Report: Canada falls behind U.S., Europe in PET usage

Canada lags behind other developed nations in its use of PET scanning, and “a nationally coordinated strategy to take up this technology and standardize its use could bring Canada back to the forefront of global cancer care,” according to a report commissioned by TRIUMF and Advanced Applied Physics Solutions.

Increased utilization of this technology could provide more clinically effective and cost-effective treatment for cancer patients in Canada, wrote independent medical research consultant and medical writer, Susan D. Martinuk.

“PET is revolutionizing clinical cancer care in the U.S. and Europe, yet many Canadian doctors and policy officials continue to see PET as experimental and unproven technology,” wrote Martinuk. “Cancer patients can suffer because of this reluctance.” She reported that she was surprised at the variability among provinces in the utilization of, and access to, this key diagnostic technology.

One exception to the lack of use in Canada is Quebec, where there is a network of 12 clinical PET scanners and PET imaging serves as the gateway to cancer treatment since patients are referred for a PET scan as soon as cancer is suspected. Some provinces have no PET scanners (e.g., Saskatchewan), while others have adequate equipment but restrict access (e.g., Ontario). In British Columbia, PET scanners are overwhelmed by patient volume.

Studies show that PET imaging is clinically effective; it can change the planned treatment regime of a patient in 36.5 to 50 percent of cases, according to the report. Based on this, there is an implication that Quebec cancer patients will experience a very different standard of cancer management than their counterparts in other provinces. Of course, other factors beyond PET imaging contribute to overall success in managing cancer.

Martinuk compiled the report by interviewing nuclear medicine leaders within each province and collecting data about the deployment and utilization of PET-based technology for clinical oncology. She identified key constraints that currently stand in the way of cancer patients having ready access to PET, including Canada's geography and population density; equipment and operating costs; a limited availability of FDG (the active component of PET); and the lack of national policies, protocols and indications. In particular, it was noted that a lack of education and a low awareness of PET were evident among the public, cancer patients and medical professionals.

The 203-page report is available online.