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Errors in prostate core biopsy diagnosis in an era of specialisation and double reporting
  1. Cornelia Margaret Szecsei,
  2. Jon D Oxley
  1. Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
  1. Correspondence to Dr Jon D Oxley, Cellular Pathology, North Bristol NHS Trust, Westbury on Trym, Bristol BS10 5NB, UK; jon.oxley{at}


Aim To examine the effects of specialist reporting on error rates in prostate core biopsy diagnosis.

Method Biopsies were reported by eight specialist uropathologists over 3 years. New cancer diagnoses were double-reported and all biopsies were reviewed for the multidisciplinary team (MDT) meeting. Diagnostic alterations were recorded in supplementary reports and error rates were compared with a decade previously.

Results 2600 biopsies were reported. 64.1% contained adenocarcinoma, a 19.7% increase. The false-positive error rate had reduced from 0.4% to 0.06%. The false-negative error rate had increased from 1.5% to 1.8%, but represented fewer absolute errors due to increased cancer incidence.

Conclusions Specialisation and double-reporting have reduced false-positive errors. MDT review of negative cores continues to identify a very low number of false-negative errors. Our data represents a ‘gold standard’ for prostate biopsy diagnostic error rates. Increased use of MRI-targeted biopsies may alter error rates and their future clinical significance.

  • prostate
  • carcinoma
  • diagnosis
  • clinical audit
  • morphological and microscopic findings

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  • Handling editor Runjan Chetty.

  • Contributors Both authors contributed to the design of the work, data acquisition, analysis, writing and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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