Patterns of care and access to resources in neuroendocrine tumors (NETs): A cross-sectional survey among Mexican oncologists.

Abstract

630 Background: NETs are uncommon malignancies whose optimal management depends on timely diagnosis, access to specialised imaging and therapies, and multidisciplinary collaboration. Data on how NETs are managed in middle-income countries are scarce. We aimed to characterise local practice patterns, resource availability and professional perceptions among oncologists in Mexico. Methods: Between May-Aug 2025, we conducted a nationwide, anonymous, cross-sectional survey of medical oncologists registered with the Mexican Society of Oncology (SMEO). Each physician received an invitation with a REDCap link. Responses were exported from REDCap. The statistical analysis was performed using SPSS v25. Results: One-hundred oncologists responded to the survey; 28 worked exclusively in public practice, 28 exclusively in private and 43 in both settings. Demographic characteristics: 54 % men, age range 30–40 years in 71%; 41–50 years in 17%, and over 50 years in 12%. Geographic distribution: 18% practiced in Mexico City, 12% in Nuevo León, 5% in Jalisco, and the remaining were dispersed across other states. Data were analyzed according to practice setting independently (N=142 answers), see table 1 for results of practice patterns, diagnostic resources, therapy availability. Conclusions: This study reveals marked disparities in NET care in Mexico. Access to advanced imaging and targeted therapies is concentrated in the private sector, whereas many public-sector oncologists lack basic diagnostic tools and multidisciplinary support. The identification of distinct practice profiles highlights the need for targeted interventions to reduce gaps and to develop national guidelines tailored to resource-limited settings. Variable Total N=142 (%) Private n=71 (%) Public n=71 (%) p-value* Nuclear imaging  Octreoscan 75 (52.8) 38 (53.5) 37 (52.1) 1.00  NET-PET 57 (40.1) 43 (60.6) 14 (19.7) <0.0001  No nuclear imaging studies 19 (13.4) 10 (14.1) 9 (12.7) 1.00 Systemic therapies  SSA 104 (73.2) 60 (84.5) 44 (62.0) 0.004  Everolimus 62 (43.7) 38 (53.5) 24 (33.8) 0.027  Sunitinib 58 (40.8) 40 (56.3) 18 (25.4) 0.0003  Lenvatinib 60 (42.3) 42 (59.2) 18 (25.4) <0.0001  Cabozantinib 41 (28.9) 32 (45.1) 9 (12.7) <0.0001  PRRT 29 (20.4) 16 (22.5) 13 (18.3) 0.68  Chemotherapy 102 (71.8) 57 (80.3) 45 (63.4) 0.039 Multidisciplinary resources  Tumor board not available 79 (55.6) 44 (62) 35 (49.3) 0.19  Frequent interventional radiology availability 28 (19.7) 19 (26.8) 9 (12.7) 0.056 Practice patterns and other variables  < 5 NET-cases/year 77 (54.2) 39 (54.9) 38 (53.5) 1.00  Pathology reports incomplete 111 (78.2) 57 (80.3) 54 (76.1) 0.69  Chromogranin A (≥ 50% ordered) 75 (52.8) 43 (60.6) 32 (45.1) 0.09  Echocardiogram (≥ 25 % ordered) 92 (64.8) 50 (70.4) 42 (59.2) 0.22  Active surveillance for metastatic NETs 91 (64.1) 43 (60.6) 48 (67.6) 0.48  Dose escalation of SSA 113 (79.6) 54 (76.1) 59 (83.1) 0.41 *Fisher's exact test; “No response” categories excluded from analysis.