National Comprehensive Cancer Network

The NCCN Framework™ guides evidence-based adaptation to available clinical treatment resources. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) are used widely around the world, including in a number of low and middle income countries (LMICs) where certain diagnostic tests and/or treatment approaches may be unavailable. The goal of the NCCN Framework™ is to define appropriate treatment pathways based on available resources—Basic, Core, Enhanced, and NCCN Guidelines®—and deliver a tool for health care providers to identify treatment options that will provide the best possible outcomes given specific resource constraints.

The NCCN Framework™ outlines a rational approach for building cancer management systems to provide the highest achievable cancer care by applying available and affordable services in a logical sequence. Each NCCN Framework™ builds on the one before it, with incremental changes to the allocation of resources, providing a structure for improving cancer care. Treatment recommendations applicable to each NCCN Framework can be viewed within the context of the NCCN Guidelines®.

The NCCN Framework™ resources are defined as:

Basic Resources: Basic Resources include essential services needed to provide basic minimal standard of care.
Core Resources: Core Resources include those provided in the Basic Resources Framework plus additional services that provide major improvements in disease outcomes (e.g. survival) and that are not cost prohibitive.
Enhanced Resources: Enhanced Resources include those provided in the Core Resources Framework and additional services that provide lesser improvements in disease outcomes and/or services that provide major improvements in disease outcomes but are cost prohibitive in lower resource settings.
NCCN Guidelines: The NCCN Guidelines are evidence-based, consensus-driven recommendations made by the NCCN Guidelines panels. They include services from the Enhanced Resources Framework and additional services that provide minor improvements in disease outcomes, interventions that are cost prohibitive in lower resource settings, and/or services that do not provide improvement in disease outcomes but are desirable services.

NCCN believes that the best available resources should be provided. If Basic Resources for cancer treatment are unavailable, palliative and best supportive care should be provided.

NCCN extends its sincere gratitude to those clinicians from around the world who generously give their time and expertise to review the NCCN Framework™ and provide thoughtful input. Learn more about the International Review of NCCN Framework™.

NCCN Framework for Resource Stratification of NCCN Guidelines
(NCCN Framework™)

Acute Lymphoblastic Leukemia

Adult Cancer Pain

B-cell Lymphomas – Diffuse Large B-cell Lymphoma and Burkitt Lymphoma

Bladder Cancer

Breast Cancer

Breast Cancer Screening and Diagnosis

Cervical Cancer

Colon Cancer

Esophageal and Esophagogastric Junction Cancers

Gastric Cancer

Head and Neck Cancers – Cancers of the Lip and Oral Cavity

Hepatobiliary Cancers – Hepatocellular Carcinoma and Gallbladder Cancer

Kidney Cancer

Non-Small Cell Lung Cancer

Palliative Care

Pancreatic Cancer

Prostate Cancer

Rectal Cancer

Uterine Neoplasms – Endometrial Carcinoma

The NCCN Framework™ is copyrighted by NCCN. All rights reserved. NCCN Content may not be reproduced in any form for any purpose without the express written permission of NCCN. Permissions Requests Section