Patterns of Care, Resource Disparities, and Professional Perceptions in Neuroendocrine Tumors in Mexico: A Nationwide Survey of Medical Oncologists.
TL;DR
This first nationwide survey of Mexican oncologists highlights substantial public-private inequities in NET diagnostics, therapies, and multidisciplinary support, alongside concerns about pathology quality and low NET caseloads.
Abstract
Purpose
Neuroendocrine tumors (NETs) require accurate pathology, functional imaging, targeted therapies, and multidisciplinary care. We described NET care patterns and resource availability among Mexican medical oncologists in public and private settings.
Methods
We conducted a nationwide survey of Mexican medical oncologists. The questionnaire assessed NET caseload, perception of pathology report completeness, use of biomarkers and echocardiography, access to multidisciplinary teams (MDTs) and interventional radiology (IR), availability of nuclear medicine studies and systemic therapies, and management in key clinical scenarios. For oncologists working in both sectors, responses were reshaped into a long format, yielding 142 practice-specific observations (71 public, 71 private).
Results
One hundred oncologists responded, and 54% reported seeing fewer than five NET patients per year. Nearly 80% perceived that NET pathology reports were incomplete or incongruent, only 9.9% reported frequent MDT meetings, and IR was available in 19.7% of practices. NET-specific somatostatin receptor (SSTR) positron emission tomography was concentrated in private practice (60.6% v 19.7% public), and peptide receptor radionuclide therapy was available in 20.4% (similar for both practices). Somatostatin analogs were the most widely available systemic therapy (73.2% overall; 84.5% private v 62.0% public). Active surveillance, chemotherapy use, and post-somatostatin analogues sequencing were heterogeneous, with sector differences in first-line treatment for SSTR-positive grade 3 NETs.
Conclusion
This first nationwide survey of Mexican oncologists highlights substantial public-private inequities in NET diagnostics, therapies, and multidisciplinary support, alongside concerns about pathology quality and low NET caseloads. Strengthening pathology practice, imaging, treatment access, MDTs, and education may help close NET care gaps in Mexico and other middle-income settings.