{ "abstract": "Summary points: As China’s cancer burden continues to rise and treatment becomes increasingly complex, clinical practice guidelines (CPGs) are crucial to standardising cancer care and supporting clinical decision-making. Over the past decades, China has made substantial progress in developing oncology CPGs, transitioning from expert consensus and international adaptation toward domestically led guideline production.This Policy Forum presents an analysis of the optimisation and implementation of oncology CPGs in China. We argue that the core challenge facing oncology CPGs in China is not a lack of guidelines, but the absence of an integrated governance and implementation ecosystem, and insufficient alignment with local evidence.By situating China's oncology sector within a macro-health-system perspective, this Policy Forum provides a conceptual blueprint for other transition economies experiencing a mismatch between rapid clinical technology scaling and fragmented regulatory governance.We propose a four-part strategic framework: (1) Establishing a national joint clearinghouse and registration system; (2) integrating resource-stratified pathways with locally relevant evidence; (3) expanding free, diversified dissemination channels; and (4) embedding implementation science alongside healthcare financing alignment.Addressing these systemic gaps offers scalable lessons for global health systems aiming to transition from the quantity-driven expansion of clinical guidelines to equity-oriented, system-integrated quality enhancement. In this This Policy Forum, Minzhi Lv, Duanduan Yuan, Yue Suo and colleagues argue that the core challenge for implementation of oncology clinical practice guidelines in China is not a lack of guidelines, but the absence of an integrated governance and implementation ecosystem, and propose a four-part strategic framework for addressing these issues.", "abstract_shown": true, "affiliations": [ "Department of Cancer Screening and Prevention, Zhongshan Hospital, Fudan University, Shanghai, China.", "Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.", "Center of Evidence-based Medicine, Fudan University, Shanghai, China.", "Innovation Lab for Cancer Prevention and Control (CALab), Duke Kunshan University, Kunshan, Jiangsu, China.", "School of Public Health, Fudan University, Shanghai, China.", "National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.", "Department of Medical Affairs, Zhongshan Hospital, Fudan University, Shanghai, China.", "Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.", "Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.", "Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.", "Duke-NUS Medical School, Singapore, Singapore." ], "article_type": "Policy Forum", "arxiv": null, "author_total": 10, "authors": [ { "affs": [ 0, 1, 2 ], "name": "Minzhi Lv", "orcid": "0000-0002-7994-2257" }, { "affs": [ 3 ], "name": "Duanduan Yuan", "orcid": "0009-0006-1946-7921" }, { "affs": [ 4, 5 ], "name": "Yue Suo", "orcid": "0000-0001-8585-2699" }, { "affs": [ 6 ], "name": "Fang Ding" }, { "affs": [ 6 ], "name": "Lijuan Hu", "orcid": "0000-0001-8094-7103" }, { "affs": [ 6 ], "name": "Lei Cao" }, { "affs": [ 0, 1 ], "name": "Yi Wang", "orcid": "0009-0008-6571-5759" }, { "affs": [ 0, 1 ], "name": "Jing Lei" }, { "affs": [ 3, 7, 8, 9, 10 ], "name": "Shenglan Tang" }, { "affs": [ 0, 1, 2 ], "name": "Tianshu Liu", "orcid": "0000-0002-8604-6311" } ], "bibtex": "https://research.draconitic.com/paper/crknjx9kfjx79.bib", "cited_by": 0, "doi": "10.1371/journal.pmed.1005261", "fulltext_url": "https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005261", "id": "crknjx9kfjx79", "issns": [ "1549-1676", "1549-1277" ], "landing_url": "https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005261", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Asia" ], [ "heading", "Cancer Treatment" ], [ "heading", "Cancers and Neoplasms" ], [ "heading", "China" ], [ "heading", "Economics" ], [ "heading", "Finance" ], [ "heading", "Geographical Locations" ], [ "heading", "Health Care" ], [ "heading", "Health Care Policy" ], [ "heading", "Health Economics" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Oncology" ], [ "heading", "People and Places" ], [ "heading", "Policy Forum" ], [ "heading", "Social Sciences" ], [ "heading", "Treatment Guidelines" ], [ "openalex", "2739|Clinical practice guidelines implementation" ], [ "plos", "/Medicine and health sciences/Health care/Health care policy" ], [ "plos", "/Medicine and health sciences/Health care/Health care policy/Treatment guidelines" ], [ "plos", "/Medicine and health sciences/Health care/Health economics" ], [ "plos", "/Medicine and health sciences/Oncology" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment" ], [ "plos", "/Medicine and health sciences/Oncology/Cancers and neoplasms" ], [ "plos", "/People and places/Geographical locations/Asia/China" ], [ "plos", "/Social sciences/Economics/Finance" ], [ "plos", "/Social sciences/Economics/Health economics" ] ], "openalex": "W7224121287", "pdf_url": "https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1005261&type=printable", "pmcid": "PMC13716229", "pmid": "42949869", "published": "2026-10-28", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/crknjx9kfjx79.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pmed.1005261", "source": "plos", "url": "https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005261" }, { "first_seen": "2026-10-31T00:20:33Z", "native_id": "MED:42949869", "source": "europepmc", "url": "https://europepmc.org/article/MED/42949869" }, { "first_seen": "2026-11-01T12:23:16Z", "native_id": "PMC13716229", "source": "pmc", "url": "https://doi.org/10.1371/journal.pmed.1005261" } ], "subjects": [ { "field": "medicine", "origin": "plos:oncology", "subfield": "oncology" } ], "title": "Challenges and recommendations for implementation of oncology clinical practice guidelines in China", "title_text": "Challenges and recommendations for implementation of oncology clinical practice guidelines in China", "type": "peer-reviewed", "updated_at": "2026-11-01T12:23:16Z", "url": "https://research.draconitic.com/paper/crknjx9kfjx79", "venue": "PLOS Medicine", "versions": [] }