{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:04:35Z","timestamp":1790687075987,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA214960-01A1"],"award-info":[{"award-number":["R01CA214960-01A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA225701-01A1"],"award-info":[{"award-number":["R01CA225701-01A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA231471-01A1"],"award-info":[{"award-number":["R01CA231471-01A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1R21NR016736-01"],"award-info":[{"award-number":["1R21NR016736-01"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Integration of specialist palliative care into routine oncologic care improves patients\u2019 quality of life and survival. National Comprehensive Cancer Network (NCCN) cancer treatment guidelines are instrumental in standardizing cancer care, yet it is unclear how palliative and hospice care are integrated in these guidelines. In this study, we examined the frequency of occurrence of \u201cpalliative care\u201d and \u201chospice care\u201d in NCCN guidelines and compared between solid tumor and hematologic malignancy guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We reviewed all 53 updated NCCN Guidelines for Treatment of Cancer. We documented the frequency of occurrence of \u201cpalliative care\u201d and \u201chospice care,\u201d the definitions for these terms if available, and the recommended timing for these services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified a total of 37 solid tumor and 16 hematologic malignancy guidelines. Palliative care was mentioned in 30 (57%) guidelines (24 solid tumor, 6 hematologic). Palliative care was mentioned more frequently in solid tumor than hematologic guidelines (median, 2 vs. 0; p = .04). Among the guidelines that included palliative care in the treatment recommendation, 25 (83%) only referred to NCCN palliative care guideline. Specialist palliative care referral was specifically mentioned in 5 of 30 (17%) guidelines. Only 14 of 24 (58%) solid tumor guidelines and 2 of 6 (33%) hematologic guidelines recommended palliative care in the front line setting for advanced malignancy. Few guidelines (n =\u20093\/53, 6%) mentioned hospice care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>\u201cPalliative care\u201d was absent in almost half of NCCN cancer treatment guidelines and was rarely discussed in guidelines for hematologic malignancies. Our findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for Practice<\/jats:title>\n                  <jats:p>Integration of specialist palliative care into routine oncologic care is associated with improved patient outcomes. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have an important role to standardize palliative care involvement for cancer patients. It is unclear how often palliative care referral is recommended in these guidelines. In this study involving 53 NCCN Guidelines for Treatment of Cancer, the researchers found that palliative care was not mentioned in over 40% of NCCN guidelines and was rarely discussed in guidelines for hematologic malignancies. These findings underscored opportunities to standardize timely palliative care access across NCCN guidelines.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/onco.13515","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T15:00:34Z","timestamp":1599836434000},"page":"77-83","source":"Crossref","is-referenced-by-count":41,"title":["Recommendations for Palliative and Hospice Care in NCCN Guidelines for Treatment of Cancer"],"prefix":"10.1093","volume":"26","author":[{"given":"Li","family":"Mo","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, Houston, Texas, USA"},{"name":"The Center of Gerontology and Geriatrics, National Clinical Research Center of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L","family":"Urbauer","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"2021122511445642400_onco13515-bib-0001","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1001\/jamaoncol.2018.2706","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: A systematic analysis for the global burden of disease study","volume":"4","author":"Global Burden of Disease Cancer Collaboration","year":"2018","journal-title":"JAMA Oncol"},{"key":"2021122511445642400_onco13515-bib-0002","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/CCO.0000000000000086","article-title":"Definition of supportive care: Does the semantic matter?","volume":"26","author":"Hui","year":"2014","journal-title":"Curr Opin Oncol"},{"key":"2021122511445642400_onco13515-bib-0003","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>3.0.CO;2-P","article-title":"The unmet supportive care needs of patients with cancer. 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