REPRODUCIBILITY OF MAJOR DIAGNOSES IN A BINATIONAL STUDY OF LUNG-CANCER IN URANIUM MINERS AND ATOMIC-BOMB SURVIVORS

A binational panel of four Japanese and four American pathologists exa mined 208 pulmonary neoplasms, according to the World Health Organizat ion (WHO) recommendations, second edition, for the histologic typing o f lung tumors. The study design included independent evaluations by pa thologists working alone, followed by group reviews. The individual ev aluations, and their implications for reproducibility of the WHO recom mendations, are reported. Consensus (agreement by six or more patholog ists) with respect to major (ie, first digit) diagnosis was obtained f or 76.4% of the cases. Consensus was obtained for 72.5% of the cases w ith any major diagnosis of small cell cancer; the comparable figures f or adenocarcinoma and squamous cell carcinoma were 56% and 48%, respec tively. American pathologists were twice as likely as Japanese patholo gists to diagnose large-cell national difference. Consensus was far le ss frequent with the minor tie, second digit) diagnosis categories. Th is study shows that lung cancers continue to be difficult to classify reproducibly.