Survivorship care for people affected by advanced or metastatic cancer: MASCC-ASCO standards and practice recommendations

Nicolas H Hart; Larissa Nekhlyudov; Thomas J Smith; Jasmine Yee; Margaret I Fitch; Gregory B Crawford; Bogda Koczwara; Fredrick D Ashbury; Maryam B Lustberg; Michelle Mollica; Andrea L Smith; Michael Jefford; Fumiko Chino; Robin Zon; Meera R Agar; Raymond J Chan

doi:10.1007/s00520-024-08465-8

Survivorship care for people affected by advanced or metastatic cancer: MASCC-ASCO standards and practice recommendations

Support Care Cancer. 2024 Apr 29;32(5):313. doi: 10.1007/s00520-024-08465-8.

Authors

Nicolas H Hart^{1

2

3

4

5}, Larissa Nekhlyudov⁶, Thomas J Smith⁷, Jasmine Yee⁸, Margaret I Fitch⁹, Gregory B Crawford^{10

11}, Bogda Koczwara^{12

13}, Fredrick D Ashbury^{14

15

16}, Maryam B Lustberg^{17

18}, Michelle Mollica¹⁹, Andrea L Smith²⁰, Michael Jefford^{21

22}, Fumiko Chino²³, Robin Zon^{24

25}, Meera R Agar²⁶, Raymond J Chan^{27

28}

Affiliations

¹ Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia. nicolas.hart@uts.edu.au.
² Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia. nicolas.hart@uts.edu.au.
³ Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia. nicolas.hart@uts.edu.au.
⁴ Cancer and Palliative Care Outcomes Centre, School of Nursing, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia. nicolas.hart@uts.edu.au.
⁵ Institute for Health Research, The University of Notre Dame Australia, Perth, WA, Australia. nicolas.hart@uts.edu.au.
⁶ Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Division of General Internal Medicine and Sidney Kimmel Comprehensive Cancer Center, John Hopkins Medical Institutions, Baltimore, MD, USA.
⁸ Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁹ School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
¹⁰ Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
¹¹ Northern Adelaide Local Health Network, Adelaide, SA, Australia.
¹² Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
¹³ Flinders Cancer and Innovation Centre, Flinders Medical Centre, Adelaide, SA, Australia.
¹⁴ VieCure, Clinical and Scientific Division, Greenwood Village, CO, USA.
¹⁵ Department of Oncology, University of Calgary, Calgary, ON, Canada.
¹⁶ Internal Medicine-Medical Oncology, College of Medicine, The Ohio State University, Columbus , OH, USA.
¹⁷ Department of Medicine, School of Medicine, Yale University, New Haven, CT, USA.
¹⁸ Medical Oncology Division, Yale Cancer Centre, New Haven, CT, USA.
¹⁹ Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
²⁰ The Daffodil Centre and University of Sydney: a joint venture with Cancer Council NSW, Sydney, NSW, Australia.
²¹ Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
²² Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
²³ Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
²⁴ Michiana Hematology-Oncology, Mishawaka, IN, USA.
²⁵ Cincinnati Cancer Advisors, Norwood, OH, USA.
²⁶ IMPACCT Research Centre, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia.
²⁷ Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia.
²⁸ Cancer and Palliative Care Outcomes Centre, School of Nursing, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.

Abstract

Purpose: People with advanced or metastatic cancer and their caregivers may have different care goals and face unique challenges compared to those with early-stage disease or those nearing the end-of-life. These MASCC-ASCO standards and practice recommendations seek to establish consistent provision of quality survivorship care for people affected by advanced or metastatic cancer.

Methods: An expert panel comprising MASCC and ASCO members was formed. Standards and recommendations relevant to the provision of quality survivorship care for people affected by advanced or metastatic cancer were developed through conducting: (1) a systematic review of unmet supportive care needs; (2) a scoping review of cancer survivorship, supportive care, and palliative care frameworks and guidelines; and (3) an international modified Delphi consensus process.

Results: A systematic review involving 81 studies and a scoping review of 17 guidelines and frameworks informed the initial standards and recommendations. Subsequently, 77 experts (including 8 people with lived experience) across 33 countries (33% were low-to-middle resource countries) participated in the Delphi study and achieved ≥ 94.8% agreement for seven standards (1. Person-Centred Care; 2. Coordinated and Integrated Care; 3. Evidence-Based and Comprehensive Care; 4. Evaluated and Communicated Care; 5. Accessible and Equitable Care; 6. Sustainable and Resourced Care; 7. Research and Data-Driven Care) and ≥ 84.2% agreement across 45 practice recommendations.

Conclusion: Standards of survivorship care for people affected by advanced or metastatic cancer are provided. These MASCC-ASCO standards will support optimization of health outcomes and care experiences by providing guidance to stakeholders in cancer care (healthcare professionals, leaders, and administrators; governments and health ministries; policymakers; advocacy agencies; cancer survivors and caregivers. Practice recommendations may be used to facilitate future research, practice, policy, and advocacy efforts.

Keywords: Cancer Survivors; Caregivers; Elements of Care; Supportive Care; Survivorship.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Cancer Survivors*
Delphi Technique*
Humans
Neoplasm Metastasis
Neoplasms* / therapy
Palliative Care* / methods
Palliative Care* / standards
Patient-Centered Care / organization & administration
Patient-Centered Care / standards
Practice Guidelines as Topic
Quality of Health Care / standards
Survivorship*