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Setting the Guidelines for Cancer Treatment in the Middle East & North Africa

Kelly C. Simpson, Manager, Global Initiatives, Editor, eBulletin: International Edition

Last month, more than 250 oncology professionals from across the Middle East & North Africa (MENA) region gathered in Doha, Qatar for three days of intensive education and discussion surrounding the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and their application in MENA practices. Dr. Hamdy Azim of Cairo University opened the program on January 26 by describing the history of NCCN's work in the region and the goal of continued, annual collaborations by which NCCN experts contribute their time and expertise to the betterment of lives of patients with cancer in the Middle East. Dr. Azim remarked that, in MENA, the "NCCN Guidelines have emerged as a very useful tool for improving the quality of decision-making for oncology professionals." This sentiment was reiterated throughout the event and was fundamental to the over-arching theme stressing the importance of minimizing practice variation by implementing evidence-derived, region-appropriate standards.

Dr. Nagi El Saghir of American University of Beirut Medical Center emphasized that utilizing Guidelines makes physicians better physicians than they would be by relying entirely on their individual background and experience in making complex decisions regarding patient care. He expressed his belief that deviation from Guidelines recommendations should only occur with justification based upon patient-specific characteristics or preferences, rather than on a discretionary basis.

As part of a particularly inspiring lecture, Dr. Abdul Rahman Jazieh of National Guard Hospital of Riyadh made an impassioned plea to the audience to improve their service to patients and themselves by recognizing the room for improvement, the need for clinical trials, and the importance of Guidelines in the treatment of patients with cancer. He referred to the discussions with NCCN experts as a "huge reality check," and one that must be acknowledged in order for new skills to be learned.

Joan McClure represented NCCN and provided a detailed review of the Guidelines components, development process, derivative products, and their use by payors and in informatics systems. Ms. McClure described how the NCCN Guidelines represent the continuum of care, comprising 15,000 collective hours of development effort each year by NCCN's 900 panel members. She stressed NCCN's position on encouraging clinical trials.

Dr. Mohammad Jahanzeb of University of Miami and University of Tennessee spoke about the challenges in adapting treatment recommendations for regional use, including cultural and language barriers, and application in community practice. He also discussed the value of working through these challenges and illustrated examples of successful NCCN global collaborations and their resultant resources.

Dr. Robert Carlson of Stanford Cancer Institute and David Ettinger of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins represented the NCCN Breast Cancer Guidelines and NCCN Lung Cancer Guidelines panels, respectively. They educated participants on the latest updates to the Guidelines and participated in tumor board panel discussions in which they evaluated patient cases alongside the MENA experts on those tumors.

In conjunction with the congress, tumor-specific MENA committees met to review updates and proposed adaptations to the NCCN Guidelines for Breast, Colon, Prostate, and Lung Cancers, as well as Lymphomas and Hepatobiliary Carcinoma.

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