Framework for Resource Stratification

The NCCN Guidelines are used widely around the world, including in a number of low- and middle-resource countries where certain diagnostic tests and/or treatment approaches may be unavailable. The goal of the NCCN Framework™ is to define appropriate treatment pathways based on available resources—Basic, Core, Enhanced, and NCCN Guidelines—and deliver a tool for health care providers to identify treatment options that will provide the best possible outcomes in resource-constrained settings.

The NCCN Framework™ 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. Each NCCN Framework™ builds on the one before it, with incremental changes to the allocation of resources, providing a structure for improving cancer care. Treatment recommendations applicable to each NCCN Framework resource can be viewed within the context of the NCCN Guidelines.

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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