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Autopsy study shows many cancers go undiagnosed

Autopsy room  
October 13, 1998
Web posted at: 11:08 p.m. EDT (0308 GMT)

From Medical Correspondent Rhonda Rowland

(CNN) -- A recent study of autopsies shows that doctors are frequently missing cancers in patients while they are alive.

The research has prompted the Journal of the American Medical Association, which published the study, to urge that the now- rare practice of performing autopsies become more common.

During the 1950s, more than half the people who died in hospitals in the United States had autopsies. But now, autopsies are done only 5 percent to 10 percent of the time.

"Many hospitals have no autopsies at all," said the journal's editor, Dr. George Lundberg. "Now this is a new phenomenon of this decade, and it's the most troubling of all."

One important finding is that cancers are going undiagnosed.

Researchers at Louisiana State University looked at more than a thousand autopsy cases and found 250 cases of cancer. Of those, 111, or 44 percent, had undiagnosed or misdiagnosed cancer tumors. Fifty-seven of the deaths were due to the cancer.

Most of the tumors were found in the respiratory and gastrointestinal tracts or the reproductive and urinary organs. Cancer was most often overlooked in middle-aged patients.

"It means we doctors -- specifically we in the medical care delivery system, we in the hospital industry -- need to be a little more humble," Lundberg said. "We need to realize maybe we're not as smart as we think we are."

The lack of autopsies has several causes, most financial.

"There's a reimbursement issue," said Dr. Randy Hanzlick, medical examiner for Fulton County in Atlanta. "There's a fair amount of work and they're fairly expensive, and there's no automatic system for reimbursement that makes people feel like they are performing a service of value."

While though some people don't like the idea of their loved ones being studied, Lundberg writes in the journal he edits that there's another reason for falling autopsy rates: fear of malpractice.

"It represents a culture which I am afraid has begun to value covering up the truth more than finding out what the truth is," he said.

Pathologists say if a family member dies in the hospital, you do have the right to ask the doctor for an autopsy.

Reuters contributed to this report.

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