False negative chest X-rays
The main investigation for suspected lung cancer in primary care is a chest X-ray. However, reports show that some patients with normal chest X-rays still transpire to have lung cancer.
Although most large lung cancers can be seen on a chest X-ray, a study in the British Journal of General Practice in 2006 showed that there is a false negative rate of over 23% – more than 1 in 5.
Chest X-rays are a useful investigation, but be aware of false negative results. If a chest X-ray is negative, but there is still clinical suspicion, either refer the patient for a computed tomography (CT) scan (if available), or refer the patient via a suspected cancer pathway.
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