National Comprehensive Cancer Network

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NCCN Guidelines® & Clinical Resources

NCCN Harmonized Guidelines™

Clinicians around the world use NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) as a standard for clinical decision-making. The NCCN Harmonized Guidelines™ are targeted regional resources created as part of a collaborative effort to combat the skyrocketing cancer rates and unique care circumstances. They represent both the optimal care that low- and mid-resource countries aspire to provide and pragmatic approaches that provide effective treatment options for resource-constrained settings.

Using the Harmonized Guidelines

Recommendations within the NCCN Harmonized Guidelines™ are represented using the following system:

  • Black Text: Generally available standard of care
  • Gray Text: Highly advanced/optimal care that may be costly, technically challenging, and/or have a lesser impact on oncologic outcome
  • Blue Text: Regional options that may be considered when availability precludes general standard of care
  • Gray Strikethrough Text: Indicates care options that are not feasible or available at this time

NCCN Harmonized Guidelines™ for Sub-Saharan Africa

As part of a joint project with the African Cancer Coalition (ACC), American Cancer Society (ACS), the Clinton Health Access Initiative (CHAI), and IBM, NCCN and members of ACC adapted the NCCN Guidelines® and NCCN Framework for Resource Stratification of NCCN Guidelines (NCCN Framework™) to create the NCCN Harmonized Guidelines™ for Sub-Saharan Africa.

The initial offering consists of eight Guidelines for cancer treatment and supportive care; additional Harmonized Guidelines will be published in 2018.

The goal of this collaboration is to implement the NCCN Harmonized Guidelines™ along with training of an expanded group of cancer care providers to improve the availability of effective therapies for people with cancer in Africa.

The involvement of experts from Africa has been key to the success of this effort. More than 40 African Cancer Coalition members from 12 countries in Sub-Saharan Africa have participated in the adaptation process, including clinical oncologists, educators, representatives from health ministries, and health care administrators. This initiative spans national borders in Africa and spans continents in a collaborative effort. The knowledge that the ACC individuals bring to the table is extensive and invaluable. They know the challenges and many solutions to delivering cancer care in resource-constrained environments. Any success in the effort to improve oncology care in Africa is largely thanks to the dedication and participation of NCCN’s African colleagues.

NCCN Harmonized Guidelines™ for Sub-Saharan Africa


NCCN Harmonized Guidelines™ for the Caribbean

As part of a joint project with the Caribbean Association for Oncology & Hematology (CAOH), NCCN and members of CAOH are adapting the NCCN Guidelines to create the NCCN Harmonized Guidelines™ for the Caribbean. The archipelago that extends from the Bahamas in the north to Trinidad and Tobago in the south ranks among the highest regions in the world for cancer prevalence. Cancer is the second leading cause of death in the Caribbean, and the rate of breast cancer deaths is currently twice that of the United States. NCCN Guidelines Panel Members participated in a working session with local oncologists to adapt existing NCCN Guidelines® and NCCN Framework™ in order to better reflect the diverse needs and resources throughout the Caribbean.

The initial offering consists of four Guidelines for cancer treatment; additional Harmonized Guidelines will be published in 2018.

NCCN Harmonized Guidelines™ for the Caribbean


For more information about NCCN collaborations to create the NCCN Harmonized Guidelines™, visit NCCN.org/news.

NCCN Harmonized Guidelines™ are 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