Chest
Clinical InvestigationsLung CancerMiss Rate of Lung Cancer on the Chest Radiograph in Clinical Practice
Section snippets
Materials and Methods
The study included all consecutive patients with pathologically proven NSCLC selected from the database of the Dutch National Pathologic Anatomic Cancer Registration System between 1992 and 1995 in a 700-bed community hospital. Patients with recurrent cancer after therapy were excluded. The chest radiographs were obtained in the 125- to 150-kVp range, grid ratio 12:1, focus film distance 150 cm, rare earth screen with speed class 400 (Agfa ortho regular or Agfa curix HT-U films; Agfa Gevaert;
Results
From the Dutch National Pathologic Anatomic Cancer Registration System database, 495 consecutive patients from 1992 through 1995 with histopathologic proven first detected NSCLCs were identified in our hospital. In 99 patients, the radiographs were not traceable.
The characteristics of the remaining 396 patients are presented in Table 1. In 36 patients, more than one abnormality on the chest radiograph was visible.
Two radiologists preselected 259 patients with visible lesions on the chest
Discussion
To our knowledge, no studies have been reported that addressed the miss rate of the chest radiography in detecting lung cancer in clinical practice. In the literature, the miss rate of such lesions varied between 25% and 90%,10,11,12,13 but as indicated in the introduction, these figures originate from studies that differ largely in objective and design. In our study, a miss rate of 19% was found.
In 99 of the 495 cases, a chest radiograph was not available for analysis. However, there was no
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