Harmonization of survivorship guidelines for breast, prostate and colorectal cancer survivorship
cancer, prostate
CANCER, PROSTATE, BREAST CANCER
An evidence review group, consisting of seven researchers and clinicians with primary care and cancer expertise, worked with the Centre for Effective Practice (CEP), a non-profit research consulting group based out of the University of Toronto, to develop a literature search strategy and identify relevant guidelines from web-based repositories and provincial, national and international cancer organizations. Among those identified, we selected guidelines that focussed on adult cancer survivors and were published in English (2009–2016) with a rigorous evidence base, as assessed using select items of the AGREE II (Appraisal of Guidelines for Research and Evaluation) Instrument [Once identified and assessed, the cancer survivorship guidelines deemed to be of high quality by the AGREE II Instrument were harmonized by a clinical working group (CWG) consisting of 21 members: patients, clinical experts, researchers and health administrators. Members of the CWG independently assigned a vote of yes, no or maybe to specific recommendations (e.g. annual surveillance mammogram for women with a history of breast cancer) from the selected guidelines. Recommendations for which a consensus decision of “no” was reached were excluded from the algorithm. Those for which there were a range of responses were discussed until a consensus of “yes” or “no” was reached. Recommendations for which a consensus decision of “yes” was reached were harmonized by the CWG so that the lowest common requirement (e.g. frequency of testing) was included in the algorithm unless there was evidence to support the higher frequency interval. Where specific frequency recommendations were available for local jurisdictions, these were included in the BETTER WISE cancer surveillance algorithm.The search identified 26 survivorship guidelines (4 general, 6 breast, 6 prostate and 10 colorectal), of which 9 were rated high quality. These 9 guidelines contained 94 specific recommendations for review [