Diagnostic agreement in the histopathological evaluation of lung cancer tissue in a population-based case-control study.
Only few studies have compared the agreement of histological lung carcinoma diagnosis of a population-based case series and an independent pathology review. We analyzed data of our population-based lung cancer case-control study to determine the agreement in the histopathological evaluation of lung cancer. Six-hundred and sixty-eight out of 1004 interviewed male and female lung cancer cases were histologically evaluated according to the 1981 WHO classification by regional pathologists and a central pathologist who was blinded to the evaluations of the regional pathologists. The observed agreement was 0.65 with kappa = 0.54 (95% CI: 0.49-0.58). It was highest for small-cell carcinoma (0.94; kappa = 0.82) and lower for squamous-cell carcinoma (0.81; kappa = 0.58) and adenocarcinoma (0.81; kappa = 0.55). Agreement was slightly higher among women than men. The observed agreement among non-smoking cases was 58% as compared to 67% heavy smoking cases. The moderate agreement for squamous-cell and adenocarcinoma complicates epidemiological studies that address these histological subtypes.
Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle, Germany. andreas.stang@medizin.uni-halle.de
Andreas
A
Stang
Hermann
H
Pohlabeln
Klaus M
KM
Müller
Ingeborg
I
Jahn
Klaus
K
Giersiepen
Karl-Heinz
KH
Jöckel
D000230:Adenocarcinoma / Q000175:diagnosis; D000368:Aged; D018287:Carcinoma, Large Cell / Q000175:diagnosis; D018288:Carcinoma, Small Cell / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010338:Pathology, Clinical / Q000592:standards*; D015203:Reproducibility of Results