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NCCN Flash Update: NCCN Guidelines® Updated

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Distress Management These NCCN Guidelines® are currently available as Version 1.2017.

  • Global Changes: “Substance abuse” changed to “Substance use disorder”.
  • Definition of Distress in Cancer (DIS-2)
    • The definition was revised, “Distress is a multifactorial unpleasant emotional experience of a psychological (ie, cognitive, behavioral, emotional), social, spiritual, and/or spiritual physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment....”
  • Management of Expected Distress Symptoms: Under “Interventions,” a new bullet was added, “Assess coping strategies and contributing factors.” (DIS-5)
  • Psychosocial Distress Patient Characteristics (DIS-B)
    • Periods of increased vulnerability
      • New bullet added: “Learning about genetic/familial cancer risk.
      • Bullet revised: “Admission to/discharge from hospital following treatment.”
  • Psychological/Psychiatric Treatment Guidelines: Under “Evaluation for,” “Substance use disorder” was added. (DIS-6)
  • Depressive Disorders (DIS-10)
    • First column: Last bullet revised: “Dysthymia Persistent depressive disorder.”
    • Under “Evaluation,” a new bullet was added, “Evaluate using PHQ-2 or PHQ-9.”
    • “Danger to self or others” pathway: “Assure safety of others” added as a treatment option. This change was also made in the “Bipolar and Related Disorders” algorithm (DIS-12) and the “Trauma and Stressor-Related Disorders” algorithm. (DIS-18)
  • Anxiety Disorders: Under “Signs and symptoms...” (DIS-16)
    • “Agoraphobia” and “Substance/medication-induced anxiety disorder” were added.
    • Fourth bullet revised, from “Phobic disorder” to “Specific phobia.”
  • Trauma and Stressor-Related Disorders: Adjustment Disorders: Under “Evaluation,” “Assess for past trauma” was added. (DIS-17)
  • Personality Disorders: “Dependent” added under “Signs and symptoms” and under “Evaluation, “Assess home situation” added. (DIS-23)
  • Psychosocial Problems:  Under “Type of problem” the fourth bullet was revised, “Absent or unclear advance directive.” (DIS-25)

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients®, please visit NCCN.com/patients.

Free NCCN Guidelines apps for iPhone, iPad, and Android tablets are now available! Visit NCCN.org/apps

About NCCN Flash Updates™ 
NCCN Flash Updates™ is a subscription service from NCCN that provides timely notification of updated and new information appearing in the NCCN Guidelines, the NCCN Compendium®, and other NCCN Content. 

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