Cancer misdiagnosis remains one of the most serious threats to private practice physicians in the United States. Even a seemingly small oversight—like dismissing subtle symptoms or misinterpreting test results—can cascade into severe harm to a patient and a costly misdiagnosis lawsuit.
Generally speaking, most medical malpractice insurance policies cover cancer misdiagnosis claims, but it’s important to carefully review and understand the details of your coverage. If you’re concerned about how your coverage might respond in such a scenario, you can see our coverage page to learn more about typical medical malpractice coverage policy considerations.
First, it’s important to understand why misdiagnosis for cancer happens and how patients typically respond.
In many cases, a missed or delayed cancer diagnosis occurs because early symptoms seem benign. A persistent cough may be attributable to bronchitis rather than lung cancer; abdominal pain may just be irritable bowel syndrome, not colon cancer.
“Cancer will affect more than one in three U.S. residents in their lifetime, and although the diagnosis will be made efficiently in most of these cases, roughly one in five patients will experience a delayed or missed diagnosis.” – Interventions to Improve Timely Cancer Diagnosis: An Integrative Review
Common causes of cancer misdiagnosis include flawed diagnostic testing, patient record mix-ups, overlooked red flags, and simple human error under time pressure. Often, the culprit is a lapse in communication. A primary care physician orders a test but never follows up on abnormal results, or a specialist’s recommendation doesn’t make it back to the referring doctor. These cracks in the system can swiftly turn a manageable early-stage cancer into an advanced, high-risk case.
Even more challenging is the phenomenon of diseases mistaken for cancer. Some benign conditions, such as mastitis in the breast or pneumonia in the lungs, can resemble malignancies. Conversely, genuine tumors might be dismissed as less concerning ailments. In either scenario, the delays and confusion that follow can have life-threatening consequences for patients.
When a physician misses or misidentifies cancer, patients may experience drastic repercussions. In a study analyzing malpractice claims data, missed diagnoses of lung, colorectal, prostate, and breast cancers accounted for a significant portion of outpatient diagnostic errors. Not only does a delayed diagnosis increase the likelihood that the disease will spread to other parts of the body, but it also raises treatment costs and often requires more aggressive interventions.
For example, a patient presenting with rectal bleeding might receive an initial diagnosis of hemorrhoids. If further diagnostic tests, such as a colonoscopy, are delayed, a diagnosis of colorectal cancer could be missed until the disease has progressed to a more advanced stage. This type of scenario can lead to more invasive treatments, a more difficult prognosis, and a potential malpractice claim against the physician.
Such scenarios understandably spark anger and fear. Patients who once might have trusted their doctor unconditionally begin investigating legal options. They research questions like “can you sue a doctor for misdiagnosis?” or “how long do you have to sue for misdiagnosis?”
The answers depend on jurisdiction, but the momentum toward legal action often escalates quickly once the patient realizes their condition could have been caught sooner and treated earlier.
Frequently, certain cancers emerge in diagnostic error studies and malpractice claims because of overlapping symptoms and systemic challenges. According to findings from the study Characteristics of Disease-Specific and Generic Diagnostic Pitfalls: A Qualitative Study, published in JAMA Network Open, the most frequent cancer misdiagnoses include colorectal (5%), lung (4%), breast (2%), prostate (2%), and bladder (1%) cancers (Schiff GD, Volodarskaya M, Ruan E, et al., 2022). Here’s why these specific types of cancer are so high-risk:
These cancers often appear in legal proceedings as lawsuits evaluate whether the physician breached the standard of care, particularly by failing to recognize red flags or order appropriate follow-up tests, and whether any breach of the standard of care actually harmed the patient. Addressing these common pitfalls requires heightened vigilance, timely referrals, and improved communication between care teams to reduce errors and improve outcomes.
When a patient files a medical malpractice lawsuit, even small details, like a missed test result or a delayed specialist referral, can become critical. The financial impact can be significant, with settlements in cancer misdiagnosis cases ranging from tens of thousands to over a million dollars, depending on the harm caused and the specifics of the case.
The damage to a physician’s reputation can be just as serious. A single high-profile medical malpractice case can shake years of patient trust. Even if the physician ultimately prevails, the process of defending against a claim can be stressful, time-consuming, and costly. These risk factors often push private practice doctors to revisit their diagnostic procedures and make sure their malpractice insurance offers enough protection to handle such situations.
For a detailed look at how malpractice claims unfold and what to expect, visit our guide on understanding the medical malpractice claims process.
No single checklist or tool can completely prevent diagnostic mistakes, but a multi-layered approach can significantly improve accuracy and patient outcomes:
While these strategies primarily aim to protect patients, they also act as a safeguard for physicians, reducing the likelihood of errors and mitigating legal risks.
Cancer misdiagnosis claims can arise years after the initial visit, as symptoms or complications take time to surface. This delay can leave physicians vulnerable if the claim involves care provided under a previous insurance policy. That’s why it’s important to ensure a malpractice insurance policy includes prior acts coverage.
Prior acts coverage protects physicians from claims tied to earlier incidents, as long as there’s continuous coverage. For example, a patient treated for what seemed like a minor medical condition years ago might later file a claim if a cancer diagnosis was missed. Without this protection, physicians could face significant legal and financial risks for care provided in the past.
Physicians should carefully review their policies to confirm they have this essential coverage, especially given the delayed nature of cancer misdiagnosis claims.
While malpractice insurance provides critical protection, it’s also important to improve diagnostic processes and stay informed about the legal landscape surrounding misdiagnosis. Taking proactive steps not only protects your patients, but also strengthens your practice.To read more about our
Read more about our medical malpractice coverage, our coverage page explains Indigo’s malpractice coverage and for detailed information on available protections and benefits.
Photo by Olga Dykun from iStock.
