Colorectal Cancer Shared Care Model Gains Support From Clinicians

A new qualitative analysis from the Shared Care of Colorectal Cancer Survivors (SCORE) randomized controlled trial (RCT) sheds light on the real-world experiences of oncologists and general practitioners who provided shared survivorship care for patients with colorectal cancer (CRC).1 Clinicians largely supported the shared care model, but emphasized the need for improved communication, role clarity, and logistical coordination to ensure success.

This qualitative descriptive analysis is published in Psycho-Oncology.

New insights highlight clinician support for shared survivorship care and identify key factors for effective implementation. | Image credit: Kirsten D:peopleimages.com.jpeg

“Here, we explored the views of HCPs [health care professionals] who participated in the SCORE RCT regarding shared follow-up care for CRC survivors, with the view to support future implementation of shared care,” wrote the researchers of the study. “Overall, results demonstrate provider acceptability of shared care for CRC survivors, while providing valuable insights regarding modifications to the model that may support effective and sustainable implementation in the future.”

The SCORE trial is the first RCT to evaluate shared follow-up care between oncologists and general practitioners (GPs) for CRC survivors.2 Conducted across 5 public hospitals in Melbourne, Australia, the trial enrolled patients with stage I to III CRC who had completed curative-intent treatment.

The study aimed to explore the perspectives of GPs and oncologists involved in delivering shared survivorship care as part of the SCORE RCT.1 Participants included those who had provided care to CRC survivors assigned to the shared care arm of the trial. Shared care involved replacing 2 routine oncology follow-up appointments with GP visits and supporting providers with a survivorship care plan, patient education materials, and clinical management guidelines. Data were collected through semistructured interviews conducted via phone or video call between November 2022 and April 2023.

Analysis of interviews with 20 health care providers (13 GPs and 7 oncologists) revealed broad support for the shared care model, with participants generally viewing it as acceptable and appropriate for CRC survivorship. Seven key themes emerged, highlighting both facilitators and barriers to implementation. Providers emphasized the importance of clear, bilateral communication between specialists and GPs, noting that inconsistent or delayed information sharing posed challenges. Whereas some GPs felt confident managing survivorship care, others expressed uncertainty and a need for additional training. Both groups identified the value of having a designated hospital contact and detailed guidance to support GP involvement. Participants also noted that shared care was most suitable for patients with low risk of recurrence and minimal ongoing treatment needs. Finally, logistical and coordination support, such as structured care pathways and administrative assistance, was seen as critical to the model’s success.

These findings had several limitations. First, the SCORE trial was conducted exclusively within the Australian public health care system, which may limit the generalizability of results. Additionally, interviews were conducted more than a year after participants completed their involvement in the trial, which may have affected the accuracy of their recollections. These factors may have also influenced the transferability of the insights particularly in settings with differing models of care delivery or reimbursement structures.

“Both specialists and GPs found shared care for CRC survivors to be acceptable and supported the model,” wrote the researchers. “However, some aspects of the shared care intervention delivered within the SCORE RCT require further attention, namely communication from GPs to specialists, clarity regarding the role of GPs in providing holistic survivorship care, and effective provision and use of supportive resources by GPs.”

References

1. Lisy K, Tieu M, Gore C, et al. Oncologist and general practitioner perspectives of shared care for colorectal cancer survivors: a qualitative study. Psycho-Oncology. 2025;34(7):e70223. doi:10.1002/pon.70223

2. Jefford M, Emery JD, Martin AJ, et al. SCORE: a randomized controlled trial evaluating shared care (general practitioner and oncologist) follow-up compared to usual oncologist follow-up for survivors of colorectal cancer. eClinicalMedicine. 2023;66:102346. doi:10.1016/j.eclinm.2023.102346