Developing provincial cancer survivorship standards to inform quality of care in Ontario, Canada.

Abstract

641 Background: In Canada, an estimated 43% of individuals will be diagnosed with cancer during their lifetime, and survival rates now exceed 90% when cancer is diagnosed at stage I. As the population of cancer survivors continues to grow, there is a need for coordinated, high-quality survivorship care. This project aimed to develop a provincial quality standard to guide the assessment, management, and follow-up of cancer survivors across healthcare settings in Ontario and support the health and well-being of individuals living with and beyond cancer across all cancer types. Methods: A multi-phase, evidence-informed approach was used, led by Ontario Health in collaboration with a multidisciplinary advisory committee (n = 27), including clinicians, allied health professionals, people with lived experience, and representation from community support groups. A comprehensive literature review, expert consultations, and existing data informed initial priority areas. Three structured consensus meetings were conducted to refine quality statements and indicators. Public feedback was collected through surveys, email submissions, social media and targeted engagements with equity-deserving groups. Results: Five areas for improvement were identified: (1) comprehensive assessment at regular intervals, (2) transitions in care, care coordination, and primary care integration, (3) psychosocial support, (4) patient education and self-management, and (5) accessible, culturally and linguistically responsive, equitable care. These areas were consistently ranked highest across stakeholders, with strong consensus achieved during voting (100% agreement for four statements; 89% for psychosocial support). Public feedback (n = 79) demonstrated high overall support (75%–87.8%), with the strongest agreement for transitions in care and patient education and self-management. Key barriers included system capacity, fragmented care transitions, and inequities in access, while enablers included existing infrastructure, partnerships, and clinical pathways and guidelines. These findings informed the development of targeted implementation strategies and sector-specific resources to support uptake across care settings. Conclusions: The Cancer Survivorship quality standard provides a structured, evidence-informed framework to improve consistency, coordination, and quality of survivorship care in Ontario. Its successful implementation will depend on addressing system-level barriers, strengthening interdisciplinary collaboration, and ongoing evaluation to ensure meaningful improvements in patient outcomes and experiences.