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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 Genetic/Familial High-Risk Assessment: Colorectal. These NCCN Guidelines® are currently available as Version 2.2017.

  • The introductory page for the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal were updated as follows:
    • For the assessment for hereditary cancer, after "Is there a personal history of a known genetic mutation or known genetic mutation in the family?" and the reply is "No," the following criteria was added, "Family history of: 1 relative with polyposis". (HRS-1)
      • If the response to these criteria is "No" the next question was revised as, "Is there a personal history of colorectal cancer (CRC), endometrial or a Lynch syndrome-related cancer?"
      • If the response to this question is "No" the next question was revised as, "Is there a family history of colorectal, endometrial or a Lynch syndrome-related cancer?
      • If the response to this question is "No", then "See NCCN Guidelines for Colorectal Cancer Screening - Average risk," was clarified by adding, "unless other significant personal or family history that may indicate increased risk for hereditary cancer syndrome."
    • The “Criteria For Further Risk Evaluation For High-Risk Syndromes For Unaffected (No Personal History of Colorectal or Endometrial Cancer or Concerning polyposis)” heading has been revised as, "Evaluation to Exclude Lynch Syndrome." The bullets were updated for both a personal history and family history of a Lynch syndrome-related cancer. (HRS-3).
      • Footnote g was added, "Tumor screening for mismatch repair deficiency is appropriate for all colorectal and endometrial cancers regardless of age at diagnosis, however, germline genetic testing is generally reserved for patients with early-age at diagnosis; positive family history; or abnormal tumor testing results: MSI or loss of mismatch repair protein expression. See LS-A for details on tumor screening for Lynch syndrome."
  • Lynch Syndrome (LS)
    • After "No known LS mutation," the criteria was revised as, "No tumor available or insufficient tumor or affected relative unavailable."

       

*For your reference, the previous update (Version 1.2017) to the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal, published on June 5, 2017, is available at the following link: https://www.nccn.org/professionals/physician_gls/pdf/genetics_colon.pdf.

 

NCCN has published updates to the NCCN Guidelines for Lung Cancer Screening. These NCCN Guidelines are currently available as Version 2.2018.

  • The Discussion section has been updated to reflect the changes in the algorithm.

 

*For your reference, the previous update (Version 1.2018) to the NCCN Guidelines for Lung Cancer Screening, published on June 23, 2017, is available at the following link: https://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf.

 

NCCN has published updates to the NCCN Guidelines for Adolescent and Young Adult Oncology. These NCCN Guidelines are currently available as Version 1.2018.

  • Purpose of the NCCN Guidelines for AYA Oncology (AYAO-1)
    • Added a new paragraph “Adolescents and young adult patients with cancer have a number of unique psychosocial concerns that have been identified by panels of experts, including (although not limited to) fertility preservation, parenting, schooling, employment attainment, and retention. The relative importance of these issues understandably varies markedly across the broad age range defined. These issues should be considered as part of the overall therapeutic plan for the patient. Specific recommendations are highlighted in the NCCN Guidelines for Adolescent and Young Adult (AYA) Oncology. Many centers have established AYA centers to accommodate the specific needs of patients with cancer in this age group. Consideration should be given to referring such patients to one of these AYA centers of excellence if feasible.”
       
  • Screening, Assessment, and  Evaluation (AYAO-2)
    • Removed: “AYA patients usually tolerate more intensive therapies than older patients."
       
  • Comprehensive Assessment (AYAO-3)
    • Added a new recommendation “All women of child-bearing potential must receive a pregnancy test prior to initiating therapy.”
       
  • Psychosocial Considerations (AYAO-7)
    • Added “Communication preferences and potential barriers (eg, literacy and language considerations as well as preferred learning methods).”
       
  • Supportive Care Services/Interventions (AYAO-8 and AYAO-9)
    • Recommend “Providing education about the impact of early cannabis use on cognitive development and mental health. If AYA chooses to continue use, provide education on risks and benefits of varying methods of ingestion and dosing.”
    • Added “Refer to reputable providers of integrative therapies and CAM services.”
    • For evaluation of family status added “Interaction and relationship with sibling(s),” “sexual orientation,” and “consider role of cultural and/or family values.”
       
  • Survivorship (AYAO-11)
    • Added “Encourage relationship with primary health care provider for routine health issues”

 

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.org/patients.

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

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