The Centers for Disease Control (CDC) recently reported that primary care doctors are failing to properly screen high-risk patients for lung cancer. A physician’s failure to order screening, particularly as part of a well-office visit, can give rise to a medical malpractice claim.
Many people hear the word “cancer” and think that it is a singular disease process that may affect different organs. In fact, there are many different kinds of cancer, each with its own characteristics, prognosis, and treatment protocols. To a medical malpractice lawyer, a delay in diagnosis of cancer is a common complaint from prospective clients. Usually, delayed diagnosis and delayed treatment occurs as a result of a doctor’s failure to take symptoms seriously or the failure to create a differential diagnosis that takes into account that a patient’s symptoms may be caused by a malignancy rather than a benign medical condition. Delayed diagnosis can also occur when test results are misinterpreted, lost, or ignored. In some cases, early diagnosis can mean the difference between life and death. As a result, the American Cancer Society (ACS) has published guidelines for screening of patients to identify different types of cancer at the earliest possible moment.
Most patients are not aware of the ACS screening guidelines. They rely on their physician to alert them to important health-related information. Likewise, primary care physicians owe a duty to alert patients to applicable screening protocols. Screening recommendations are appropriate when a patient comes in for a routine well check-up, also called an annual physical exam. Not all patients regularly schedule annual physicals. The question remains open as to whether a primary care physician owes a duty of care to alert patients about screening recommendations during sick visits, if the patient does not have a history of regular annual check-ups.
High Risk Patients
One such recommendation is that patients between the ages of 55 and 80 years old who smoke, or have quit smoking within the last 15 years but have a smoking history of greater than 30-pack years, should have an annual low dose CT scan to assess for evidence of lung cancer. Survival rates are better if lung cancer is found at an early stage.
However, despite these clear-cut recommendations, the U.S. Preventive Services Task Force found that only one in eight high-risk patients was undergoing the low dose CT screening exam on an annual basis. Therefore, 87.5% of patients who should be screened were not being screened. While the 5-year survival rate for lung cancer is 17%, the survival rate improves to 52% if the disease is found at an early stage. The rate of early detection is best with low dose CT imaging, as opposed to chest x-rays.
Though lung cancer screening is confirmed to save lives, many patients report long delays in the diagnosis of lung cancer, which leads to a poor long-term survival rate.
Why are primary care doctors negligently failing to recommend lung cancer screening to high risk patients? There are many reasons for the low compliance rate. First, many patients do not schedule or even understand the need to schedule annual check-ups. Until primary care doctors are held fully accountable for failing to make screening recommendations during sick visits for those patients who do not routinely schedule annual check-ups, these patients will remain neglected. In other instances, negligent physicians are simply not aware of the ACS screening guidelines. Family physicians and internal medicine doctors who provide primary care would be well-advised to establish a notification system to alert patients to screening recommendations by mail or email on their birthdate. A medical malpractice lawyer, like a medical malpractice lawyer in Cleveland, OH, can advise you whether a physician’s failure to order lung cancer screening falls below accepted standards of medical care.
Thanks to Mishkind Kulwicki Law for their insight into how the failure to screen for lung cancer could be medical negligence.