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PSNet: Patient Safety Network
Journal Article

Frequency and outcome of cervical cancer prevention failures in the United States.

Raab SS, Grzybicki DM, Zarbo RJ, et al. American journal of clinical pathology. 2007;128:817-24.

This AHRQ-funded study of cervical cancer screening results found a remarkably low incidence of missed malignancies. The authors analyzed Papanicolaou test results and the results of subsequent biopsies and found that the results were discordant in only 0.3% of cases, with most of these inconsistencies being clinically insignificant. Delayed diagnosis of cancer is a common cause of malpractice suits in ambulatory care. Although a prior study by Raab and colleagues found a higher overall error rate in anatomic pathology cancer diagnosis, this study documents that the US cervical cancer screening system appears to be very effective at preventing squamous cervical cancer. However, a systematic review of missed or delayed cancer diagnoses found that misdiagnosis of four common types of cancer—melanoma, as well as cancer of the breast, lung, or colon—remains common.