Diagnostic agreement in the histopathological evaluation of lung cancer tissue in a population-based case-control study

Lung Cancer. 2006 Apr;52(1):29-36. doi: 10.1016/j.lungcan.2005.11.012. Epub 2006 Feb 14.


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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Aged
  • Carcinoma, Large Cell / diagnosis
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Squamous Cell / diagnosis
  • Case-Control Studies
  • Female
  • Humans
  • Lung / pathology
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Pathology, Clinical / standards*
  • Reproducibility of Results