How Common is Failure to Diagnose?


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The failure to diagnose a condition is one of the most common types of misdiagnosis. Malpractice lawsuits from failure or delayed diagnosis occur mostly, in terms of dollar value, from conditions such as heart attack, breast cancer, appendicitis, lung cancer, and colon cancer. However, these are not the most common undiagnosed conditions, but are simply the ones that lead to the most rapid damages. Serious conditions such as diabetes and hypertension are very commonly undiagnosed, but do not lead as rapidly to severe injury (and hence to dollar awards in malpractice lawsuits).

To examine how commonly failure-to-diagnose or delayed diagnosis occurs, here is a list of conditions according to the number of people undiagnosed. This is an estimate of how many people unknowingly currently have the condition. For comparison, see conditions by people affected (prevalence or incidence), conditions by prevalence and conditions by incidence. See also details about prevalence and incidence statistics for more information. In most cases, the rates refer to the USA or other industrialized nations.

Condition Percent Rate US People Data
1. Toxoplasmosis 22.06% 1 in 4 60 million less than 60 million; most do not have symptoms (DPD)
2. Sleep disorders 14.71% 1 in 6 40 million about 40 million (almost all cases are undiagnosed according to some reports)
3. Otosclerosis 10.00% 1 in 10 27.2 million as many as 10% of Caucasians have the condition but most do not get symptoms.
4. Extra Nipples 10.00% 1 in 10 27.2 million about 1 in 10 people have an extra nipple but most are small, misshapen, and mistaken for freckles or moles
5. Osteoporosis 6.62% 1 in 15 18 million 18 million with low bone mass (many are undiagnosed)
6. Hypertension 5.51% 1 in 18 15 million more than 15 million (more than 30% of 50 million are undiagnosed)
7. Chronic lower respiratory diseases 5.51% 1 in 18 15 million estimated 15 million
8. Chronic Obstructive Pulmonary Disease 5.51% 1 in 18 15 million 15 million undiagnosed or in early stages
9. Migraine 5.15% 1 in 19 14 million 14 million undiagnosed
10. Thyroid disorders 4.78% 1 in 20 13 million about 13 million (based on estimates from the AACE, as reported by Reader's Digest 1; estimated 8 million people (American Medical Women's Association)
11. Latent tuberculosis 3.68% 1 in 27 10 million estimated 10 to 15 million people in USA (NIAID)
12. Obstructive sleep apnea 3.68% 1 in 27 10 million as many as 10 million
13. Diabetes 2.10% 1 in 47 5.7 million 5.7 million Americans (based on NWHIC)
14. Sleep apnea 2.00% 1 in 50 5.4 million estimated 2-4% of Americans undiagnosed
15. Chlamydia 1.25% 1 in 80 3.4 million estimated 3.4 million cases (based in NIAID/CDC estimates with only about 600,000 to 800,000 reported from 4 million cases)
16. Parkinson's Disease 1.10% 1 in 90 3 million estimated 3-4 million people
17. Age-related macular degeneration 0.83% 1 in 120 2.3 million 0.5 million in the UK
18. Sjogren's Syndrome 0.74% 1 in 136 2 million estimated 2 million
19. Aneurysm 0.74% 1 in 136 2 million about 2 million Americans with unruptured brain aneurysms (Reader's Digest Feb 2004)1
20. Hemochromatosis 0.55% 1 in 181 1.5 million 1.5 million Americans (Hemochromatosis Foundation)
21. Salmonella food poisoning 0.51% 1 in 194 1.4 million up to 1.4 million cases (CDC/NAID); estimated that only 2% of cases are reported to CDC
22. Breast Cancer 0.37% 1 in 272 1 million estimated 1 million
23. Glaucoma 0.37% 1 in 272 1 million 1 to 1.5 million (about half of 3 million Americans) for chronic glaucoma
24. Celiac Disease 0.37% 1 in 272 1 million estimated 1 million undiagnosed Americans; more than a million (Reader's Digest Feb 2004)
25. Von Willebrand disease 0.37% 1 in 272 1 million estimated 1 million undiagnosed US women with Von Willebrand disease
26. Open-angle glaucoma 0.37% 1 in 272 1 million 1 to 1.5 million (about half of 3 million Americans)
27. Cryptosporiosis 0.18% 1 in 544 500,000 0.5 to 2 million undiagnosed cases each year
28. Gonorrhea 0.15% 1 in 679 400,000 estimated 400,000 cases (CDC/NIAID based on 800,000 estimates with about 400,000 reported)
29. HIV/AIDS 0.08% 1 in 1,208 225,000 estimated 225,000 Americans (based on NIAID 900,000 prevalence with quarter undiagnosed).
30. Narcolepsy 0.06% 1 in 1,813 150,000 estimated 150,000 undiagnosed (based on NHLBI estimates)


Footnotes:
1. Reader's Digest, February 2004, "10 Diseases Doctors Miss", page 120

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