Quality Standard Details
Cancer Survivorship: Care for Adults in All Settings
- Status
- Under Review
- Topic Area
- Cancer
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Cancer survivorship in Ontario is increasing, with a 33% increase in the number of survivors between 2019/20 and 2023/24. As of March 31, 2023, there were 753,023 cancer patients in Ontario living with a current or previous cancer diagnosis.
Cancer survivors experience tiredness and significant psychosocial needs, with depression, well-being, anxiety, and pain being the top reported symptoms across multiple cancer types. Cancer can have a considerable impact on a person’s mental health both during and after they have completed their treatment.
With the increasing number of cancer survivors, disparities stemming from health inequities also persist. Factors such as belonging to a racialized group or ethnicity, socioeconomic status, geography, and age have been identified to consistently influence outcomes throughout the cancer survivorship trajectory. These factors often intersect, driving increased inequities, thus highlighting the need for increased support and availability of resources for cancer survivors.
This quality standard addresses care for adults age 18 and over who are living with, through, and beyond a cancer diagnosis (cancer survivors). The quality standard focuses on the assessment, management, and follow-up care of cancer survivors, including those from equity-deserving communities in Ontario. The quality standard addresses the health and well-being of cancer survivors of all cancer types and applies to all adult health care settings, including hospitals with or without a cancer program offering specialized care (e.g., regional cancer centres), emergency departments, primary and long-term care, and other home and community care settings.
The quality standard does not address cancer screening, care for patients in workup for cancer, treatment pathways, palliative care, or end-of life care. Rather, it outlines high-quality survivorship care that is initiated early in the cancer journey following diagnosis to support long-term wellness, improved quality of life, and proactive management of health risks.
Quality Standard in Brief
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Quality Statement 1: Comprehensive Assessment at Regular Intervals
Cancer survivors receive a comprehensive assessment of their survivorship care needs at regular intervals. Assessments are documented in an individualized, person-centred care plan that is updated regularly. Cancer survivors with identified needs receive or are referred to appropriate care and services.
Quality Statement 2: Transitions in Care, Care Coordination, and Primary Care Integration
Cancer survivors transition between levels of cancer care as appropriate for their needs. Transitions in care for cancer survivors involve care coordination, shared care, and support between health care teams and settings, ensuring integration with primary care.
Quality Statement 3: Psychosocial Support
Cancer survivors and their care partners have access to psychosocial screening (as part of a comprehensive assessment) to identify any psychosocial needs or barriers to accessing care. Cancer survivors with unmet psychosocial needs receive information and support or are referred for treatment.
Quality Statement 4: Patient Education and Self-Management
Cancer survivors receive comprehensive, health-literate education about survivorship care, both during and after active treatment. They are offered self-management support and strategies to address their survivorship care needs, with the goal of optimizing their health and quality of life.
Quality Statement 5: Accessible, Culturally and Linguistically Responsive, Equitable Care
Cancer survivors receive care in a health care system that is accessible, compassionate, and responsive to their culture, traditions, values, and linguistic and other needs. Health care teams work to build trust, remove barriers to accessing care, and provide equitable care, giving special consideration to First Nations, Métis, Inuit, urban Indigenous communities, racialized populations, Francophones, and additional equity-deserving populations.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
