Underdiagnosed

Underdiagnosed describes a health condition that exists in people but has not been detected by the medical system. The diagnosed prevalence of the condition is therefore lower than its true prevalence in the population. It is distinct from misdiagnosis, where the wrong condition is identified, and from underreporting, where cases are not captured in statistics.

Causes include limited access to healthcare, disparities in care, and gaps in screening practices. Symptoms may be nonspecific or vary by age, sex, or ethnicity, making recognition difficult. Additional factors include clinician awareness, patient health literacy, and the sensitivity and specificity of available tests.

The consequences of underdiagnosis can be serious. Delays in diagnosis can lead to progression, worse outcomes, and higher morbidity. It also masks the true burden of disease, complicating resource allocation and public health planning.

Examples include chronic kidney disease in patients without routine screening; cardiovascular disease in women with atypical symptoms; depression in men due to stigma; autoimmune conditions such as celiac disease and thyroid disease in certain populations; endometriosis that remains undiagnosed for years.

Addressing underdiagnosis requires improving access to care and screening, enhancing clinician education, and using data-driven approaches to identify gaps. Population-based surveys, electronic health record analytics, and targeted screening can help estimate true prevalence and shorten diagnostic delays. Culturally competent care and community outreach can reduce barriers to diagnosis.

See also: underdiagnosis, diagnostic delay, health disparities.