Examining the use of PET scans in the diagnosis and management of non-small cell lung cancer patients.

Abstract

311 Background: PET Scans are increasingly used in the diagnosis and management of non-small cell lung cancer (NSCLC) patients. However, uptake of PET at provincial level is not well studied. This project, led by the Canadian Partnership Against Cancer, established processes and indicators to describe utilization of PET in patients with NSCLC. These indicators support the monitoring of uptake and highlight areas for quality improvement strategies at the national and provincial level. Methods: Cases of NSCLC, diagnosed in the study period of 2009-2011, were identified from cancer registries and linked to PET utilization data. PET scans were identified as indicated for diagnosis/staging or treatment response, based on the timing of scans relative to diagnosis and treatment dates. Scans conducted three months prior to and up to four months post-diagnosis but before start of treatment (surgery or radiation) were identified as diagnosis/staging. Scans conducted after the start of treatment to ten weeks post-treatment were identified as management and follow-up of treatment. Results: A total of 27,984 cases of NSCLC were identified. Preliminary analysis revealed that 8,947 (32.0%) of NSCLC patients had at least one PET scan. Some variation was seen in age, with those 18 to 69 years more likely to receive a scan than those 70 years and older. PET scan use was higher among stages I and II (52.3% to 50.6%) compared to stage IV (17.98%). A majority of PET scans were performed for diagnosing/staging NSCLC (91.1%). PET scans for diagnosis/staging were highest for patients with stage I (36.7%) followed by stage IV (24.6%). Conclusions: This study provided information on the current use of PET technology across Canada, allowing for identification of opportunities for increasing evidence-based use while decreasing extra-evidential use, and forming a baseline for future monitoring as evidence evolves.