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/CT) is usually sufficient for the management of metastatic colorectal cancer (mCRC). This retrospective national cohort study evaluated the use of PET/CT 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 PET/CTs performed per patient was 5. Overall, during the follow-up period (up to 10/2024), 44% of patients underwent >5 PET/CTs, and the median number of PET/CTs performed per patient per year was 2.2. In conclusion, our study identified a substantial overuse of PET/CT 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.