An Autopsy Study of Cancer Patients

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Abstract
We reported previously that 41% of all cancers in a large autopsy series were incorrectly diagnosed before death. We have now detected a direct association between accurate clinical diagnoses of cancer and increasing length and number of hospital admissions. The prevalence of incorrectly diagnosed cancer progressively decreased from a high of 53% to a low of 30% when both the number and length of hospitalizations increased. However, these relationships were limited to the first five hospital admissions and the first 20 hospital days. Beyond these limits, no further improvement in diagnostic accuracy was noted. Undiagnosed cancer caused 11% of the deaths of patients with more than 40 days of hospitalization as well as the deaths of those with more than one hospital admission. Accurate clinical diagnoses of diseases such as cancer can be associated with an optimum length and number of hospitalizations, beyond which little or no improvement in diagnostic accuracy occurs.

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