Error rates in reporting prostatic core biopsies

To evaluate the false-negative and false-positive error rates both in a screening and a non-screening population.

A total of 4192 prostatic biopsies were reported in a 6-year period by 15 consultant histopathologists, two of whom had an interest in uropathology and were deemed to be specialists (J.O. and C.S.). All biopsies were reviewed prior to the multidisciplinary team (MDT) meeting. The overall false-negative rate was 1.7% (screening 2.1%, non-screening 1.5%). The overall false-positive rate was 0.5% (screening 0.9%, non-screening 0.4%). These error rates varied among pathologists, with the false-negative rate ranging from 0% to 9.3%, and the false-positive rate ranging from 0% to 3.8%.

The false-negative rate was three times greater than the false-positive rate, showing that detection of significant pathology is far greater in the negative biopsies. More errors occurred in the screening population than in the non-screening population. The consultants making the most errors were non-specialists, but the specialists also made false-negative errors, suggesting that just using specialist reporting alone would not have eradicated errors.