Clinically undiagnosed malignant tumours found at autopsy

Abstract

In a series of over 20,000 autopsies carried out over a 25‐year period, 700 cancers (11%) were found in patients in whom the diagnosis of cancer had not been considered relevant clinically. In over half of them the unrecognized tumour was considered an incidential finding and thus of no importance to the individual concerned, though of epidemiological concern. As expected from the literature the main organs involved were kidney and prostate, with stomach cancer in third place. In contrast, the unrecognized cancers that caused death were most often from the pancreas or lung, again with the stomach in third place. These patients with stomach or lung cancer were frequently thought to have died of other diseases in the gastrointestinal/respiratory tract, and the disease cited was often present though not the cause of death. These patients tended to be older than those with clinically recognized disease, and had been hospitalized late in the course of their fatal illness, at which time clinical recognition would not have influenced the outcome. Earlier recognition of this type of cancer is thus essential. This cannot be achieved without definition and further analysis of the entities concerned.

Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary

“…A recent study in the Czech Republic, another Central European country, found a 44% higher incidence of lung cancer in autopsy reports compared to clinical settings (17). Previous publications also reported a 11–28% higher incidence of cancer in autopsy reports than those reported by clinicians (18, 19). Based on a WHO report, Hungary is one of the countries with the highest autopsy rates for hospital deaths: dissection is performed in 36.9% of patients who die at hospitals (20).…”

Universal cancer screening: revolutionary, rational, and realizable

“…Prevalence estimates vary widely based on methods used and on age and other demographic factors in populations studied. 10 Extrapolations from autopsy series suggest that roughly 7–11% of those aged 50–75 harbor an internal malignancy, 11 – 13 and that cancer may be the unsuspected cause of death in 3–5%. 11 , 12 …”

Diffuse large B-cell lymphoma: A metabolic disorder?

“…Diagnostic errors in medicine are on the rise and the incidence of post-mortem findings of undiagnosed malignancy at autopsy have been reported as high as 11% [ 1 ]. B cell lymphoma constitutes 80–85% of cases of Non Hodgkin’s lymphoma (NHL) in the Untied States, most of which are diffuse large B cell lymphomas (DLBCL, 32%), and is the seventh leading cancer in both male and female patients [ 2 ].…”