Description of survivorship recommendations in NCCN guidelines.

Abstract

483 Background: The National Comprehensive Cancer Network (NCCN) issues evidence-based guidelines to ensure that all patients receive preventive, diagnostic, treatment, and supportive services that are most likely to lead to optimal outcomes. The information offered by these guidelines is used as the standard for clinical management and policy in cancer care. This study aimed to assess the content of survivorship recommendations in the NCCN guidelines. Methods: In April 2023, a total of 59 guidelines were downloaded from the NCCN website and assessed for survivorship recommendations and information provided. The guidelines were aimed at both adults and children with cancer. Results: Among the evaluated NCCN cancer guidelines (n=59), only 20% included a dedicated survivorship section. Of the 12 guidelines with survivorship sections, all targeted survivors of adult-onset cancer. Half of these guidelines featured only general survivorship recommendations, for example, gynecological and colorectal cancers. When cancer survivorship sections were included, the most common domains were surveillance/management of late and long-term physical effects (92%), health promotion (92%), and psychosocial effects (75%). Surveillance for recurrences/new cancers and chronic disease management were less common (58% and 50%, respectively). Surprisingly, only 47% of guidelines without survivorship sections referred to other resources for the care of cancer survivors (including the NCCN survivorship guideline). Conclusions: The findings indicate that less than a quarter of NCCN guidelines include a section dedicated to cancer survivorship recommendations and less than half of the guidelines without survivorship sections referred to other resources for the care of cancer survivors. Though NCCN has a dedicated survivorship guideline, the lack of survivorship recommendations in disease-based guidelines shows a gap in the comprehensive provision of survivorship guidance. Standardization of survivorship care recommendations across all NCCN guidelines is needed.