Framework for Resource Stratification Of NCCN Guidelines 

The NCCN Framework for Resource Stratification Of NCCN Guidelines (NCCN FrameworkTM) outlines a rational approach for building cancer management systems to provide the highest achievable cancer care by applying available and affordable services in a logical sequence. The goal of the NCCN Framework™ is to support the use of NCCN Guidelines in countries with limited resources by defining appropriate treatment pathways based on available resources (Basic, Core, and Enhanced)—and to deliver a tool for health care providers to identify treatment options that will provide the best possible outcomes in resource-constrained settings. Each resource level builds on the one before it, with incremental changes to the allocation of resources, providing a structure for improving cancer care. Treatment recommendations applicable at each resource level can be viewed within the context of the NCCN Guidelines.

The NCCN Framework™ is developed by NCCN Framework Subcommittees, which include members of the relevant NCCN Guidelines Panel with experience/knowledge in the care of patients with cancer in countries with limited resources. Following initial development by members of the NCCN Framework Subcommittee, the NCCN Framework™ is reviewed by clinicians from around the world (international review) with expertise in cancer care in resource-constrained settings as identified by NCCN Framework Subcommittee members. The NCCN Framework Subcommittee reviews the input from all international reviewers and amends the NCCN Framework™ as appropriate before publication on NCCN’s website. 

The NCCN Framework™ resources are defined as follows:

  • Basic Resources: Basic Resources include essential services needed to provide basic minimal standard of care that improves disease-specific outcomes.
  • Core Resources: Core Resources include services provided in the Basic Resources Framework plus additional services that provide major improvements in disease outcomes (e.g. survival) and that are not cost prohibitive.
  • Enhanced Resources: Enhanced Resources include services provided in the Core Resources Framework plus additional services that provide lesser improvements in disease outcomes and/or services that provide major improvements in disease outcomes but are cost prohibitive in lower resource settings.
  • NCCN Guidelines: The NCCN Guidelines are evidence-based, consensus-driven recommendations made by the NCCN Guidelines panels. They include services provided in the Enhanced Resources Framework plus additional services that provide minor improvements in disease outcomes, interventions that are cost prohibitive in lower resource settings, and/or services that do not provide improvement in disease outcomes but are desirable services.

NCCN believes that the best available resources should be provided. If Basic Resources for cancer treatment are unavailable, palliative and best supportive care should be provided. Referral to a higher-resource-level provider with the best available resources, to provide the highest level of cancer care possible, is always an appropriate option for the patient.

NCCN extends its sincere gratitude to those clinicians from around the world who generously give their time and expertise to review the NCCN Framework™ and provide thoughtful input. Learn more about the International Review of NCCN Framework™.

NCCN Framework™ - Guidelines for Treatment of Cancer by Type

Acute Lymphoblastic Leukemia

B-Cell Lymphomas

Biliary Tract Cancers

Bladder Cancer

Breast Cancer

Cervical Cancer

Colon Cancer

Esophageal and Esophagogastric Junction Cancers

Gastric Cancer

Head and Neck Cancers

Hepatocellular Carcinoma

Kidney Cancer

Non-Small Cell Lung Cancer

Pancreatic Adenocarcinoma

Prostate Cancer

Rectal Cancer

Thyroid Carcinoma

Uterine Neoplasms

NCCN Framework™ - Guidelines for Supportive Care

Adult Cancer Pain

Palliative Care

NCCN Framework™ - Guidelines for Detection, Prevention, & Risk Reduction

Breast Cancer Screening and Diagnosis

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