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The NCCN adaptations account for metabolic differences in populations, accessibility of technology, and regulatory status of health care technologies used in cancer management in the specified country.
The NCCN Guidelines: Local Editions are developed by the host country's oncology thought leaders in conjunction with NCCN Guidelines Panel Members. Modified NCCN Guidelines are developed to aid clinicians in determining appropriate and effective avenues of care in the specified country.
Recommendations within the NCCN Guidelines: Local Editions are represented as follows:
• Black Text: Recommendations that are applicable for the specific country/region.
• Green Text: Regional modifications that are appropriate/feasible in the specific country/region.
Green Text with Strikethrough: Recommendations that are not feasible or available in the
specific country/region at this time.
Manuscript statements outlining, describing, and rationalizing variations in care within a country or region or across multiple countries within a region as compared to the recommendations of the NCCN Guidelines. An exploratory and analytical account of the impact of genetic variations in metabolism of agents, regulatory environments, and practice standards of participating countries.
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Translating NCCN Guidelines speaks directly to the NCCN mission of making NCCN Content accessible to providers and patients globally. As a result, NCCN works to translate the NCCN Guidelines into multiple languages and publishes these important resources.
NCCN International Adaptations and Translations from before 2012 are available upon request.
The international adaptations of the NCCN Guidelines (NCCN Guidelines: Local Editions) account for the genetic variations in the drug metabolism in different patient populations, accessibility/availability of health care technologies, and regulatory environment in the specified country/region.
The NCCN Guidelines: Local Editions are developed by the host country's oncology thought leaders in conjunction with NCCN Guidelines Panel Members. The goal of these modified NCCN Guidelines is to aid clinicians in determining appropriate and effective avenues of care in the specified country/region.
Participating countries select disease-specific representatives (recognized experts in the management of these malignancies in their home countries) to review and suggest modifications to specific NCCN Guidelines. It is important that the fields of surgical oncology, medical oncology, and radiation oncology are represented for each type of cancer. In addition, because the process involves the development of consensus through compromise, they are sufficiently influential that they can speak for the general oncology community in their own countries.
Members of each regional committee receive a copy of the most recent version of the NCCN Guidelines for the specific type of cancer. The members circulate the NCCN Guidelines among a representative group of multidisciplinary physicians in their country to determine areas where local practice is not concordant with the NCCN Guidelines. There is discussion of how the NCCN Guidelines might be adapted to accommodate local circumstances. The regional representative is responsible for bringing these recommendations forward to the regional meeting.
A regional meeting is conducted so that all participating representatives can develop a single proposal for adaptation of the disease-specific NCCN Guidelines. Any proposed modification of the NCCN Guidelines must be supported by data.
At this meeting, NCCN Guidelines Panel Members present the data used to develop the NCCN Guidelines and representatives of the regional alliance present proposed changes and the literature that supports them. A discussion of the issues takes place and at the end of the meeting, a consensus is developed regarding an adaptation of the NCCN Guidelines that is acceptable to the NCCN.
NCCN authorizes the following international organizations/groups to adapt the NCCN Guidelines to be used for the management of cancer in the specific country/region, subject to approval by NCCN and representatives of NCCN's disease-specific panels.
NCCN MAKES NO REPRESENTATIONS OR WARRANTIES CONCERNING THE NCCN CONTENT, THE NCCN GUIDELINES OR DERIVATIVE RESOURCES PROVIDED BY NCCN, ALL OF WHICH ARE PROVIDED "AS IS." NCCN DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. NCCN DOES NOT WARRANT THE ACCURACY, APPROPRIATENESS, APPLICABILITY OR COMPLETENESS OF THE NCCN CONTENT, THE NCCN GUIDELINES OR ANY DERIVATIVE RESOURCES, NOR DOES NCCN MAKE ANY REPRESENTATIONS REGARDING THE USE OR RESULTS OF THE USE OF THE NCCN CONTENT, THE NCCN GUIDELINES OR ANY SUCH DERIVATIVE RESOURCES.
NCCN EXPLICITLY DISCLAIMS THE APPROPRIATENESS OR APPLICABILITY OF THE NCCN CONTENT, THE NCCN GUIDELINES, AND ANY DERIVATIVE RESOURCES, OR THE USE OR APPLICATION OF THE NCCN CONTENT, THE NCCN GUIDELINES OR ANY SUCH DERIVATIVE RESOURCES, TO ANY SPECIFIC PATIENT'S CARE OR TREATMENT. ANY CLINICIAN SEEKING TO APPLY OR CONSULT THE NCCN CONTENT, THE NCCN GUIDELINES AND/OR ANY DERIVATIVE RESOURCES IS EXPECTED TO USE INDEPENDENT MEDICAL JUDGMENT IN THE CONTEXT OF THE INDIVIDUAL CLINICAL CIRCUMSTANCES TO DETERMINE ANY PATIENT'S CARE OR TREATMENT.