Implementation and Evaluation of a Fear of Cancer Recurrence Screening, Referral and Management Program for Chinese Cancer Survivors: a Stepped Wedge and Cluster Randomized Trial

What this Trial Is About

Researchers are evaluating a program designed to implement fear of cancer recurrence screening, referral, and management into routine cancer care clinics. This study uses a stepped-wedge cluster randomized controlled trial to compare this implementation program against usual care without such strategies. The study aims to increase both the number of eligible patients screened for fear of cancer recurrence and the number of patients referred for psychosocial support, while also exploring patient and provider experiences to identify factors affecting program adoption and sustainability. The program being tested involves five implementation strategies including training nursing staff, providing weekly audit and feedback reports, facilitating site visits to address operational challenges, and allowing adaptable workflows tailored to each clinic's context. In the control condition, clinics continue their usual operations with the fear of cancer recurrence screening tool and referral forms provided but without the active implementation supports. Patients referred for psychosocial support are managed according to a predefined clinical pathway. Participants will be patients diagnosed with non-metastatic breast, gynecological, or colorectal cancer who completed primary and adjuvant treatment within the past two years. Researchers will track changes in the number of patients screened and referred before and after the implementation over up to 24 months. They will also evaluate referral uptake, staff training numbers, and staff knowledge and confidence about the screening program through surveys and qualitative interviews. The study is sponsored by The University of Hong Kong and aims to complete by August 2026.

Implementation and Evaluation of a Fear of Cancer Recurrence Screening, Referral and Management Program