Diagnosis errors have put patient health in danger: NPSA study

Cancer Research UKApr 16 2010

Cancer diagnosis blunders impact on patient health

Diagnosis errors have put the health of hundreds of people in danger, a new investigation carried out by the NHS has revealed.

The study, which was conducted by the NHS' National Patient Safety Agency (NPSA), analysed over a thousand cases where cancer had been misdiagnosed or indentified late over a 12-month period.

According to the NPSA, of the 508 cases assessed in detail, 177 of the patients suffered as a result of avoidable shortcomings. These cases included two deaths and 25 further incidents of "severe harm".

Problems arose as a result of a number of factors, including a failure by doctors to identify key signs of cancer, the mixing up of tissue samples, the delaying of diagnostic tests due to staff shortages or the unavailability of equipment, and errors in giving patients the all-clear.

Where details of the length of the delay were available, the hold-up was less than a month in 25 per cent of cases, between one and three months in 37 per cent of cases and more than three months in the remaining 38 per cent of cases.

The importance of an early diagnosis is highlighted by figures which show that the UK is ranked ninth in Europe for male cancer mortality rates and 22nd for female cancer mortality rates.

While treatment availability, quality of care, screening programmes and the effectiveness of public health initiatives are all factors in the rate of mortality, it is thought that the UK's poor performance when compared with other EU countries is due in large part to late or missed diagnosis.

As a result, the study concludes that there is "considerable scope for improvements in practice".

"Factors more likely to lead to improvements include greater patient empowerment, stronger clinical leadership, local processes that engage clinicians using systematic monitoring of delay indicators, education and training, particularly in use of clinical guidelines, and the promotion of improved safety culture towards learning organisations," the report said.

Individual examples detailed in the investigation include the case of a 29-year-old woman whose breast lump was diagnosed as mastitis.

By the time it was eventually diagnosed as breast cancer, the cancer had spread "extensively", the report revealed.

Ed Yong, head of health evidence and information at Cancer Research UK, said: "GPs play a critical role in spotting cancers early. Detecting cancer at an early stage is challenging, especially when GPs see so many patients and when the signs and symptoms of cancer are often those of less threatening conditions. Nonetheless, reports like this show that there is always room for improvement."