Misdiagnosed Lung Cancer and the Cost of Diagnosis Delays

Lung cancer is the most commonly misdiagnosed cancer. When detected in an early stage, lung cancer is highly treatable. However, if lung cancer is not identified or misdiagnosed, it may progress to a more advanced stage and become more difficult to treat.

Coping with lung cancer can be difficult, and when you know you’ve been misdiagnosed and didn’t get treatment as quickly as you could have, it can be even more devastating. Advocating for your health and seeking a second opinion can help ensure you get an accurate diagnosis and timely treatment.

This article will cover conditions that share similar symptoms of lung cancer, common factors that contribute to misdiagnosis, and what you can do to ensure adequate treatment after a misdiagnosis.  

Lung X-ray for lung cancer

utah778 / Getty Images

How Often Is Lung Cancer Misdiagnosed?

It is common for the early signs of lung cancer to be mistaken for another condition, or for screening test results to be misinterpreted. A recent study found that nearly 38% of all cancer-related medical malpractice claims were due to lung cancer misdiagnoses.

For some people, a misdiagnosis may mean missing a critical window for treating lung cancer in its early stages. The disease may progress, which can impact treatment options and prognosis. 

Typical Diagnostic Tests and Procedures 

If you have early symptoms of lung cancer, your healthcare provider will do a physical examination and review your family and medical history to help determine the cause of your symptoms. They may also order diagnostic tests and procedures to diagnose lung cancer, such as:

  • Biopsy
  • Imaging tests
  • Lab procedures/tests

Conditions With Overlapping Symptoms 

Many medical conditions have symptoms similar to lung cancer. For example, shortness of breath, a nagging cough, and chest pain can be caused by several diseases. Conditions that have overlapping symptoms with lung cancer include:

Factors That Contribute to Misdiagnosis and Delayed Treatment 

There are a variety of factors that may contribute to lung cancer misdiagnosis and delayed treatment.

Healthcare Provider Dismissal

Though most healthcare providers have your best interests in mind, some may dismiss your symptoms or concerns. Healthcare providers may dismiss the concerns of young and healthy people because they don't fit the profile of a person with lung cancer.

Systemic issues such as racial bias also play a role in misdiagnoses—people of color face higher rates of diagnostic error due to racial discrimination by their healthcare provider.

Lab Result Errors 

Typical lab result errors associated with lung cancer misdiagnosis include:

  • Lab technician error when processing a tissue sample obtained during biopsy
  • Nodules detected on imaging scans are mistaken for another disease, such as tuberculosis
  • Radiologists misreading imaging results

Referral Delay

If your primary care physician (PCP) knows the care you need is outside their expertise, they will refer you to a specialist. Because health care systems can be large and complex, a breakdown in communication between PCPs and specialists may lead to a delayed referral. 

In one study, nearly 39% of referral delays were due to a lack of appointments available with the referred specialist.

Sometimes, a PCP may fail to recognize the need for a specialist referral, leading to a delayed diagnosis.

Patient Responsibilities

Advocating for yourself can help ensure you don't fall through the cracks of a large health system. If you are referred to a specialist, ask your healthcare provider if you need to schedule the appointment yourself or if the specialist will contact you to arrange the appointment. 

Symptom Presentation 

Because lung cancer symptoms overlap with so many other health conditions, it is common for healthcare providers to initially attribute symptoms to a more benign cause, such as allergies or an upper respiratory infection.

This is particularly true for individuals who seek care at urgent, convenient, or retail store clinics, where healthcare providers are pressed for time and may rush through appointments.

Patient Awareness 

Your lack of awareness of the risk factors for lung cancer, symptoms, and available treatments can lead to a delayed diagnosis. Personal beliefs and prior experiences with healthcare providers can also play a role in a delayed diagnosis.

One study found that some people with lung cancer do not seek medical care out of fear of a diagnosis and death due to a lack of knowledge about effective lung cancer treatments.

Socioeconomic 

Socioeconomic factors such as education, employment, community safety, income, and social support can significantly impact lung cancer diagnosis, treatment, and survival. Lower socioeconomic status is associated with a 50% to 70% increased risk of lung cancer.

People with lower socioeconomic status are also less likely to undergo screening tests and receive appropriate treatments, which may be due to the fear of the financial burden associated with lung cancer treatments.

A Late Diagnosis Affects Prognosis 

A late diagnosis can result in missed treatment opportunities and higher mortality rates. Because lung cancer is easier to treat when detected in earlier stages, survival rates significantly decrease when it is detected in later stages.

The five-year survival rate for stage 1 lung cancer is as high as 70% to 92%. Stage 4 lung cancer survival rates are as low as 7%. 

Increased Healthcare Costs 

A late lung cancer diagnosis is associated with higher healthcare costs. Research shows the average monthly cost for people diagnosed with stage 1 lung cancer is $7,000 per month compared to $21,000 per month for people diagnosed with stage 4 lung cancer.

Advanced-stage lung cancer is associated with increased costs because people living with stage 4 lung cancer generally require more intensive treatments, such as chemotherapy, for a more extended period.

Getting a Second Opinion 

Getting a second opinion from a different healthcare provider is common after an initial diagnosis, and it is well within your rights to ask. You may want to seek a second opinion if:

  • Your healthcare provider isn't sure what's wrong with you
  • You don't feel heard by your current healthcare provider
  • You want peace of mind that you have an accurate diagnosis and the best treatment options

The second healthcare provider will review your symptoms, medical history, imaging, and lab results to provide their opinion on your diagnosis and suggested treatment plan.

Summary

Lung cancer is the most commonly misdiagnosed cancer. Misdiagnosis occurs for several reasons. If you suspect you've been misdiagnosed or are facing a late-stage lung cancer diagnosis after an initial misdiagnosis, you may want to ask for a second opinion to ensure you have access to appropriate treatment options and an accurate prognosis.

A Word From Verywell 

Dealing with a lung cancer misdiagnosis can be devastating. You may be facing additional hardships due to your misdiagnosis and have many questions about how to move forward. Ask for support from your loved ones or seek resources, such as a patient navigator, who can help ensure you get appropriate, timely treatment.

Frequently Asked Questions

  • Does a black spot on your lung always mean cancer?

    A spot detected on the lung, also known as a nodule, can indicate cancer but is not always the case. Lung spots on X-rays are common and often associated with a more benign condition, such as a lung infection. 

  • What rights do you have for misdiagnosed lung cancer?

    If you have experienced a misdiagnosis or delayed lung cancer diagnosis by a healthcare provider, you may be able to file a medical malpractice claim against the healthcare provider and sue for damages. Many states have laws protecting patients, and some healthcare facilities have a patient bill of rights.

  • What are the silent symptoms of lung cancer?

    Among the silent symptoms of lung cancer are hoarseness, fatigue, loss of appetite, clubbing of fingernails, and unexplained weight loss. If lung cancer spreads to other areas of the body, symptoms may include bone pain, headache, weakness, swollen lymph nodes in the neck and around the collarbone, and jaundice (yellowing of the skin).

  • Should you tell your healthcare provider you smoke?

    Absolutely. Your healthcare provider must know as much as possible about your medical history and lifestyle habits, including smoking. Smoking increases your risk of developing certain health conditions. Your healthcare provider can suggest screening tests to detect health problems early and help you quit smoking when ready.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Newman-Toker DE, Schaffer AC, Yu-Moe CW, et al. Serious misdiagnosis-related harms in malpractice claims: the "big three" - vascular events, infections, and cancers. Diagnosis (Berl). 2019;6(3):227-240. doi:10.1515/dx-2019-0019

  2. American Cancer Society. Tests for lung cancer.

  3. Moffit Cancer Center. 12 diseases that lung cancer is commonly misdiagnosed as.

  4. Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A systematic review of the impact of physician implicit racial bias on clinical decision making. Acad Emerg Med. 2017;24(8):895-904. doi:10.1111/acem.13214

  5. Xiang Y, Huang C, He Y, Zhang Q. Cancer or tuberculosis: a comprehensive review of the clinical and imaging features in diagnosis of the confusing mass. Front Oncol. 2021;11:644150. doi:10.3389/fonc.2021.644150

  6. Patel MP, Schettini P, O'Leary CP, Bosworth HB, Anderson JB, Shah KP. Closing the referral loop: an analysis of primary care referrals to specialists in a large health systemJ Gen Intern Med. 2018;33(5):715-721. doi:10.1007/s11606-018-4392-z

  7. Cassim S, Chepulis L, Keenan R, Kidd J, Firth M, Lawrenson R. Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review. BMC Cancer. 2019;19(1):25. doi:10.1186/s12885-018-5169-9

  8. Redondo-Sánchez D, Petrova D, Rodríguez-Barranco M, Fernández-Navarro P, Jiménez-Moleón JJ, Sánchez MJ. Socio-economic inequalities in lung cancer outcomes: an overview of systematic reviews. Cancers (Basel). 2022;14(2):398.  doi:10.3390/cancers14020398

  9. Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P. Revisions to the tumor, node, metastasis staging of lung cancer (8 edition): rationale, radiologic findings and clinical implications. World J Radiol. 2017;9(6):269-279. doi:10.4329/wjr.v9.i6.269

  10. National Institutes of Health. Lung and bronchus cancer SEER 5-year relative survival rates, 2010-2016 by stage at diagnosis and age, both sexes, all races (includes Hispanic).

  11. Gildea TR, DaCosta Byfield S, Hogarth DK, Wilson DS, Quinn CC. A retrospective analysis of delays in the diagnosis of lung cancer and associated costs. Clinicoecon Outcomes Res. 2017;9:261-269. doi:10.2147/CEOR.S132259

  12. American Cancer Society. Seeking a second opinion.

  13. Healthcare.gov. Rights and protections.

  14.  American Cancer Society. Signs and symptoms of lung cancer.