Challenges in Collaborative Long-Term Health Management for Childhood Cancer Survivors Between General Physicians and Pediatric Oncologists in Japan: A Qualitative Study.
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BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.