Transitioning to adolescent and young adult or adult cancer survivorship care: A systematic review of contemporary guidelines and trials
Clinical Snapshot
PICO Framework
| P — Population | Child, adolescent, and young adult cancer survivors transitioning between paediatric and adult cancer care services |
| I — Intervention | Clinical guidelines and trials addressing age-related transitional cancer care |
| C — Comparator | Various approaches to care transition (no standardised comparator) |
| O — Outcomes | Care coordination, patient satisfaction, adverse outcomes, transition practices, and methodological quality of interventions |
Bottom Line
This systematic review reveals significant gaps in evidence-based approaches to cancer survivor care transitions. While clinical guidelines show general consistency in recommendations, they appropriately diverge to address local contexts. The paucity of robust trials (only 4 completed, with none including control groups) represents a critical evidence gap. The high variability in intervention components and outcome measures prevents meaningful comparison of effectiveness. For Australian clinicians, this highlights the need for standardised transition protocols and core outcome measures. The review's call for regionally specific guidelines supports tailored approaches within Australian cancer services. However, the insufficient trial evidence means current transition practices lack robust empirical support. Future research should prioritise controlled trials with standardised outcomes to build the evidence base needed for effective care transitions in this vulnerable population.
Key Findings
P Value: Not applicable - qualitative synthesis
Effect Size: Not applicable - descriptive synthesis
Primary Outcome: Identification and synthesis of contemporary guidelines and trials for cancer survivor care transitions
Nnt Or Sensitivity: 18 records identified from 3706 screened (0.5% inclusion rate)
Confidence Interval: Not applicable - no meta-analysis conducted
Clinical Application
Moderate - requires coordinated approach between paediatric and adult oncology services with resource allocation Highly relevant given Australian authors and institutions involved. Aligns with Australian cancer care frameworks and could inform Cancer Australia guidelines and state-based cancer services coordination Australian adolescent and young adult cancer survivors transitioning from paediatric to adult care services
Abstract
BACKGROUND: Health service transitions of child, adolescent, and young adult cancer survivors between paediatric and adult cancer care services are pervasively fragmented, resulting in poor coordination, reduced satisfaction, and adverse outcomes for cancer survivors and significant others (e.g., caregivers and family members). Numerous trials and clinical guidelines have been developed to support care transitions, but their convergence, divergence, and methodological quality remain unclear. To advance clinical practice and quality research about care transitions, a synthesis of trials and guidelines on child, adolescent, and young adult care transition across age-appropriate cancer services is required to inform future research, practice, guideline, and policy development. METHODS: A systematic review (CRD420251029796) was conducted. Studies were identified from searches of six bibliographic databases, four trial registers, and grey literature. Inclusion criteria focused on clinical guidelines or trials published between January 2020 and April 2025 that addressed age-related transitional cancer care. RESULTS: A total of 3706 records were identified. After screening, 18 records met the inclusion criteria: 10 clinical guidelines, 4 completed trials, and 4 ongoing trials with registrations. While general recommendations between guidelines were consistent, they diverged in detail relating to their local contexts. Only two ongoing trials, and no completed studies, included independent control groups. CONCLUSION: Completed trials were limited and highly variable in approach, components, and outcome measures, suggesting regionally specific guidelines enhance relevance, applicability, and transition practices. Future research should develop core outcome sets for care transition trials to facilitate comparison of outcomes and should develop robust study designs, including control groups.
References
- 1.Haywood, D., Hammersley, J., Sansom-Daly, U. M., McLoone, J., Dauer, E., Wilding, H., Hart, N. H., & Walwyn, T. (2026). Transitioning to adolescent and young adult or adult cancer survivorship care: A systematic review of contemporary guidelines and trials. Supportive Care in Cancer. https://doi.org/10.1002/cncr.34257
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