Hospital misdiagnoses lead to as many as 40,500 patients dying annually, according to a Johns Hopkins study.

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The study finds that diagnostic errors for patients in the intensive care unit may claim as many lives each year as breast cancer.

“Our study shows that misdiagnosis is alarmingly common in the acute care setting,” says Bradford Winters, who is the lead author and associate professor of anesthesiology and critical care medicine and neurology and surgery in the Johns Hopkins University School of Medicine.

The medical conditions most commonly missed in hospitals are: heart attack; pulmonary embolism, an artery blockage in the lungs; pneumonia; and aspergillosis, a fungal infection that most commonly affects individuals with a weakened immune system, Johns Hopkins said.

The four conditions make up about one-third of all illnesses that doctors failed to detect, the study said.