NCCN Updates Resources for Improving Cancer Care in the Middle East and North Africa

NCCN has published updated resources for improving and facilitating quality, effective, efficient, and accessible cancer care in the Middle East and North Africa (MENA). These newly published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): MENA Editions provide cancer treatment recommendations that are adapted for regional needs, resource availability, and patient characteristics. The new updates to these NCCN Adaptations reflect recent advances in care.

“The process of exchange between the experts from the region and US-based NCCN experts is very dynamic and educational, with mutual benefits to all those involved,” said Abdul-Rahman Jazieh, MD, MPH, Chairman, MENA NCCN Adaptation Project, King Abdulaziz Medical City, Riyadh, Saudi Arabia. “It gives a chance for in-depth review of the guidelines by international experts who serve as external reviewers. At the same time, our regional specialists get a better understanding of the internal process for NCCN Guidelines development.”

The following NCCN Guidelines: MENA Editions have been updated recently, and are available to view or download free-of-charge online at NCCN.org, or via the Virtual Library of NCCN Guidelines app for smartphones and tablets:

  • B-Cell Lymphomas

  • Colon Cancer

  • Hepatobiliary (Liver, Gallbladder, and Bile Duct) Cancers

  • Hodgkin Lymphoma

  • Lung Cancer (Non-Small Cell)

“NCCN Adaptations are derived from the evidence- and expert consensus-based recommendations from NCCN Guidelines, while allowing for considerations of metabolic differences in populations, local accessibility, and regulatory status of health care technologies used for cancer care in a specific region,” explained Robert W. Carlson, MD, CEO, NCCN. “Oncologists worldwide tell us they rely on NCCN Guidelines for determining optimal care and streamlining processes. Our global program works with local clinicians to customize our recommendations and make the regional content even more practical, relevant, and accessible.”

Additional NCCN Guidelines: MENA Editions exist for the following diagnoses:

  • Breast Cancer

  • Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

  • Hairy Cell Leukemia

  • Primary Cutaneous B-Cell Lymphomas

  • Prostate Cancer

  • T-Cell Lymphomas

The NCCN Guidelines: MENA Editions are just one facet of NCCN’s work to improve cancer care across the world, including work in other parts of Africa. NCCN is also working with the African Cancer Coalition, in conjunction with the American Cancer Society, Clinton Health Access Initiative, and IBM, to create and share NCCN Harmonized Guidelines for Sub-Saharan Africa. The organization has also translated content from various NCCN Guidelines into 11 different languages, provided several Asian Consensus Statements, published NCCN Adaptations for Spain and Latin America, and helped define appropriate treatment pathways for low- and middle-income countries through the NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework).

In 2018 alone, NCCN Guidelines were downloaded more than 10 million times; with approximately 300,000 downloads from people located in the MENA region. Visit NCCN.org/Global for more information on resources and projects to advance cancer care worldwide, and take part in the conversation online with the hashtag #NCCNGlobal.

On World Cancer Day, NCCN Announces National Endorsements for Guidelines to Improve Cancer Care in Sub-Saharan Africa

NCCN announced formal endorsements from the governments of Ethiopia, Nigeria, and Tanzania for the NCCN Harmonized Guidelines for Sub-Saharan Africa, while joining cancer leaders across the globe to raise awareness and take action for World Cancer Day on February 4. Those 3 countries are home to 335 million people, approximately 33% of the Sub-Saharan African population,1 and have a combined 225,500 new cancer diagnoses every year.2 The NCCN Harmonized Guidelines are part of the organization’s year-round commitment to reducing the global cancer burden by defining and advancing high-quality, high-value, patient-centered cancer care.

“We know that cancer patients who are treated according to standard clinical guidelines have better outcomes, but until now, we haven’t had guidelines to fit the complexities of cancer in Africa,” said David Atuwo, MD, National Cancer Control Coordinator at the Federal Ministry of Health Nigeria. “This collaborative project from the African Cancer Coalition and the National Comprehensive Cancer Network allows us to bring together African oncology experts and their U.S. counterparts to create up-to-date, evidence-based guidance for cancer treatment in Africa and to ensure that people with cancer in Africa will get the best quality of care we can give them.”

“Working together with the African Cancer Coalition, we’re able to adapt the easy-to-follow algorithms and evidence-based treatment recommendations that NCCN Guidelines are known for, in order to account for different resource levels,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “Standardizing practices make the medication market more predictable, which helps with negotiations to lower prices. It also allows for more regional training and collaboration, while reducing needless duplications of efforts.”

NCCN’s work with the African Cancer Coalition is part of a broader collaboration with The American Cancer Society (ACS), the Clinton Health Access Initiative (CHAI), and IBM, which is addressing rising cancer rates and limited resources in parts of Africa. So far, the NCCN Harmonized Guidelines for Sub-Saharan Africa include:

  • Adult Cancer Pain

  • Antiemesis (nausea and vomiting prevention)

  • B-Cell Lymphomas (Non-Hodgkin’s Lymphomas)

  • Bladder Cancer

  • Breast Cancer

  • Cervical Cancer

  • Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

  • Colon Cancer

  • Esophageal Cancer

  • Gastric Cancer

  • Gestational Trophoblastic Neoplasia (GTN)

  • Head and Neck Cancers (concentrating on the lip, oral, and oropharynx)

  • Kaposi Sarcoma

  • Kidney Cancer

  • Myeloid Growth Factors

  • Palliative Care

  • Prostate Cancer

  • Rectal Cancer

  • Small Cell Lung Cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines)—which were downloaded more than 10 million times across the world in 2018—are already being used by 90% of radiation oncologists in Nigeria, according to a study published in the Journal of Global Oncology on April 11, 2018.3 But the study also found some clinicians can have difficulty implementing the recommendations due to facility resource limitations. The NCCN Harmonized Guidelines are helping to address that problem by including two tiers of treatment recommendations, which vary depending on access to resources like radiation equipment or laparoscopic surgical tools. NCCN Harmonized Guidelines are available free-of-charge for non-commercial use online at NCCN.org/harmonized, or via the NCCN Virtual Library of NCCN Guidelines Mobile App for tablets and smartphones.

“Improving access to high-quality cancer care worldwide is the cornerstone to everything we do at NCCN,” said Dr. Carlson. “We believe everyone should be able to get the best treatment possible; we are committed to doing our part to see that medical advances reach every corner of every country across the world.”

NCCN Resource Campaign for Cervical Cancer Patients and Caregivers

NCCN was also a member of the World Cancer Day advisory group, representing the United States in the lead-up to the worldwide event on February 4. Nigeria’s Project PINK BLUE also participated in the group, along with representatives from Australia, Brazil, Canada, Cyprus, Greece, India, Malaysia, The Netherlands, Portugal, and the United Kingdom.

“This World Cancer Day, we want people to know that many cancers can be managed and even cured, especially if they’re detected and treated as early as possible,” said Dr. Cary Adams, Chief Executive Officer, Union for International Cancer Control. “By detecting cancer at its earliest stage, we seize the greatest opportunity to prevent millions of avoidable deaths worldwide”.

Cervical cancer is one area where early detection and prevention, such as the HPV vaccine, can have particularly powerful results in reducing the number of deaths. In the United States, the 5-year survival rate for women diagnosed with cervical cancer at the advanced stage is just 15%, compared with 93% if diagnosed before cancer has spread.4

In a new effort to raise patient awareness of effective therapies for the prevention and treatment of cervical cancer, NCCN is raising funds through the NCCN Foundation to create NCCN Guidelines for Patients: Cervical Cancer.

References

  • 1.

    United Nations Department of Economic and Social Affairs Population Division. World Population Prospects: The 2017 Revision. Available at: https://population.un.org/wpp/. Custom data acquired via website.

  • 2.

    Globocan dataset. Available at: https://gco.iarc.fr/.

  • 3.

    Ismaila NSalako OMutiu JAdebayo O. Oncology guidelines usage in a low- and middle-income country. J Global Oncol 2018;4:16.

  • 4.

    American Cancer Society. Survival Rates for Cervical Cancer, by Stage. Available at: https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html. Accessed December 19 2018.

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References

  • 1.

    United Nations Department of Economic and Social Affairs Population Division. World Population Prospects: The 2017 Revision. Available at: https://population.un.org/wpp/. Custom data acquired via website.

  • 2.

    Globocan dataset. Available at: https://gco.iarc.fr/.

  • 3.

    Ismaila NSalako OMutiu JAdebayo O. Oncology guidelines usage in a low- and middle-income country. J Global Oncol 2018;4:16.

  • 4.

    American Cancer Society. Survival Rates for Cervical Cancer, by Stage. Available at: https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html. Accessed December 19 2018.

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