title: NCCN Framework for Resource Stratification: A Framework for Providing and Improving Global Quality Oncology Care.
abstract: More than 14 million new cancer cases and 8.2 million cancer deaths are estimated to occur worldwide on an annual basis. Of these, 57% of new cancer cases and 65% of cancer deaths occur in low- and middle-income countries. Disparities in available resources for health care are enormous and staggering. The WHO estimates that the United States and Canada have 10% of the global burden of disease, 37% of the world's health workers, and more than 50% of the world's financial resources for health; by contrast, the African region has 24% of the global burden of disease, 3% of health workers, and less than 1% of the world's financial resources for health. This disparity is even more extreme with cancer. NCCN has developed a framework for stratifying the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) to help health care systems in providing optimal care for patients with cancer with varying available resources. This framework is modified from a method developed by the Breast Health Global Initiative. The NCCN Framework for Resource Stratification (NCCN Framework) identifies 4 resource environments: basic resources, core resources, enhanced resources, and NCCN Guidelines, and presents the recommendations in a graphic format that always maintains the context of the NCCN Guidelines. This article describes the rationale for resource-stratified guidelines and the methodology for developing the NCCN Framework, using a portion of the NCCN Cervical Cancer Guideline as an example.
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington. From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington. From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Robert W
authors: RW
authors: Carlson
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Jillian L
authors: JL
authors: Scavone
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Wui-Jin
authors: WJ
authors: Koh
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Joan S
authors: JS
authors: McClure
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Benjamin E
authors: BE
authors: Greer
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Rashmi
authors: R
authors: Kumar
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Nicole R
authors: NR
authors: McMillian
authors: From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington. From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; Department of Medicine, Stanford University Medical Center, Stanford, California; and Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Benjamin O
authors: BO
authors: Anderson
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D014943:Global Health / Q000592:standards*; D006295:Health Resources; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000628:therapy