International Adaptations 

The International Adaptations of the NCCN Guidelines address the availability of resources, metabolic differences in populations, evidence-based regional practice patterns, and regulatory status of health care technologies used in cancer care in a specific country or region. These targeted regional resources are created to combat the rising cancer rates and unique care circumstances in different countries/regions. International Adaptations reflect both the recommendations as delineated in the NCCN Guidelines as well as locoregional variations in care contemplated by the local care environment. Additionally, they may represent both the optimal care that resource-constrained areas aspire to provide and pragmatic approaches that provide effective treatment options in the setting of resource constraints.

International Adaptations are developed by oncology thought leaders in the specific country or region in collaboration with NCCN Guidelines Panel Members to aid clinicians in determining the appropriate and effective care in the specific country or region. These International Adaptions have been used to support improved availability of effective treatment options in specific countries or regions. NCCN has collaborations with the oncologists/oncology organizations in the following countries/regions: Brazil, China, Middle East and North Africa (MENA), Poland, Spain, Sub-Saharan Africa (SSA), and Vietnam.

Using the International Adaptations & Harmonizations

Recommendations within the guidelines are represented as follows:

Black Text:  Recommendations that are widely applicable.
Italicized Blue Text: Country/region-specific modifications that are appropriate and/or feasible.
Gray Text: Recommendations that may be costly, technically challenging, and/or not widely available in the specific country/region.*
Gray Text with Strikethrough: Recommendations that are not feasible or available in the specific country/region.**
  • Recommendations that are considered clinically appropriate by national/regional experts but are not currently available due to lack of reimbursement by the national/regional healthcare financing system.
  • Recommendations that are considered as inconsistent with national/regional medical practice.

Brazil

China

Middle East & North Africa (MENA)

Poland

Spain

Sub-Saharan Africa

Vietnam

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