Study on Constructing Content Framework for Follow-up of Cancer in Primary Care Based on Cancer Survivorship Care Quality Framework postprint

Abstract: Background　China has established a nationwide cancer registry system that provides a solid data foundation for cancer follow-up services in primary care. However, the imbalance in medical resource allocation and the low efficiency of existing services hinder the chronic disease management of cancer. Therefore, it is essential to identify key service components and develop an effective, replicable cancer follow-up service model in primary care to enhance the quality of cancer survivorship care. Objective　This study aimed to construct a content framework for follow-up of cancer in primary care which was suitable for China’s national context, identify core service components, and provide evidence for improving the current cancer follow-up management model in China. Methods　First, based on the Cancer Survivorship Care Quality Framework, a preliminary content framework for follow-up of cancer in primary care was developed. Second, a systematic review of literature and policy documents related to follow-up of cancer in primary care was conducted by searching English databases including PubMed and Web of Science, Chinese databases including CNKI and Wanfang Data, as well as the Google Scholar search engine. The search period was limited from 2000 to 2023. Core components of follow-up of cancer in primary care were identified and refined. Finally, from December 2023 to February 2024, expert consultation questionnaires were distributed by email. Based on assessments of expert enthusiasm, authority, and coordination, two rounds of Delphi expert consultation were completed. Through qualitative and quantitative analyses, the items were revised and refined, resulting in a final framework. Results　A total of 18 experts participated two consultation rounds. The response and validity rates of the questionnaires were both 100%, indicating high enthusiasm; the authority coefficient exceeded 0.7, reflecting good authority; and the coordination coefficient P-values were all <0.001, suggesting strong consistency among expert ratings. After two rounds of scoring and selection, the final framework comprised four primary categories-health monitoring, medical intervention, health promotion, and health assessment; eight secondary categories-risk factor monitoring, routine examination review, risk avoidance intervention, recommended therapy utilization, health knowledge dissemination, health experience exchange, cancer prognosis evaluation, and comorbidity assessment; as well as 24 specific subcategories. Conclusion　It is recommended that this framework be adopted to guide practice, with emphasis on strengthening general practitioners’capacity in chronic cancer management and rehabilitation guidance; actively expanding the scope of followup of cancer in primary care; and enhancing the attractiveness of such services, thereby providing comprehensive support for patients’ physical and psychological recovery.