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

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.