm patients.

In the study, “Clinical Impact and Frequency of Anatomic Pathology Errors in Cancer Diagnoses,” researchers reviewed cases in which diagnoses differed on multiple tests from the same patient.

They found that as many as 12 percent of specimen pairs taken from the same body site on a patient show an erroneous diagnosis. The findings appear online and in the Nov. 15 edition of the American Cancer Society journal Cancer.

The study is based on a review of tissue specimens, pathology reports and medical records from the School of Medicine’s Department of Family Medicine and Clinical Epidemiology and from the pathology departments at Pitt’s School of Medicine, Detroit’s Henry Ford Health System, University of Iowa Healthcare and Western Pennsylvania Hospital.

The study found that up to 9 percent of gynecologic specimen pairs (Pap test and cervical biopsy) and up to 12 percent of non-gynecologic specimens contained an error attributed either to sampling or interpretation.

Gynecologic test errors resulted in harm in 45 percent of cases; non-gynecologic errors resulted in harm in 39 percent of cases, although the error rarely resulted in death or the loss of a body part. In cases where there was harm, most was rated either minimal (requiring additional non-invasive testing or delaying diagnosis by less than six months), or moderate (requiring additional invasive testing, subjecting the patient to unnecessary treatment or delaying diagnosis by more than six months).

Based on those figures, as many as 305,000 diagnostic errors nationwide could occur each year, resulting in some degree of harm to 127,950 patients.

The researchers concluded that standardization and uniform reporting of errors in cancer diagnosis would be an initial step toward improving safety.

“It is exceedingly difficult to measure the true frequency of errors in cancer diagnosis because of variably used detection methods, bias and the inability for institutions to secondarily review large case volumes.

“In a multi-institutional national effort to improve practice, we are in the process of standardizing methods, decreasing bias by sharing cases and data among institutions and establishing more accurate error frequencies by detecting errors using multiple methods,” the study stated.

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GSPH-Drexel partnership gets $2 million CDC grant

The Graduate School of Public Health (GSPH) has been awarded a $2 million grant from the Centers for Disease Control & Prevention for an environmental public health tracking project with the Drexel University School of Public Health.

The five-year grant will be used to establish an academic center to help public health agencies and professionals develop the infrastructure for a network to link environmental exposures and health outcomes.

Primary researchers on the project are Evelyn Talbott and Jeanne Zborowski, both of epidemiology.

In part, the grant will fund a partnership between GSPH and the state Department of Health and the Allegheny County Health Department.

GSPH and Drexel will serve as partners for the state’s asthma in schools demonstration program. They also will be instrumental in the formation of an asthma surveillance system in Allegheny County, with the development of a statewide asthma registry as the long-term goal.

Pitt also will research the relationship between environmental exposures and disease, based on the needs of regional public health agencies.