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False positives and misdiagnosis

A study published in the Journal of Medical Screening this week has stated that breast cancer screening, by way of mammograms, saves the lives of two women for every one patient who receives unnecessary treatment.

This can only be a good thing for the female population overall, but those who are given false positives are often forgotten.  In the main, they are eventually just grateful that the diagnosis has been incorrect and no long-term harm has been caused.  However, occasionally the misdiagnosis will result in unnecessary treatment, and the development of significant psychological conditions such as post traumatic stress disorder.

It must be remembered that diagnosis is an art, taking into account all the symptoms experienced by the patient.  As such, a degree of interpretation may come into the diagnosis and, if it is the case that most reasonable clinicians would have made the error, then the misdiagnosis must be put down to being one of life’s trials.  However, if a reasonably competent clinician would not have diagnosed the cancer incorrectly, and that, as a result of the error, some harm has occurred, then there may be a legal claim for clinical negligence.  The harm could be unnecessary procedures, even surgery, and/or the development of a recognised psychological disorder.  It must also be shown that this harm has been at least largely caused by the negligent diagnosis.

We cannot take away the positives of screening programmes.  For every 1,000 women screened in the breast cancer study, between 7 and 9 lives were saved and only 4 cases were over-diagnosed.  Clearly the screening programmes go towards the greater good and should not be criticised or reduced.  But let’s not forget that the statistics involve individuals whose lives may be changed by incorrect diagnosis.

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