Use and overuse of positron emission tomography for patients with metastatic colorectal cancer

In all healthcare systems, and particularly those that are resource limited, using diagnostic techniques efficiently is essential. According to consensus guidelines, standard computed tomography (CT) imaging without positron emission tomography (PET) is usually sufficient for the management of metastatic colorectal cancer (mCRC). This retrospective national cohort study evaluated the use of PET in mCRC management among members of Clalit Health Services (CHS, the largest Israeli health maintenance organization covering >50% of the Israeli population), utilizing the CHS central database. The cohort included CHS members diagnosed with mCRC between 2017 and 2022 (N = 998). The median number of PETs performed per patient was 5. Overall, during the follow-up period (up to 10/2024), 44% of patients underwent >5PETs, and the median number of PETs performed per patient per year was 2.2. In conclusion, our study identified a substantial overuse of PET in the management of mCRC in Israel, marking a divergence from clinical guidelines. More research is needed to assess this in other diseases and in other countries/regions.