Survivorship Care in Middle-Income Countries: A Guideline Development for Colombia Using Breast Cancer as a Model.

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Increased cancer survival necessitates robust survivorship care, particularly in low- and middle-income countries (LMIC).
• Existing survivorship guidelines, often developed in high-income countries, face challenges in LMIC due to workforce shortages and fragmented care.
• Colombia's cancer care is fragmented, with survivorship focus on relapse surveillance, lacking supportive care and equitable access.

Purpose of the Study:

• To develop a novel guideline for cancer survivorship care tailored for middle-income countries.
• To propose a risk-based approach integrating oncology specialists and family physicians.
• To address limitations in current survivorship care models within resource-constrained settings.

Main Methods:

• A three-phase development process was employed.
• Recommendations were formulated for disease control (disease-centered review).
• Interventions for quality of life and care delivery models were assessed (patient-centered and delivery model reviews).

Main Results:

• A breast cancer framework was utilized to develop the guideline.
• The proposed guideline integrates specialist and primary care roles.
• The approach emphasizes a risk-based strategy for survivorship care.

Conclusions:

• The developed guideline offers a framework suitable for middle-income countries.
• This model aims to standardize and improve cancer survivorship care in LMIC.
• Integration of different healthcare professionals is key for comprehensive survivorship management.