NCCN Clinical Practice Guidelines in Oncology™
Doctors and other clinicians throughout the United States and the world use the NCCN Clinical Practice Guidelines in Oncology™ to help them determine the best approaches to diagnosing, treating, managing and monitoring cancer patients at each stage of illness.
The NCCN Guidelines are developed by 44 panels of experts comprised of more than 800 clinicians and cancer researchers from the National Comprehensive Cancer Network’s 21 Member Institutions and their affiliates.
These medical professionals donate more than 15,000 hours of their time annually to revising and updating the NCCN Guidelines to reflect new data and clinical information.
The goal of the NCCN Guidelines, and all clinical practice guidelines in medicine, is to bring together and interpret the best available medical evidence to support a doctor’s treatment recommendations.
The step-by-step approach
The basic format of an NCCN Guideline is an algorithm or decision tree. Its purpose is to depict – both visually and through narrative text – an orderly pathway of the clinical decisions that need to be made to manage and treat specific tumors from initial diagnosis and treatment through post-treatment monitoring and the treatment of recurrence, if necessary.
The NCCN Guidelines Panel Members determine the definition of “appropriate care” by weighing the benefits and risks of various treatments. For example, certain chemotherapy regimens increase the risk of heart disease, but this would be considered an acceptable risk for a patient who would be less likely than others to live without the treatment. Such a regimen, however, would not be appropriate in patients who would likely live as long and as high-quality a life as others without the treatment.
Although NCCN Guidelines may be implemented at any hospital in the U.S. and throughout the world, there may be instances when the NCCN Guidelines reflect the expertise and capabilities of specialized, comprehensive and/or large cancer centers.
People who have particularly complex or uncommon cancers may want to ask their doctor for a referral to a comprehensive cancer center if they are not currently being treated at one.
Conflict of interest disclosures
As faculty members of large academic cancer centers, most NCCN Guidelines Panel Members are involved in clinical research and many have active relationships with sponsors developing new therapies.
NCCN has policies and procedures to address these and other external relationships that could potentially cause a conflict during the NCCN Guidelines development.
Each NCCN Guidelines Panel Member must disclose any organizational or corporate relationship that could be financially advantaged or disadvantaged by the action of the NCCN Guidelines Panel. Examples of relationships include:
- Participation in a speaker’s bureau
- Involvement on an advisory board
- Receipt of research support
- An equity stake in an organization or company.
Each relationship is reviewed by NCCN executive staff and the NCCN Guidelines Panel Chair. If a conflict of interest is determined to be significant, the NCCN Guidelines Panel Member is excused from the panel discussion.
All NCCN Guidelines Panel Members disclose their external relationships verbally at NCCN Guidelines update meetings and teleconferences. These disclosures are available to the public and updated annually.
Protecting the process
While any pharmaceutical company, patient advocacy group, health insurance company, or other interested party is permitted to submit scientific data and comments for NCCN Guidelines Panel consideration, these organizations have no control over the NCCN Guidelines Panel's recommendations. To ensure this:
- No pharmaceutical industry funds are accepted for any component of NCCN Guideline development.
- Pharmaceutical and other industry representatives do not make presentations to the NCCN Guidelines Panels or participate in panel deliberations.
As an organization, NCCN accepts general sponsorship grants from multiple pharmaceutical and biotechnology companies and grants for the support of specific projects that are part of NCCN's ongoing activities.
For example, pharmaceutical and other industry funds are accepted in the form of educational grants for the presentation of guidelines updates at NCCN meetings; for dissemination of the NCCN Guidelines; and to support the dissemination of patient information through this site.
Accessing the NCCN Guidelines
Although the NCCN Clinical Practice Guidelines in Oncology™ are written for physicians and other healthcare professionals, anyone may access these professional guidelines free of charge. When you visit this page of NCCN.org, you will be asked to accept an "end user license agreement," which is a standard agreement that details how our materials can and cannot be used. You will then see a page that lists the NCCN Guidelines, which are available as PDF documents that you may print.
If you are a patient or family member, please review the NCCN Guidelines with your doctor, as they are intended for professionals and are written in highly specialized language.