**Background:** Cancer is a leading cause of death globally, with 18.1 million new diagnoses and 9.6 million deaths annually, projected to reach 29.5 million by 2040. In China, cancer has become the leading cause of death, with approximately 2.338 million cancer deaths in 2015. The oncology nursing workforce is essential for cancer control, yet China faces a severe shortage of specialized oncology nurses and lacks unified training and certification standards. This narrative review summarizes the development, current status, challenges, and future directions for oncology nursing in China.
**Methods:** This is a narrative review synthesizing existing literature on Chinese oncology nursing. The authors discuss the historical development of oncology nursing in China, beginning with the establishment of early oncology departments in the 1930s and the formal founding of the oncology nursing professional committee by the Chinese Nursing Association in 1989. The review examines clinical practice patterns, community care models, training criteria, and nurses' knowledge and attitudes regarding cancer pain management, palliative care, and end-of-life care. It draws on published studies, WHO reports, and national policy documents.
**Key Results:** The review identifies several major findings: (1) China lacks unified criteria for accreditation of oncology training organizations and no unified administrative department for certification of oncology specialty nurses. Training requirements vary by hospital but typically include age under 40, nursing college degree or above, more than 2 years of clinical experience, and senior nurse title or above. (2) Chinese oncology nurses frequently demonstrate inadequate knowledge and attitudes about cancer pain management, with studies showing unfamiliarity with the three-ladder analgesic treatment principle, pain evaluation principles, and adverse responses to opioids. (3) Palliative care development is severely imbalanced across regions—professional palliative care departments exist in first-tier cities like Beijing, Shanghai, Guangzhou, and Shenzhen, but are absent in less developed areas. Most nurses in oncology departments have middle or lower cognitive levels of palliative care. (4) Community oncology nursing remains underdeveloped despite policy initiatives since 2009 promoting a "first diagnosis in community, hierarchical medical treatment and two-way referral" system. (5) Cultural taboos around death in Chinese society create communication barriers between nurses, patients, and families regarding end-of-life care. (6) Globally, there are 19.3 million professional nurses, but an estimated shortage of 5.9 million nurses, with 89% of this shortage in low- and middle-income countries. In LMICs, only 1.3 physicians and 2.5 nurses are available per 1,000 people, compared to 3.1 physicians and 10.9 nurses in high-income countries.
**Clinical Implications:** The review provides five key recommendations for advancing oncology nursing in China: (1) Strengthen systematic symptom management for cancer patients, addressing both physical symptoms (fatigue, pain, sleep disorders, nausea, vomiting, diarrhea) and psychological symptoms (anxiety, depression, uncertainty, hopelessness), with attention to "symptom clusters." (2) Restructure oncology nursing education by developing authoritative curricula, expanding graduate-level training, improving faculty qualifications, and integrating oncology content as required rather than elective courses. (3) Establish a unified certification system for oncology nurses and create corresponding clinical positions, including disease-specific specialists (e.g., breast cancer, lung cancer) and role-specific specialists (e.g., pain management, chemotherapy, radiotherapy, hospice care). (4) Develop community-based oncology nursing through medical association models, hospital-community continuous service models, two-way referral systems, and "hospital-community-family" interactive intervention models, with government support for insurance coverage of home-based palliative care services. (5) Integrate precision medicine training for oncology nurses, including genetic screening (e.g., BRCA-1 and BRCA-2 for breast cancer), symptom-related genetic variation research, and individualized care programs. The authors emphasize that palliative care should be established as an independent discipline, supported by laws and regulations, included in medical insurance, and promoted through death education to improve public acceptance.