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February 27, 1967

Validity of Lung Cancer Mortality Data

JAMA. 1967;199(9):674-675. doi:10.1001/jama.1967.03120090116035

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To the Editor:—  The concern about the accuracy of lung cancer mortality statistics evinced by Dr. Skinner (198:1374, 1966) is shared by other observers. Autopsy follow-up of cases clinically diagnosed as bronchogenic carcinoma has often revealed the pulmonary lesion to be secondary to carcinoma of the pancreas, breast, stomach, colon, prostate, kidney, or adrenal gland. With approximately 300,000 deaths from cancer annually, the potentiality for mistaken diagnoses is considerable.When an erroneous diagnosis of bronchogenic carcinoma is corrected at autopsy, there are no procedures readily available for the amending of death certificates, nor is modification encouraged by local or national authorities. By the time the pathologic examination has been completed, the case has long been classified as primary lung cancer in official vital statistic bureaus and tumor registries.There is an even greater reservoir for inaccuracy in lung cancer data in the vast majority of cases certified without autopsy