A comparative analysis: international variation in PET-CT service provision in oncology-an International Cancer Benchmarking Partnership study

Charlotte Lynch; Irene Reguilon; Deanna L Langer; Damon Lane; Prithwish De; Wai-Lup Wong; Fergus Mckiddie; Andrew Ross; Lorraine Shack; Thida Win; Christopher Marshall; Mona-Eliszabeth Revheim; Bolette Danckert; John Butler; Sabina Dizdarevic; Cheryl Louzado; Canice Mcgivern; Anne Hazlett; Cindy Chew; Martin O'connell; Samantha Harrison

doi:10.1093/intqhc/mzaa166

A comparative analysis: international variation in PET-CT service provision in oncology-an International Cancer Benchmarking Partnership study

Int J Qual Health Care. 2021 Feb 20;33(1):mzaa166. doi: 10.1093/intqhc/mzaa166.

Authors

Charlotte Lynch¹, Irene Reguilon^{1

2}, Deanna L Langer³, Damon Lane⁴, Prithwish De⁵, Wai-Lup Wong⁶, Fergus Mckiddie⁷, Andrew Ross⁸, Lorraine Shack⁹, Thida Win¹⁰, Christopher Marshall¹¹, Mona-Eliszabeth Revheim¹², Bolette Danckert¹³, John Butler^{1

14}, Sabina Dizdarevic¹⁵, Cheryl Louzado¹⁶, Canice Mcgivern¹⁷, Anne Hazlett¹⁷, Cindy Chew¹⁸, Martin O'connell¹⁹, Samantha Harrison¹

Affiliations

¹ International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK.
² Brand & Strategy, eConsult Health Ltd, 46-48 East Street, Surrey, KT17 1HQ, UK.
³ Cancer Imaging, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada.
⁴ Radiology, Pacific Radiology, 123 Victoria Street, Christchurch Central, Christchurch 8013, New Zealand.
⁵ Surveillance and Cancer Registry, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada.
⁶ Nuclear Medicine, Mount Vernon Hospital, East and North Hertfordshire NHS Trust, Rickmansworth Road, Northwood, HA6 2RN, UK.
⁷ Nuclear Medicine and PET Department, NHS Grampian, 2 Eday Road, Aberdeen AB15 6RE, UK.
⁸ Dalhousie Medical School, Dalhousie University, 6299 South Street, Halifax, Nova Scotia, NS B3H 4R2, Canada.
⁹ Surveillance and Reporting, Alberta Health Services (Cancer Control Alberta), 10030-107 Street NW, Edmonton, Alberta, T5J 3E4, Canada.
¹⁰ General and Respiratory Medicine, Lister Hospital, East and North Hertfordshire NHS Trust, Coreys Mill Lane, Stevenage, SG1 4AB, UK.
¹¹ Wales Research and Diagnostic PET Imaging Centre, Cardiff University, Cardiff University School of Medicine Health Park, Cardiff, CF14, 4XN, UK.
¹² Division of Radiology and Nuclear Medicine, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Pb 4950 Nydalen, Oslo, 0424, Norway.
¹³ Research Centre, Danish Cancer Society, Strandboulevarden 49, 2100 Kobenhavn, Denmark.
¹⁴ Gynaecology Department, Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK.
¹⁵ Imaging and Nuclear Medicine, Brighton and Sussex University Hospital Trust, Kemptown, Brighton, BN2 1ES, United Kingdom and Brighton and Sussex Medical School, University of Sussex and Brighton, London Road, Brighton, BN1 4GE, UK.
¹⁶ Strategy Implementation Planning & Partner Relations, Canadian Partnership Against Cancer, 145 King St, Toronto, ON M5H 1J8, Canada.
¹⁷ Department of Regional Medical Physics, Belfast Health and Social Care Trust, 83 Shankill Road, Belfast, BT13 1FD, UK.
¹⁸ School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK.
¹⁹ Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin, DO7 R2WY, Ireland.

Abstract

Objective: To explore differences in position emission tomography-computed tomography (PET-CT) service provision internationally to further understand the impact variation may have upon cancer services. To identify areas of further exploration for researchers and policymakers to optimize PET-CT services and improve the quality of cancer services.

Design: Comparative analysis using data based on pre-defined PET-CT service metrics from PET-CT stakeholders across seven countries. This was further informed via document analysis of clinical indication guidance and expert consensus through round-table discussions of relevant PET-CT stakeholders. Descriptive comparative analyses were produced on use, capacity and indication guidance for PET-CT services between jurisdictions.

Setting: PET-CT services across 21 jurisdictions in seven countries (Australia, Denmark, Canada, Ireland, New Zealand, Norway and the UK).

Participants: None.

Intervention(s): None.

Main outcome measure(s): None.

Results: PET-CT service provision has grown over the period 2006-2017, but scale of increase in capacity and demand is variable. Clinical indication guidance varied across countries, particularly for small-cell lung cancer staging and the specific acknowledgement of gastric cancer within oesophagogastric cancers. There is limited and inconsistent data capture, coding, accessibility and availability of PET-CT activity across countries studied.

Conclusions: Variation in PET-CT scanner quantity, acquisition over time and guidance upon use exists internationally. There is a lack of routinely captured and accessible PET-CT data across the International Cancer Benchmarking Partnership countries due to inconsistent data definitions, data linkage issues, uncertain coverage of data and lack of specific coding. This is a barrier in improving the quality of PET-CT services globally. There needs to be greater, richer data capture of diagnostic and staging tools to facilitate learning of best practice and optimize cancer services.

Keywords: appropriate healthcare; benchmarking; cancers; diagnostics; healthcare system.

MeSH terms

Australia
Benchmarking*
Canada
Humans
Ireland
Neoplasms* / diagnostic imaging
New Zealand
Norway
Positron Emission Tomography Computed Tomography