NCCN Guidelines Are Being Adopted Internationally

The National Comprehensive Cancer Network (NCCN) is increasingly collaborating with other nations to develop foreign editions of the NCCN Guidelines. These editions, which are developed through collaborations between the host country’s oncology thought leaders and NCCN Guidelines Panel Chairs or Members, may be direct translations of the NCCN Guidelines or modified versions that consider metabolic differences in populations, accessibility of technology, and the regulatory status of healthcare technologies in the country seeking to adopt the guidelines.

The most recent country to adopt NCCN Clinical Practice Guidelines is Japan, and the NCCN recently announced that the NCCN Guidelines for Colon Cancer and Rectal Cancer are being translated into Japanese by the Japanese Society for Cancer of the Colon and Rectum. Translations of the NCCN Guidelines for Anal Carcinoma and Colorectal Cancer Screening into Japanese are also in progress, as are translations of the NCCN Guidelines regarding urological cancers, which will be developed throughout the coming year.

In a press statement, William T. McGivney, PhD, CEO, NCCN, said “NCCN is pleased to be able to collaborate with clinicians in Japan in determining appropriate and effective avenues of care for their oncology patients. As the arbiter of high-quality cancer care, NCCN remains dedicated to enhancing our international relationships to improve the quality, effectiveness, and efficiency of oncology practice so patients worldwide can live better lives.”

In Japan, cancer is the leading cause of death, with one of every three individuals dying of the disease. “By aligning with NCCN to provide our clinicians with treatment recommendations developed by world-renowned experts in cancer, we look to improve the care provided to patients and impact the number of cancer survivors in Japan,” said Masanori Fukushima, MD, PhD, Professor Emeritus, Kyoto University, Director and Chairman of TRI.

The Process

The NCCN outlines the process of adapting its guidelines as follows on the NCCN website:

NCCN authorizes selected groups to adapt its Clinical Practice Guidelines to reflect genetic variations in metabolism of agents and regulatory environments of host countries, subject to approval by NCCN and representatives of NCCN’s disease-specific panels.

Participating countries select disease-specific representatives to review and suggest modifications to specific Guidelines. It is important that the fields of surgical oncology, medical oncology, and radiation oncology are represented for each type of cancer. Representatives are recognized experts in the management of these malignancies in their home countries. In addition, because the process involves the development of consensus through compromise, they are sufficiently influential that they can speak for the general oncology community in their own countries.

Each member of each committee receives a copy of the most recent version of the NCCN Clinical Practice Guidelines for the specific type of cancer. The members circulate the Guidelines among a representative group of multidisciplinary physicians in their country to determine areas where local practice is not concordant with the NCCN Guidelines. There is discussion of how the Guidelines might be adapted to accommodate local circumstances. The representative to the regional meeting is responsible for bringing these recommendations forward to the regional meeting.

A regional meeting is conducted so that all participating representatives can develop a single proposal for adaptation of each disease-specific Guideline. Any proposed modification of a Guideline must be supported by data.

At this meeting, NCCN panel members present the data used to develop the Guidelines and representatives of the regional alliance present proposed changes and the literature that supports them; a discussion of the issues takes place. At the end of the meeting, a consensus is developed regarding an adaptation of the Guidelines that is acceptable to the NCCN. Any changes from the original NCCN Guideline are identified in the adaptations.

Currently, international initiatives are underway in Asia and the Middle East. For more information on NCCN International Programs, visit www.nccn.org/international/default.asp.