18F-FDG PET/CT oncológico no Estado do Rio Grande do Norte: caracterização dos usuários e indicações do exame

Abstract

Cancer has contributed dramatically in terms of morbidity, mortality and costs for healthcare systems in the world. The management of these patients is complex and new technologies have emerged for their best care. Positron emission tomography associated with computed tomography (PET/CT) is a diagnostic method available more recently in Brazil and led to a paradigm shift in the management for many cancer patients. Therefore, the aim of this study is to analyse the access to the exam 18F-FDG PET/CT in Oncology in the State of Rio Grande do Norte, according to the users characteristics, indications and sources of funding. This is an individual, observational and transversal study. All patients who underwent 18FFDG PET-CT examinations for oncologic purposes at Liga Norteriograndense contra o Câncer from 01/05/2011 to 30/04/2013 were included. Data on the date of the examination, sex, age, indication (diagnosis / staging / monitoring response to treatment / restaging / suspected recurrence and control), type of cancer or condition that determined the exam and the source financing (public or private) were collected. During the two years that comprised the period of data collection for the study, 924 18F-FDG PET/CT exams were performed in 718 patients. The mean age was 51.4 (19.1) years, ranging from 4 to 88 years. There were more exams among women with a total of 539 examinations (58.3%). Increases were observed in the exams from the first year (37.4%) for the second year (62.6%). Accordingly, the 18F-FDG PET/CT indications were: 3.8% for diagnostic purposes, 6.6% for staging, 1.0% for monitoring response to treatment, 49.8% for restaging and 38.9% in suspected recurrence/control, only 10.4% of the exams were performed as initial strategy (diagnosis and staging). Regarding the financing of 18F-FDG PET/CT, the majority of tests were carried out with the agreement signed with the State Department of Public Health (45% of the exams). The main types of cancer referred for examination were lymphoma (36.7%), colorectal cancer (10.6%), lung (9.7%) and breast (8.5%). Few PET/CT studies were performed in some cancers, especially oesophagus (0.4%), pancreas (0.9%), stomach (1.2%) and head and neck (2.1%). Among those patients classified as initial strategy, only 21% had access to the exam by the public system, which demonstrates the low access of 18F-FDG PET/CT in Oncology in the state for this purpose. For health systems, it is essential to promote the rational use of this method.