Should Patients Seek a Second Opinion for Pathology Results?
Labaratory tests indicating the presence of cancer are sometimes incorrect or contain errors, leading to the misdiagnosis of "several thousand patients" every year, the Wall Street Journal reports. Studies at Johns Hopkins University have shown that about 1.4% of pathology cases involve "serious errors," such as diagnosing cancer when a tumor is benign, finding no problems in patients with cancer and diagnosing the wrong type of cancer. However, the risk of error could rise according to the type of cancer and body part involved in the testing. For example, biopsies involving female reproductive organs showed an error rate of 5.1%, skin cancer tests had an error rate of 2.9% and a review of 6,000 prostate cancer cases found that mistakes in staging and grading were made about 20% of the time. Pathology errors could lead to patients receiving the wrong treatment or no treatment at all, the Journal reports.
One reason for lab errors is that less invasive biopsy techniques mean pathologists must make a diagnosis based on small amounts of tissue. In addition, health plans do not always allow physicians to refer biopsies to "expert" pathologists, requiring lab work to go automatically to certain facilities that may be staffed by pathologists who lack "expertise" in specialty fields. Some physicians suggest that patients obtain a second opinion from specialty pathologists, a service usually covered by health plans. Dr. Barry Shmookler, staff pathologist at Suburban Hospital in Bethesda, Md., has even launched a Web site -- www.findcancerexperts.com -- that gives the name of "nationally known pathology specialists." Other physicians, however, feel it is "impractical and expensive" to seek second opinions on every test (Parker-Pope, Wall Street Journal, 4/13).