JMIR Publications

ABSTRACT

Background:

The number of cancer survivors is steadily increasing worldwide, leading to an increased demand for long-term follow-up and supportive care. Many survivors face ongoing physical and psychosocial issues that highlight the need for innovative management approaches. Mobile health applications offer potential benefits by facilitating patient-led follow-ups, self-management, and more efficient use of healthcare resources. Although the market for cancer-related mobile apps has grown rapidly, their sustainability and scientific basis remain unclear. In the EU, the Medical Device Regulation (MDR), which has been in effect since May 2021, has introduced stricter criteria for classifying medical devices, including certain software applications. While aiming to improve patient safety, MDR could pose challenges for small companies and academic developers, potentially limiting the availability of such applications. No scoping review has delineated the changes in active applications before and after the implementation of the new legislation regulating medical devices.

Objective:

This scoping review aimed to evaluate the current availability and longevity of mobile applications supporting cancer recovery, with a specific focus on changes before and after the implementation of the EU Medical Device Regulation (MDR), and to assess the extent to which these applications are supported by clinical evidence.

Methods:

Searches were conducted in mobile application stores (Apple App Store and Google Play) and literature databases (MEDLINE, Embase, Cochrane Library, and Web of Science), using predefined terms. Mobile applications targeting cancer recovery and published articles on their effectiveness were included. Two reviewers independently extracted the data. A descriptive analysis was conducted to report trends in mobile device application availability and updates over time.

Results:

A total of 151 mobile applications were identified in 2018. However, by 2024, only 30% (45/151) were still available. Among these, 25 (17%) were updated within the past two years. During the search in December 2024, one new mobile application supported by scientific evidence was discovered. This mobile application was developed to assist cancer survivors in managing insomnia through cognitive behavioural therapy. Rapid turnover and a potential lack of sustainability in the mobile health application market for cancer survivors were evident, with most mobile applications identified in 2018 no longer available by 2024.

Conclusions:

This review revealed a significant lack of publicly available mobile applications that support cancer recovery. The longevity of existing mobile applications is limited, potentially because of regulatory and financial barriers. Prioritising rigorous effectiveness trials, addressing implementation barriers, and developing sustainable business models are essential to ensure the long-term availability and success of mobile health applications in cancer survivorship care.