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As Incoming CEO, Dr Crystal Denlinger Highlights NCCN Guidelines, Challenges, and Treatment Access


Crystal Denlinger, MD, FACP, incoming CEO of the National Comprehensive Cancer Network (NCCN), talks about the organization’s challenges and solutions to keeping up with the ever-changing oncology landscape and improving patient access to guideline-recommended treatments.

Incorporating National Comprehensive Cancer Network (NCCN) guidelines into care and clinical decision making at the point of care and policy levels can continuously improve patient access to Category 1 recommended treatments, according to Crystal Denlinger, MD, FACP, incoming CEO of the NCCN.


Becoming CEO during a time of rapidly-increasing NCCN guideline usage and importance, what are NCCN’s biggest challenges?

I think the NCCN's biggest challenge is the same as the challenge for every oncologist, which is keeping up with the evidence in an ever-evolving landscape that really characterizes today's oncology care landscape. We recognize our role in the oncology field and we work to ensure that our guidelines remain up to date and reflective of the current evidence that define appropriate care. We don't only have to ensure that our guidelines are up to date, but also that the compendia and the chemotherapy order templates and all of the derivative products are also updated to reflect the recommendations in the guidelines. We recognize that oncologists in academia and community look to our guidelines to remain current with what the current standards of care are, and we want to rise to that challenge...we do rise to that challenge every day.

I think the other challenge that we face is ensuring that our guideline recommendations are really accessible to the entire oncology community, including providers, payers, policymakers, and patients around the world. We're working to do this through a number of different avenues. In addition to the clinical practice guidelines and our compendia products, we have guidelines for patients that turn our clinical practice guideline recommendations into guidelines for patients in lay language that will be useful for patients and caregivers to follow along in the treatment recommendations that we make in the clinical guidelines. We also work with health information technology companies and payers to ensure that our recommendations are usable by them. And we work through our policy and advocacy program with federal and state policymakers to ensure that cancer policy and decision making is up to date with the current standards.

We also have a very large global effort, and our adaptation and harmonization efforts with in-country experts allow for our guideline recommendations to be disseminated to other regions of the world to ensure that, really, the entire world is able to have sort of the same appropriate recommendations delineated. We want to make sure that everyone is receiving quality, effective, equitable, and accessible cancer care, and our challenge is to ensure that we stay up to speed and disseminate our guidelines in a way that is accessible, informative, and easy to use at the point of care and beyond.

How has the ability of patients to access Category 1 recommended treatments changed in the last 5 years?

I think that's a really good question, and certainly one that we strive to answer every day. First of all, in the last 5 to 10 years—I've been an oncologist now about 15 years—I think we have seen improvements in access to appropriate care, although I recognize there's still work to be done. We know from a number of studies that the evidence shows that guideline concordant care improves cancer related outcomes, lowers costs, and decreases disparities in care and care delivery. So I think one of the most important things is that there is inclusion of nationally-recognized clinical practice guidelines such as NCCN's in cancer coverage policy, and that really ensures that the cancer coverage policies and decision making remain evergreen with the changing landscape and increases the access to appropriate care.

We also need to make sure that we have an educated workforce that understands the recommendations on the guidelines and that our patients are able to participate in that shared decision making through patient resources like our guidelines for patients. I think incorporating our guidelines into care and clinical decision making at both the point of care level as well as at the policy level can continuously improve access by providing the most up to date information for all participants in the cancer decision making process.

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