Challenges in Collaborative Long-Term Health Management for Childhood Cancer Survivors Between General Physicians and...

Advances in treatment have improved the survival rates of childhood cancer, which could make long-term health management (LTHM) a critical challenge. We aimed to identify challenges and perspectives associated with building a collaborative system between pediatric oncologists (POs) and general physicians (GPs) for LTHM of childhood cancer survivors (CCS).

This qualitative study was conducted as part of a regional initiative in Fukushima, Japan aimed at establishing a community-based collaboration model between a university hospital-based specialized center and local GPs. We performed a thematic analysis of focus group discussions involving seven GPs and three POs to identify professional perspectives and barriers for future collaboration.

Three primary themes were identified. First, GPs recognized their potential to contribute by leveraging daily experience in multidisciplinary community networks, yet they acquired a deeper understanding of survivorship-specific psychosocial needs and clear consultation channels with POs. Second, POs maintained a strong sense of responsibility for lifelong care but harbored anxieties regarding care discontinuity, which were linked to structural problems, including undefined professional roles and the lack of robust information-sharing mechanisms. Third, both groups identified that the deep emotional bonds formed among CCS, families, and POs could hinder the involvement of new healthcare providers.

Establishing a collaborative system requires bridging knowledge gaps regarding specific needs for CCS, and implementing structural improvements (e.g., clearly defined roles and effective information-sharing systems). Integrating these changes together with the values of patients and their families is essential for sustainable long-term care for CCS in the Japanese healthcare system.