ACCURACY OF ADMISSION AND CLINICAL-DIAGNOSIS OF TUMORS AS REVEALED BY2000 AUTOPSIES

Admission, clinical and autopsy diagnoses of tumour were computed in 2 000 consecutive cases, aged 30-80 years, using data collected in two u niversity pathology departments in Budapest, Hungary. Based on diagnos is of tumour, regardless of site, as the underlying cause of death fal se-negative rates were 37.4% at admission and 8.8% clinically. Corresp onding false-positive rates were 8.4 and 9.1%. General practitioners w ho correctly diagnosed a tumour as the cause of the terminal illness i dentified the primary site wrongly in 20.6% (90/436) of cases. Hospita l clinicians did so in 20.4% (130/636) of cases. Overall, of site-spec ific tumours considered as the underlying cause of death at autopsy, 2 7.4% were incorrectly diagnosed clinically and 50.4% at admission. Dia gnostic errors were particularly common for tumours of the lung, liver , ovary and gall bladder. Graduate and postgraduate education, plannin g of the health care system and quality of cancer care may benefit fro m statistical data derived from autopsy diagnoses. Copyright (C) 1996 Elsevier Science Ltd