Shared Care Models for Cancer Survivorship: A Narrative Review of What Works, for Whom, and Why

The number of people living after a cancer diagnosis is growing, increasing demand on specialist-led followup, which has traditionally centred on recurrence surveillance and may not address broader needs such as late effects and coexisting chronic conditions.Shared care models, which distribute post-treatment followup across oncology, general practice, nursing, and pharmacy, have been proposed as one response.Three decades of randomised trials of general practitioner (GP)-led, nurse-led, structured shared care, and patientinitiated follow-up have generally reported patient-reported outcomes similar to those of specialist-led follow-up in selected, mostly lower-risk survivor populations, and several reported higher satisfaction or lower costs.Evidence on survival and recurrence detection remains uncertain, and quality-of-life findings are mixed.In this narrative review of randomised trials identified through a structured PubMed/MEDLINE and trialregistry search, we examine how shared-care interventions are organised and which components warrant further evaluation, while recognising remaining uncertainty about clinical outcomes and generalisability.Rather than organising evidence by model, we map the randomised trials onto six recurring components: GP education and protocols, survivorship care plans, structured intersectoral communication, nurse coordination, pharmacist teleconsultation, and patient activation tools.As most trials tested packages of care rather than individual components, this mapping is descriptive and hypothesis-generating.In the available trials, protocols and nurse coordination were common features of interventions with similar safety-related outcomes, while care plans and activation tools were more often associated with satisfaction and process outcomes than with quality of life.Exploratory findings suggest that culturally and linguistically tailored interventions may improve communication, but the influence of health literacy and cultural context requires further study.We recommend factorial and dismantling trials to assess the contributions of individual components and identify combinations that meet prespecified clinical and patient-reported outcome targets within local resource constraints, alongside embedded implementation research.