Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations

Pimentel Parra, Gustavo Adolfo; García Vivar, Cristina; Escalada Hernández, Paula; Santos Martín, José Luis; Soto Ruiz, María Nelia

Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations

dc.contributor.author	Pimentel Parra, Gustavo Adolfo
dc.contributor.author	García Vivar, Cristina
dc.contributor.author	Escalada Hernández, Paula
dc.contributor.author	Santos Martín, José Luis
dc.contributor.author	Soto Ruiz, María Nelia
dc.contributor.department	Ciencias de la Salud	es_ES
dc.contributor.department	Osasun Zientziak	eu
dc.contributor.department	Institute of Smart Cities - ISC	en
dc.date.accessioned	2025-06-26T12:02:35Z
dc.date.available	2025-06-26T12:02:35Z
dc.date.issued	2025-05-17
dc.date.updated	2025-06-26T11:58:36Z
dc.description.abstract	BACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evidence-based care. Despite the growing survivor population, no systematic evaluation of Clinical Practice Guidelines (CPGs) for this group has been conducted. This study assesses the quality of CPGs and their evidence-based recommendations. METHODS: A systematic review was conducted in PubMed, CINAHL, and Cochrane Library (2015–2023), including guidelines from major oncology organisations. The AGREE II instrument evaluated CPG quality across six domains, and recommendations were classified using a Primary Care survivorship framework: prevention, surveillance, care coordination, and long-term effect management. RESULTS: Ten CPGs met inclusion criteria, with 7 classified as high quality. Most recommendations focused on prevention (adjuvant therapy, alcohol) and surveillance (follow-up, mammography), while gaps remained in lifestyle guidance, psychosocial support, and management of complications (lymphedema, osteoporosis, cognitive dysfunction). Care coordination and psychosocial interventions were inconsistently addressed. CONCLUSIONS: Current CPGs inadequately cover the complex needs of long-term survivors, particularly in psychosocial care. Evidence-based, patient-centred guidelines are urgently needed to optimise long-term outcomes and quality of life.	en
dc.description.sponsorship	This research was funded by the National Institute of Health Carlos III (ISCIII), Spain, grant number PI21/00894.
dc.format.mimetype	application/pdf
dc.format.mimetype	application/msword
dc.identifier.citation	Pimentel-Parra, G. A., García-Vivar, C., Escalada-Hernández, P., San Martín-Rodríguez, L., Soto-Ruiz, N. (2025). Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations. British Journal of Cancer, 1-16. https://doi.org/10.1038/s41416-025-03059-5.
dc.identifier.doi	10.1038/s41416-025-03059-5
dc.identifier.issn	0007-0920
dc.identifier.uri	https://academica-e.unavarra.es/handle/2454/54333
dc.language.iso	eng
dc.publisher	Springer Nature
dc.relation.ispartof	British Journal of Cancer (2025)
dc.relation.projectID	info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI21%2F00894/ES/
dc.relation.publisherversion	https://doi.org/10.1038/s41416-025-03059-5
dc.rights	© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/
dc.subject	Breast cancer survivorship	en
dc.subject	Clinical Practice Guidelines (CPGs)	en
dc.subject	Long-term outcomes	en
dc.subject	Psychosocial care	en
dc.subject	Evidence-based recommendations	en
dc.subject	Survivorship care framework	en
dc.title	Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations	en
dc.type	info:eu-repo/semantics/article
dc.type.version	info:eu-repo/semantics/publishedVersion
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