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Access to PET/CT Scans

Key findings

There has been a steady increase in the proportion of people with non-small cell lung cancer who had a PET/CT (positon emission tomography – computed tomography) scan before radical treatment between 2013 (the first year this indicator was measured) and 2017.

The proportion of PET/CT scans in this patient population is approaching, but still below, the 90% provincial target.

Why is this important to Ontarians?

  • In Ontario, a PET/CT scan is recommended only in situations where available evidence shows it improves patient care and outcomes. This evidence-based approach ensures that patients receive the right test at the right time. This helps to avoid the use of tests that are not of clinical benefit to the patient.
  • PET/CT scanning typically takes place at a decision point for a patient’s treatment. For example, for people with non-small cell lung cancer, a PET/CT scan helps to determine whether radical treatment (i.e., treatment intended to cure the disease) is appropriate. If it is determined not to be beneficial, then a patient avoids an unnecessary significant procedure and the associated recovery.
  • The results help us identify where we need to improve the use of this technology to support appropriate patient care.

See Access to PET/CT Scans Methodology for technical information.

Report date: January 2019

Data source: Ontario Cancer Registry, Ontario Registered Persons Database (RPDB), Cancer Activity Level Reporting (ALR), Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD), Canadian Institute for Health Information’s National Ambulatory Care Reporting System (CIHI-NACRS), Ontario Health Insurance Plan (OHIP)

Prepared by: Analytics and Informatics, Cancer Care Ontario

Data Table 1. Percentage of non-small cell lung cancer patients who had a PET/CT scan before radical treatment, diagnosed 2013 to 2017
ON Percentage (%)
2013 81.6
2014 83.7
2015 83.8
2016 85.2
2017 86.1

Report date: January 2019

Data source: Ontario Cancer Registry, Ontario Registered Persons Database (RPDB), Cancer Activity Level Reporting (ALR), Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD), Canadian Institute for Health Information’s National Ambulatory Care Reporting System (CIHI-NACRS), Ontario Health Insurance Plan (OHIP)

Prepared by: Analytics and Informatics, Cancer Care Ontario

Results

  • In 2017, 86% of people with non-small cell lung cancer had a PET/CT scan before radical treatment.
  • This continues the slight upward trend in the use of PET/CT scanning in this population since 2013 (82%).
  • This year-over-year increase is slowly approaching the provincial target (90%). There is still opportunity to improve use of PET/CT scanning in staging people with non-small cell lung cancer.

Comparisons

Getting comparable data and measures from other jurisdictions is a challenge. Be aware of the different data definitions, methodologies and years used in indicators measured outside of Ontario. Jurisdictional comparison is still useful to provide a rough indication of how well Ontario is doing relative to other provinces and countries.

  • Scotland uses a methodologically comparable indicator to measure the use of PET/CT in people with non-small cell lung cancer before treatment (including radical radiotherapy, radical chemoradiotherapy or surgical resection). The Scottish target for this indicator is set at 95%.[1]
  • In the most recent reporting period (between 2013 and 2015), all National Health Service Boards in Scotland met or exceeded the 95% quality performance target. The average performance rate in Scotland reached 97.5%.
  • The higher indicator result in Scotland shows that there could be room for Ontario to improve beyond our 90% target.
  • However, it is important to consider the differences in the relative population size and geography between Scotland and Ontario. Differences in patient population (e.g., at what stage people are diagnosed with non-small cell lung cancer) may also contribute to the variance in indicator outcomes, and should be explored further.
  • Nonetheless, there is a clear alignment between the jurisdictions in terms of the desire to optimize the use of PET/CT in this population before treatment. Ontario is on the right path, and will continue to work towards meeting or exceeding the provincial target.

For more information

  • For more information about PET/CT scans and to learn about the provincial program, visit PET Scans Ontario.
  • Cancer Care Ontario’s Cancer Imaging Program oversees the PET Scans Ontario program. The Imaging Program also focuses on the appropriateness of cancer imaging use, timely access, development of an imaging community of practice and synoptic radiology reporting. To find out more, visit the Cancer Imaging Program
  • Ontario also reports wait times for CT and MRI (magnetic resonance imaging) scans for all disease types. Find reports through Health Quality Ontario

References

  1. National Services Scotland. Lung Cancer Quality Performance Indicators [Internet]. 2017 [cited 2019 April 05]. Available from https://www.isdscotland.org/Health-Topics/Quality-Indicators/Publications/2017-02-28/2017-02-28-Lung-QPI-Report.pdf