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Peer-reviewedCC BYPLOS Medicine

Challenges and recommendations for implementation of oncology clinical practice guidelines in China

  • Minzhi Lv1,2,3
  • Duanduan Yuan4
  • Yue Suo5,6
  • Fang Ding7
  • Lijuan Hu7
  • Lei Cao7
  • Yi Wang1,2
  • Jing Lei1,2
  • Shenglan Tang4,8,9,10,11
  • Tianshu Liu1,2,3
11 affiliations
  1. 1Department of Cancer Screening and Prevention, Zhongshan Hospital, Fudan University, Shanghai, China.
  2. 2Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China.
  3. 3Center of Evidence-based Medicine, Fudan University, Shanghai, China.
  4. 4Innovation Lab for Cancer Prevention and Control (CALab), Duke Kunshan University, Kunshan, Jiangsu, China.
  5. 5School of Public Health, Fudan University, Shanghai, China.
  6. 6National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
  7. 7Department of Medical Affairs, Zhongshan Hospital, Fudan University, Shanghai, China.
  8. 8Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
  9. 9Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
  10. 10Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.
  11. 11Duke-NUS Medical School, Singapore, Singapore.
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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.

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Cite

BibTeXRIS
BibTeX
@article{lv2026challenges,
  title = {{Challenges and recommendations for implementation of oncology clinical practice guidelines in China}},
  author = {Minzhi Lv and Duanduan Yuan and Yue Suo and Fang Ding and Lijuan Hu and Lei Cao and Yi Wang and Jing Lei and Shenglan Tang and Tianshu Liu},
  journal = {PLOS Medicine},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pmed.1005261},
  url = {https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005261},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Challenges and recommendations for implementation of oncology clinical practice guidelines in China
AU  - Minzhi Lv
AU  - Duanduan Yuan
AU  - Yue Suo
AU  - Fang Ding
AU  - Lijuan Hu
AU  - Lei Cao
AU  - Yi Wang
AU  - Jing Lei
AU  - Shenglan Tang
AU  - Tianshu Liu
PY  - 2026
DA  - 2026/10/28
JO  - PLOS Medicine
DO  - 10.1371/journal.pmed.1005261
UR  - https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005261
AB  - 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.
SN  - 1549-1676
SN  - 1549-1277
ER  -