From c62360051a3dc2af890d80f7068c48012e164f08 Mon Sep 17 00:00:00 2001 From: Nisarg Oza Date: Thu, 30 Jul 2026 14:56:27 -0400 Subject: [PATCH] Add CCO scraper --- .gitignore | 1 + cco.jsonl | 379 ++++++++++++++++++++ datasets/amfv_datasets/__init__.py | 75 +++- datasets/amfv_datasets/scraping/base.py | 13 +- datasets/amfv_datasets/scraping/cco.py | 442 ++++++++++++++++++++++++ datasets/amfv_datasets/scraping/cli.py | 21 +- datasets/test/test_scraping_cco.py | 325 +++++++++++++++++ datasets/test/test_scraping_cli.py | 8 +- 8 files changed, 1246 insertions(+), 18 deletions(-) create mode 100644 cco.jsonl create mode 100644 datasets/amfv_datasets/scraping/cco.py create mode 100644 datasets/test/test_scraping_cco.py diff --git a/.gitignore b/.gitignore index 83972fad..802dbfc9 100644 --- a/.gitignore +++ b/.gitignore @@ -216,3 +216,4 @@ __marimo__/ # Streamlit .streamlit/secrets.toml +data/ \ No newline at end of file diff --git a/cco.jsonl b/cco.jsonl new file mode 100644 index 00000000..7c10862a --- /dev/null +++ b/cco.jsonl @@ -0,0 +1,379 @@ +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17781/download?token=OYchrOsp)", "external_id": "cco-1011", "metadata": {"authors": "R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2014-2 Jun 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/17781/download?token=OYchrOsp", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2014", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1011"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17736/download?token=-k40XhEv)", "external_id": "cco-1016", "metadata": {"authors": "R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2014-1 Dec 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/17736/download?token=-k40XhEv", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2014", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1016"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17761/download?token=HD3aavfG)", "external_id": "cco-1026", "metadata": {"authors": "R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2013-2 Sep 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/17761/download?token=HD3aavfG", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to Dec 2013", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1026"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy, with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17756/download?token=2yEdJBuW)", "external_id": "cco-1036", "metadata": {"authors": "S. Kellett, R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2013-1 May 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/17756/download?token=2yEdJBuW", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July 2012 to June 2013", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1036"} +{"content": "## Patient Population\n\nAdult patients with advanced (stage IIIB or IV) non\u2013 small-cell lung cancer.\n\n## Intended Guideline Users\n\nClinicians involved in the delivery of systemic treatment for cancer patients.\n\n## Research Question(s)\n\nIn patients with advanced non\u2013small-cell lung cancer (NSCLC) who have not received any chemotherapy (chemo-naive), is first-line therapy with the epidermal growth factor receptor (EGFR) inhibitors gefitinib (Iressa\u00ae), erlotinib (Tarceva\u00ae), afatinib, dacomitinib or icotinib superior to platinum-based chemotherapy for clinical meaningful outcomes (overall survival, progression-free survival (PFS), response rate and quality of life)? In patients with advanced NSCLC who have progressed on platinum-based chemotherapy, does subsequent therapy with EGFR inhibitors gefitinib (Iressa\u00ae), erlotinib (Tarceva\u00ae), afatinib, dacomitinib or icotinib improve overall survival or PFS? Is there a preferred sequence for second-line therapy with an EGFR inhibitor or chemotherapy? In patients with advanced stage IIIB or IV NSCLC who have received initial first-line platinum-based chemotherapy, does maintenance therapy with erlotinib, gefitinib, afatinib, dacomitinib or icotinib improve overall survival or PFS? What are the toxicities associated with gefitinib (Iressa\u00ae), erlotinib (Tarceva\u00ae), afatinib, dacomitinib or icotinib? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/31806/download?token=Ab1NDANf)", "external_id": "cco-1066", "metadata": {"authors": "P.M. Ellis, N. Coakley, R. Feld, S. Kuruvilla, Y.C. Ung, Lung Cancer Disease Site Group", "document_status": "In-Review", "id": "7-9 Apr 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31806/download?token=Ab1NDANf", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib (Iressa\u00ae), Erlotinib (Tarceva\u00ae), Afatinib, Dacomitinib or Icotinib in the Treatment of Non\u2013SmallCell Lung Cancer: A Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1066"} +{"content": "## Guideline Objective\n\nTo provide recommendations for the use of imaging tests to detect distant metastases in women with newly diagnosed breast cancer.\n\n## Patient Population\n\nWomen with newly diagnosed primary breast cancer (originated in the breast) who have no symptoms of distant metastasis.\n\n## Intended Guideline Users\n\nThis guideline is intended for health care professionals, policy makers, program planners, and institutions involved in the management of women with clinical and pathologically confirmed primary breast cancer.\n\n## Research Question(s)\n\nShould women with newly diagnosed primary breast cancer receive imaging staging tests to rule out distant metastases? If so, when should they be performed and what are the optimal staging imaging modalities? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81786/download?token=bFpEKgAx)", "external_id": "cco-1096", "metadata": {"authors": "A. Arnaout, N. Varela, M. Allarakhia, L. Grimard, A. Hey, J. Lau, L. Thain, A. Eisen, and the Staging in Early Stage Breast Cancer Advisory Committee", "document_status": "Current", "id": "GL 1-14 Oct 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/81786/download?token=bFpEKgAx", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "Baseline Staging Imaging for Distant Metastasis in Women with Stage I, II, and III Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1096"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s) (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in clinical management of patients with cancer, with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17751/download?token=UvGrJvRl)", "external_id": "cco-1101", "metadata": {"authors": "S. Kellett, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2012-1 Sep 2013", "pdf_url": "https://www.cancercareontario.ca/en/file/17751/download?token=UvGrJvRl", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July 2011 to June 2012", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1101"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s) (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in clinical management of patients\u2019 with cancer, with respect to the following: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17731/download?token=Btm_JAKg)", "external_id": "cco-1106", "metadata": {"authors": "S. Henderson, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2011-1 Apr 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/17731/download?token=Btm_JAKg", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2011", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1106"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult patients with suspected or diagnosed cancer(s) (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, or safety recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17766/download?token=hFqmodrk)", "external_id": "cco-1111", "metadata": {"authors": "A. Raifu, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2010-2 Apr 2011", "pdf_url": "https://www.cancercareontario.ca/en/file/17766/download?token=hFqmodrk", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2010", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1111"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult patients with suspected or diagnosed cancer(s) (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP)-insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients\u2019 with cancer, with respect to: diagnosis and staging? assessment of treatment response? detection and restaging of recurrence? evaluation of metastasis? The outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, or safety recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17721/download?token=-ZfBqHUz)", "external_id": "cco-1116", "metadata": {"authors": "A. Raifu, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2010-1 Apr 2011", "pdf_url": "https://www.cancercareontario.ca/en/file/17721/download?token=-ZfBqHUz", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2010", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1116"} +{"content": "## Guideline Objective\n\nIn response to several requests for PET in the presurgical planning of patients with medically intractable epilepsy through the Ontario PET Access Program, a systematic review of the literature was conducted to provide potential recommendations for the use of 18F-FDG PET in this indication.\n\n## Patient Population\n\nAdult and pediatric patients with medically intractable epilepsy being considered for surgery.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making with respect to the development of indications for the use of PET in epilepsy. This recommendation report may also be useful to inform clinicians who are seeking information about PET as a presurgical tool in epilepsy.\n\n## Research Question(s)\n\nWhat is the diagnostic accuracy and clinical utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in the presurgical evaluation of adult and pediatric patients with medically intractable epilepsy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/60601/download?token=w5FLWliS)", "external_id": "cco-1121", "metadata": {"authors": "J.G. Burneo, R. Poon, S. Kellett, S. Houle, O.C. Snead, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 13 Jan 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/60601/download?token=w5FLWliS", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "The Utility of Positron Emission Tomography in Epilepsy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1121"} +{"content": "## Guideline Objective\n\nTo provide a synthesis of the current evidence surrounding FDG PET/CT and provide recommendations with respect to PET in the diagnosis, staging, response evaluation, diagnosis of suspected recurrence, and routine follow-up of both HL and NHL.\n\n## Patient Population\n\nAdult patients suspected of, with a diagnosis of, or recurrence of lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nDiagnosis and Staging What benefit to clinical management does 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) contribute to the initial diagnosis or staging of lymphoma? Diagnosis of Recurrence and Routine Follow-Up What benefit to clinical management does FDG PET/CT contribute after conventional imaging is performed, in patients with suspected or proven recurrence of lymphoma? What benefit to clinical management does FDG PET/CT contribute to routine follow-up at the time of documented recurrence for lymphoma? Response Evaluation (interim and at completion of therapy) What benefit to clinical management does FDG PET/CT contribute to the interim assessment of treatment response and assessment of residual mass for lymphoma? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17856/download?token=61kyvWjc)", "external_id": "cco-1126", "metadata": {"authors": "C.T. Kouroukis, M. Cheung, J. Sussman, D. Hodgson, M. Freeman, S. Kellett, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 12 Mar 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/17856/download?token=61kyvWjc", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "PET Imaging in Lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1126"} +{"content": "## Guideline Objective\n\nTo summarize the current state of the science and provide potential recommendations for the use of PET in the diagnosis, staging, and clinical management of PET in sarcoidosis patients.\n\n## Patient Population\n\nPatients with suspected or proven non-cardiac sarcoidosis.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful to inform clinical decision making regarding the appropriate role of PET imaging and to guide priorities for future PET imaging research.\n\n## Research Question(s)\n\nIs positron emission tomography/computed tomography (PET/CT) beneficial in the diagnosis, staging, or clinical management of patients with suspected or proven sarcoidosis? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/36691/download?token=TCWVaBbX)", "external_id": "cco-1131", "metadata": {"authors": "J. You, B. Hyland, S. Henderson, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 11 Aug 2011", "pdf_url": "https://www.cancercareontario.ca/en/file/36691/download?token=TCWVaBbX", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Clinical Utility of Positron Emission Tomography in the Diagnosis, Staging and Management of Sarcoidosis", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1131"} +{"content": "## Patient Population\n\nPatients with gliomas.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of gliomas? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for gliomas? What benefit to clinical management does PET or PET/CT contribute when recurrence of gliomas is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for gliomas? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17806/download?token=dJZ2tTo-)", "external_id": "cco-1136", "metadata": {"authors": "N. Laperriere, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 10 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17806/download?token=dJZ2tTo-", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Brain Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1136"} +{"content": "## Patient Population\n\nPatients with SCLC.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of small cell lung cancer (SCLC)? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for SCLC? What benefit to clinical management does PET or PET/CT contribute when recurrence of SCLC is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for SCLC? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17896/download?token=sLr9HjKw)", "external_id": "cco-1156", "metadata": {"authors": "Y. Ung, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 9 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17896/download?token=sLr9HjKw", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1156"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the use of adjuvant systemic therapy in adult patients with completely resected cutaneous or mucosal melanoma with a high risk of recurrence.\n\n## Patient Population\n\nAdult patients with cutaneous or mucosal melanoma with high risk of recurrence who are rendered disease-free following resection (including resection of all locoregional or distant metastases, if present). Patients with unresected primary disease or metastases fall outside the scope of this document.\n\n## Intended Guideline Users\n\nMedical oncologists, surgical oncologists, and other health care providers involved in the management and referral of patients with resected melanoma at high risk for recurrence.\n\n## Research Question(s)\n\nWhat systemic therapy should clinicians recommend to adult patients who have been rendered disease-free following the resection of cutaneous melanomas (including all sites of metastases, if present) and who are at high risk for subsequent recurrence? What systemic therapy should clinicians recommend to adult patients who have been rendered disease-free following the resection of mucosal melanomas? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/73981/download?token=AuDhgL8C)", "external_id": "cco-1161", "metadata": {"authors": "Teresa M. Petrella, Tara D. Baetz, Glenn G. Fletcher, Gregory Knight, Elaine McWhirter, Sudha Rajagopal, Xinni Song, and members of the Melanoma Disease Site Group", "document_status": "Current", "id": "8-1 Mar 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/73981/download?token=AuDhgL8C", "type_of_content": "Guidelines & Advice, Clinical", "version": "6"}, "section_count": 4, "source": "cco", "title": "Systemic Adjuvant Therapy for Adult Patients at High Risk for Recurrent Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1161"} +{"content": "## Guideline Objective\n\nTo determine the risk of cutaneous malignant melanoma (herein referred to as melanoma) associated with use of indoor tanning devices, including impact of age at first use and frequency of use on the relative risk of developing melanoma.\n\n## Patient Population\n\nAll users of indoor tanning beds.\n\n## Intended Guideline Users\n\nClinicians, other healthcare providers, users and potential users of indoor tanning devices in Ontario.\n\n## Research Question(s)\n\nDoes the use of indoor tanning devices increase the risk of developing melanoma? Does age at first use of indoor tanning device affect the relative risk of developing melanoma? Does the frequency of indoor tanning device use affect the relative risk of developing melanoma? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81556/download?token=gF85toBJ)", "external_id": "cco-1166", "metadata": {"authors": "Members of the Indoor Tanning Devices Expert Panel", "document_status": "Current", "id": "8-8 Sep 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/81556/download?token=gF85toBJ", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "The Use of Indoor Tanning Devices and the Risk of Developing Cutaneous Malignant Melanoma: A Systematic Review and Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1166"} +{"content": "## Intended Guideline Users\n\nHealthcare professionals who prescribe, prepare, or administer intravenous chemotherapy, including medical oncologists, pharmacists, pharmacy technicians, and oncology nurses, as well as designers of prescription label software, patient safety directors in organizations, administrators of hospitals, and community access care organizations.\n\n## Research Question(s)\n\nWhat are the necessary components and formatting of a chemotherapy label to maximize safe delivery and minimize errors? Chemotherapy labels associated with the delivery of a dose of intravenous chemotherapy are of particular interest. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81241/download?token=yI0rVA_6)", "external_id": "cco-1191", "metadata": {"authors": "M. Trudeau, E. Green, R. Cosby, F. Charbonneau, T. Easty, Y. Ko, P. Marchand, D. U, N. Berger, S. Hertz, Chemotherapy Labelling Panel", "document_status": "Current", "id": "12-11 Apr 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81241/download?token=yI0rVA_6", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "Patient Safety Issues: Key Components of Intravenous Systemic Cancer Therapy Labelling", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1191"} +{"content": "## Guideline Objective\n\nTo provide guidance on processes, technologies, and devices for the prevention of errors during systemic cancer treatment administration in adult patients in areas that cut across the entire process and in the planning and preparation stages.\n\n## Patient Population\n\nAdult patients who are going to receive chemotherapy treatment or who are already receiving chemotherapy treatment for cancer in hospital settings.\n\n## Intended Guideline Users\n\nOrganizations that provide chemotherapy treatment to cancer patients. Clinicians and healthcare providers (e.g., nurses, pharmacists, physicians, clerks) involved with the administration of chemotherapy agents, and hospital administrators.\n\n## Research Question(s)\n\nEnvironmental considerations: What are the best strategies to reduce distractions and interruptions during chemotherapy administration? Patient identification: When, how often, and by whom should patients be identified? Which and how many pieces of information should be required for patient identification (ID)? What are the most effective technologies for patient identification? (wristbands, barcoding, radiofrequency identification systems, automated ID, data capture) Patient information and education and role in plan of care: What are the pieces of information that need to be conveyed to the patients and their families, and what is the timing for information delivery, regarding the chemotherapy drugs that are going to be administered, or regarding any changes in treatment plan? What role do patients play in determining the plan of care? Is there a role for informed consent in safety outcomes? CPOE: What is the most effective technology to reduce adverse drug events at the time of ordering, prescribing, and transcribing for chemotherapy drugs? Checklists: Are checklists effective in preventing medication-related adverse events during the administration of chemotherapy agents? Patient assessment: What are the essential components of patient assessment (for new and returning patients)? Screening tools: What are the most effective screening tools for symptom assessment? Written plan: What are the necessary parts of a written treatment plan? Scheduling models: What is the most effective scheduling model for reducing errors in the administration of chemotherapy to cancer patients? Pharmacy practices: What are the most effective pharmacy practices for reducing errors in the administration of chemotherapy to cancer patients? What are the most effective strategies to reduce errors in the packaging and transporting chemotherapy drugs? Infusion pumps: What is the most effective type of infusion pump for preventing errors during the administration of chemotherapy agents? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/60616/download?token=TuvMP3vD)", "external_id": "cco-1196", "metadata": {"authors": "M. Leung, R. Bland, F. Baldassarre, E. Green, L. Kaizer, S. Hertz, J. Craven, M. Trudeau, A. Boudreau, M. Cheung, S. Singh, V. Kukreti, R. White , Safe Administration of Systemic Cancer Treatment Expert Panel", "document_status": "In-Review", "id": "12-12-1 Jul 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/60616/download?token=TuvMP3vD", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 4, "source": "cco", "title": "Safe Administration of Chemotherapy: Safety During Chemotherapy Ordering, Transcribing, Dispensing, and Patient Identification", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1196"} +{"content": "## Guideline Objective\n\nTo provide guidance on processes, technologies and devices for the prevention and control of adverse effects that can happen during or following the administration of systemic treatment to adult cancer patients.\n\n## Patient Population\n\nAdult patients who are going to receive chemotherapy treatment or are already receiving chemotherapy treatment for cancer.\n\n## Intended Guideline Users\n\nOrganizations that provide systemic cancer treatment, including chemotherapy, targeted therapy, and biologics to patients. Clinicians and healthcare providers (e.g., nurses, pharmacists, physicians, administrative support) involved with the administration of systemic cancer treatment, and hospital administrators.\n\n## Research Question(s)\n\nArea of interest 1: Selection, use and management of vascular access devices, including potential complications, during the administration of systemic cancer treatment What are the most effective and safe access devices to administer chemotherapy? When is access assessed? What options are presented to patients? What are the most effective techniques for insertion and management of access devices to prevent infection, lumen occlusion and venous thrombosis as well as for reducing error rates? What are the most effective intravenous (IV) access devices for patients (central vs. peripheral devices)? What are the indications for insertion of a peripheral access device in the delivery of chemotherapy? Area of interest 2: Extravasation, phlebitis, flare, allergy and hypersensitivity complications of chemotherapy administration What are the best strategies for the prevention of extravasation? What are the best strategies for the detection and differential diagnosis of extravasation? What are the best strategies for the management of extravasation once it has occurred? What are the best strategies for documenting extravasation? What are the best strategies for the prevention and treatment of irritation and flare reaction? What are the best strategies for the prevention and treatment of allergic/hypersensitivity reactions to chemotherapy? Area of interest 3: Nursing practices before, during and immediately after the administration of systemic cancer treatment, including verification and maintenance of the treatment plan What are the most effective nursing strategies for reducing errors of administration of systemic cancer treatment agents to cancer patients while using volumetric pumps and other devices (e.g., elastomeric pumps)? What are the most effective strategies for double checking calculations prior to administration of chemotherapy drugs? What are the best strategies for the preparation and administration of pre-medications? What are the best strategies to prevent errors during the administration of systemic cancer therapy? What are the best strategies for post care (e.g., hydration)? What are the best strategies for management of error-related toxicity? What are the best strategies for the verification and maintenance of treatment (e.g., identification of needs, support measures to help maintain the treatment)? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/60626/download?token=Ud_ZeNXC)", "external_id": "cco-1201", "metadata": {"authors": "M. Leung, R. Bland, F. Baldassarre, E. Green, L. Kaizer, S. Hertz, J. Craven, M. Trudeau, A. Boudreau, M. Cheung, S. Singh, V. Kukreti, R. Raha, Safe Administration of Chemotherapy Expert Panel", "document_status": "In-Review", "id": "12-12-2 Nov 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/60626/download?token=Ud_ZeNXC", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 4, "source": "cco", "title": "Safe Administration of Systemic Cancer Therapy Part 2: Administration of Systemic Treatment and Management of Preventable Adverse Events", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1201"} +{"content": "## Patient Population\n\nPatients with testicular cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of testicular cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for testicular cancer? What benefit to clinical management does PET or PET/CT contribute when recurrence of testicular cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for testicular cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17906/download?token=q1u5oTrw)", "external_id": "cco-1206", "metadata": {"authors": "P. Chung, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 8 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17906/download?token=q1u5oTrw", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Testicular Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1206"} +{"content": "## Patient Population\n\nPatients with ovarian cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of ovarian cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for ovarian cancer? What benefit to clinical management does PET or PET/CT contribute when recurrence of ovarian cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for ovarian cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17876/download?token=1ZesztWp)", "external_id": "cco-1211", "metadata": {"authors": "M. Prefontaine, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 7 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17876/download?token=1ZesztWp", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Ovarian Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1211"} +{"content": "## Patient Population\n\nPatients with cervical cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of cervical cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for cervical cancer? What benefit to clinical management does PET or PET/CT contribute when recurrence of cervical cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for cervical cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17816/download?token=HTvf3AbF)", "external_id": "cco-1216", "metadata": {"authors": "A. Fyles, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 6 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17816/download?token=HTvf3AbF", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Cervical Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1216"} +{"content": "## Patient Population\n\nPatients with pancreatic cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of pancreatic cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for pancreatic cancer? What benefit to clinical management does PET or PET/CT contribute when recurrence of pancreatic cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for pancreatic cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/1856/download?token=sRahMHN9)", "external_id": "cco-1221", "metadata": {"authors": "S. Kanjeekal, J. Biagi, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 5 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/1856/download?token=sRahMHN9", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Pancreatic Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1221"} +{"content": "## Patient Population\n\nPatients with esophageal cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful to inform clinical decision making regarding the appropriate role of PET imaging and to guide priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of esophageal cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for esophageal cancer? What benefit to clinical management does PET or PET/CT contribute when recurrence of esophageal cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for esophageal cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and the metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17836/download?token=q1upuQh7)", "external_id": "cco-1226", "metadata": {"authors": "R. Wong, C. Walker-Dilks, A.O. Raifu, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 4 Version 2 Nov 2010", "pdf_url": "https://www.cancercareontario.ca/en/file/17836/download?token=q1upuQh7", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Esophageal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1226"} +{"content": "## Patient Population\n\nPatients with melanoma.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of melanoma? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for melanoma? What benefit to clinical management does PET or PET/CT contribute when recurrence of melanoma is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for melanoma? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17866/download?token=MpVnGd3W)", "external_id": "cco-1231", "metadata": {"authors": "T. Petrella, C. Walker-Dilks, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 3 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/17866/download?token=MpVnGd3W", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1231"} +{"content": "ID: 15-7 Mar 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. Brouwers, C. De Vito, A. Carol, J. Carroll, M. Cotterchio, M. Dobbins, B. Lent, C. Levitt, N. Lewis, S.E. McGregor, L. Paszat, C. Rand, N. Wathen", "external_id": "cco-1236", "metadata": {"authors": "M. Brouwers, C. De Vito, A. Carol, J. Carroll, M. Cotterchio, M. Dobbins, B. Lent, C. Levitt, N. Lewis, S.E. McGregor, L. Paszat, C. Rand, N. Wathen", "document_status": "Archived", "id": "15-7 Mar 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Interventions to Increase the Uptake of Cancer Screening", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1236"} +{"content": "## Patient Population\n\nPatients with head and neck cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nDiagnosis/Staging What benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of head and neck cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for head and neck cancer? Recurrence/Restaging What benefit to clinical management does PET or PET/CT contribute when recurrence of head and neck cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of documented recurrence for head and neck cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17846/download?token=lPQ_I808)", "external_id": "cco-1241", "metadata": {"authors": "J. Yoo, C. Walker-Dilks, S. Henderson, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2 Feb 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/17846/download?token=lPQ_I808", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Head and Neck Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1241"} +{"content": "## Patient Population\n\nPatients with colorectal cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nWhat benefit to clinical management does positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) contribute to the diagnosis or staging of colorectal cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for colorectal cancer? What benefit to clinical management does PET or PET/CT contribute when the recurrence of colorectal cancer is suspected but not proven? What benefit to clinical management does PET or PET/CT contribute to restaging at the time of the documented recurrence for colorectal cancer? What is the role of PET when a solitary metastasis is identified at the time of recurrence and a metastectomy is being contemplated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/17826/download?token=mZX14hfw)", "external_id": "cco-1246", "metadata": {"authors": "K. Chan, S. Welch, C. Walker-Dilks, A.O. Raifu, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 1 Version 2 Nov 2010", "pdf_url": "https://www.cancercareontario.ca/en/file/17826/download?token=mZX14hfw", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1246"} +{"content": "ID: 12-7 Jun 2013\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Systemic Treatment Guideline Development Group", "external_id": "cco-1256", "metadata": {"authors": "Systemic Treatment Guideline Development Group", "document_status": "Archived", "id": "12-7 Jun 2013", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of Octreotide in the Management of Patients with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1256"} +{"content": "ID: 12-6 May 2012\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. Vincent, V. Bramwell, L.A. Moran, D. Anderson", "external_id": "cco-1311", "metadata": {"authors": "M. Vincent, V. Bramwell, L.A. Moran, D. Anderson", "document_status": "Archived", "id": "12-6 May 2012", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Use of Amifostine to Ameliorate the Toxic Effects of Chemotherapy in the Treatment of Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1311"} +{"content": "## Guideline Objective\n\nTo provide the description of the general methods used to produce the two-part guideline on the safe administration of systemic cancer treatment with a focus on patient-relevant issues that the Systemic and Nursing Programs, CCO, promote. Results that are common across the two parts will also be reported here.\n\n## Patient Population\n\nAdult patients who are going to receive systemic cancer treatment or who are already receiving systemic treatment for cancer in healthcare settings or at home.\n\n## Intended Guideline Users\n\nOrganizations that provide systemic cancer treatment to cancer patients. Clinicians and healthcare providers (e.g., nurses, pharmacists, physicians, clerks) involved with the administration of systemic cancer treatment agents, and hospital administrators.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60611/download?token=aUVrHn9t)", "external_id": "cco-1336", "metadata": {"authors": "M. Leung, R. Bland, F. Baldassarre, E. Green, L. Kaizer, S. Hertz, J. Craven, M. Trudeau, A. Boudreau, M. Cheung, S. Singh, V. Kukreti, R. White, Safe Administration of Systemic Cancer Treatment Expert Panel", "document_status": "In-Review", "id": "12-12M Jul 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/60611/download?token=aUVrHn9t", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 3, "source": "cco", "title": "Safe Administration of Chemotherapy: Methods and Development", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1336"} +{"content": "## Research Question(s)\n\nGlobal Question What are the features, functions and components of a Systemic Therapy (ST) Computerized Prescriber Order Entry (CPOE) system that are required to ensure safe, highquality systemic treatment? Specific Questions Does ST CPOE decrease medication errors in chemotherapy prescribing compared to usual practice, and if so, what types of errors does it decrease? Does ST CPOE generate new errors, and if so, what types of new errors does it increase? What is the impact of ST CPOE on practice (e.g., workflow, workload, team communication)? What are the strategies that enhance or limit implementation of ST CPOE? What types of clinical decision supports are available, and are they effective or ineffective? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/41051/download?token=qs-Ndrjx)", "external_id": "cco-1366", "metadata": {"authors": "V. Kukreti, R. Cosby, A. Cheung, S. Lankshear, ST CPOE Guideline Development Group", "document_status": "Current", "id": "12-14 May 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/41051/download?token=qs-Ndrjx", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Computerized Prescriber Order Entry (CPOE) in the Outpatient Oncology Setting", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1366"} +{"content": "## Guideline Objective\n\nTo provide advice regarding the assessment of fever in cancer patients in the community who are receiving chemotherapy, given the potential for serious complications that is associated with it. To investigate whether there are predictors that are associated with a poor outcome; to determine where and how quickly the assessment should take place for these patients and who can/should perform the assessment; and what advice, information, or education should be provided to patients receiving chemotherapy in the community should they develop a fever.\n\n## Patient Population\n\nAdult patients with cancer (i.e., solid tumours or lymphoma) receiving chemotherapy in an outpatient setting who have a fever at home. Emergency department, in-hospital, and outpatient management of febrile neutropenia or serious infection are beyond the scope of the guideline (Table 1-1). There is abundant advice on managing patients after the diagnosis of febrile neutropenia is made (1-5). Patients who have had hematopoietic stem cell transplantation or who have acute leukemia or myelodysplastic syndrome are excluded secondary to the pathophysiologic differences in prognosis in the setting of fever.\n\n## Intended Guideline Users\n\nFamily physicians, emergency physicians and nurses, medical oncologists, hematologists, pharmacists, chemotherapy and community nurses, and health system administrators.\n\n## Research Question(s)\n\nHow does temperature relate to risk for febrile neutropenia, serious infection, or death? What are the clinical predictors for the development of febrile neutropenia? What is the relationship between timing or location of fever assessment, the personnel doing the fever assessment, and the outcome of a fever episode? Do the type, quantity, and content of information provided to patients affect their choice about when and where to seek care for fever? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Prevention and Outpatient Management of Febrile Neutropenia in Adult Cancer Patients: Clinical Practice Guideline\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81256/download?token=6s07s-9m)", "external_id": "cco-1376", "metadata": {"authors": "M.K. Krzyzanowska, C. Walker-Dilks, C.L. Atzema, A. Morris, R. Gupta, R. Halligan, C.T. Kouroukis, K. McCann, Fever Assessment Expert Panel", "document_status": "Current", "id": "12-15 Dec 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/81256/download?token=6s07s-9m", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Approach to Fever Assessment in Ambulatory Cancer Patients Receiving Chemotherapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1376"} +{"content": "## Guideline Objective\n\nTo determine the appropriate use, if any, of LDCT in the screening of high-risk populations for lung cancer, including: Patient considerations Patient characteristics that define a high-risk population Test considerations. The necessary elements involved in defining a positive result on LDCT and follow-up of a positive result. The appropriate screening interval. The appropriate screening duration. Structural considerations that affect effectiveness and safety Organized versus opportunistic screening.\n\n## Patient Population\n\nMen and women considered at high risk for lung cancer based on their age and smoking history.\n\n## Intended Guideline Users\n\nProvincial policy makers, primary care physicians, nurse practitioners, radiologists, respirologists, thoracic surgeons, thoracic oncologists, and any health professionals involved with patients who may be at risk for developing lung cancer. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74011/download?token=R72oahap)", "external_id": "cco-1436", "metadata": {"authors": "H. Roberts, C. Walker-Dilks, K. Sivjee, Y. Ung, K. Yasufuku, A. Hey, N. Lewis , Lung Cancer Screening Guideline Development Group", "document_status": "Archived", "id": "15-10 Apr 2013", "pdf_url": "https://www.cancercareontario.ca/en/file/74011/download?token=R72oahap", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Screening High-Risk Populations for Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/1436"} +{"content": "## Guideline Objective\n\nTo make recommendations on management strategies for patients with early-stage Hodgkin Lymphoma (HL).\n\n## Patient Population\n\nPatients with early-stage Hodgkin Lymphoma.\n\n## Intended Guideline Users\n\nClinicians involved in the management of patients with early-stage Hodgkin Lymphoma, including radiation oncologists and clinical hematologists/oncologists.\n\n## Research Question(s)\n\nWhat are the optimum radiation dose and schedule and what are the best chemotherapy regimens for the treatment of patients with early-stage Hodgkin lymphoma (HL)? What are the best strategies for the prevention of early and late adverse events in patients with early-stage HL? What is the role of PET in guiding therapeutic decisions in the management of early stage HL? What are the best strategies for the treatment of subgroups of patients with early stage HL, such as those with very favourable or unfavourable disease? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81291/download?token=lUdNGule)", "external_id": "cco-171", "metadata": {"authors": "J. Herst, M. Crump, F. Baldassarre, J. MacEachern, J. Sussman, D. Hodgson, M. Cheung , Hematology Disease Site Group", "document_status": "Current", "id": "GL 6-20 May 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81291/download?token=lUdNGule", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Management of Early-Stage Hodgkin Lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/171"} +{"content": "## Guideline Objective\n\nTo improve the quality and consistency of the management of depression for patients with cancer in Ontario.\n\n## Patient Population\n\nAdult patients with cancer who are diagnosed with a major depressive disorder based on a structured diagnostic interview, or who have a suspected depressive disorder based on meeting a threshold on a validated depression rating scale.\n\n## Intended Guideline Users\n\nMental healthcare providers (psychiatrists, psychologists), palliative care professionals, oncologists, oncology nurses, nurse practitioners, psychosocial intervention providers, primary care providers, and community nurses.\n\n## Research Question(s)\n\nWhat are the effective treatments (pharmacological and/or psychological) for depression in the adult population with cancer? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/83311/download?token=KHD7NuuR)", "external_id": "cco-176", "metadata": {"authors": "Management of Depression in Patients with Cancer Expert Panel", "document_status": "Current", "id": "19-4 Mar 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/83311/download?token=KHD7NuuR", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "The Management of Depression in Patients with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/176"} +{"content": "## Research Question(s)\n\nFor patients with CRC or EC, what is the evidence for using IHC testing to identify a) tumours that are MSI-H and b) tumours that are LS? How does IHC testing compare with MSI testing for identifying the MMR deficiencies characterizing LS in CRC tumours and endometrial tumours? For tumours that show abnormal MLH1 protein expression by IHC: How effective is BRAF V600E testing at differentiating between sporadic versus LS-associated CRC? How effective is MLH1 promoter methylation testing at differentiating between sporadic versus LS-associated CRC and EC? How effective is a combination of BRAF V600E testing and MLH1 promoter methylation testing at differentiating between sporadic versus LS-associated CRC and EC?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/58691/download?token=_toHLmKN)", "external_id": "cco-196", "metadata": {"authors": "A. Pollett, J. Brown, M. Aronson, B. Clark, N. Baxter, E. Tomiak , Molecular Oncology Advisory Committee", "document_status": "Archived", "id": "MOAC 3 Sep 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/58691/download?token=_toHLmKN", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Screening for Lynch Syndrome by Immunohistochemistry, BRAF Mutations Analysis, and MLH1 Promoter Methylation Analysis for Patients in Ontario with Colorectal or Endometrial Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/196"} +{"content": "## Guideline Objective\n\nTo provide guidance for clinicians with respect to exercise for patients living with cancer, specifically: Benefits of specific types of exercise Recommendation regarding pre-screening requirements for new referrals Safety concerns To provide specific guidance around delivery models and exercise regimens for patients living with cancer at different points in the cancer journey.\n\n## Patient Population\n\nAdult patients living with cancer, including those on active treatment and those who have completed treatment.\n\n## Intended Guideline Users\n\nOncologists, exercise consultants, primary care providers, and other members of the healthcare team, such as physiotherapists, kinesiologists, social workers, psychologists, nurses, and occupational therapists.\n\n## Research Question(s)\n\nDoes exercise improve domains of QoL compared to no prescribed amount of exercise in patients with a diagnosis of cancer? Does exercise improve physical fitness (i.e., strength, VO2 or aerobic capacity, and objective measures of work done such as distance walked/sit to stand) compared to no prescribed amount of exercise in people with cancer? Does exercise improve overall survival, disease-specific survival, disease-free survival or recurrence-free survival as compared to no prescribed amount of exercise in people with a cancer diagnosis? What is the effect of exercise on people living with cancer in terms of safety, adverse events, or injuries? Are there differential results or outcomes for different intensity levels of aerobic versus resistance types of exercise for people with cancer? What delivery models are appropriate for patients with different types or stages of cancer? Delivery models will be separated into supervised, unsupervised, and combination. Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Exercise Guide: For people with cancer Exercise Tracking Sheet: For people with cancer L'activit\u00e9 physique outils: pour les personnes atteintes de cancer L'activit\u00e9 physique guide: pour les personnes atteintes de cancer\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/76696/download?token=WaF4PHMa)", "external_id": "cco-201", "metadata": {"authors": "R. Segal, C. Zwaal, E. Green, J. Tomasone, A. Loblaw, T. Petrella , Exercise for People with Cancer Guideline Development Group", "document_status": "Current", "id": "19-5 Jul 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/76696/download?token=WaF4PHMa", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Exercise for People with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/201"} +{"content": "## Patient Population\n\nWomen at very high risk for breast cancer, \u2018very high risk\u2019 being defined as: Known mutation in BRCA1, BRCA2 or other gene predisposing to a markedly elevated breast cancer risk. Untested first-degree relative of a carrier of such a gene mutation. Family history consistent with a hereditary breast cancer syndrome and estimated personal lifetime cancer risk >25%. High-risk marker on prior biopsy (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ [LCIS]). Radiation therapy to chest (before age 30 and at least eight years previous).\n\n## Research Question(s)\n\nWhat is the effectiveness of adding breast magnetic resonance imaging (MRI) to standard screening (mammography) compared to screening mammography alone? Does the addition of breast MRI to standard screening detect breast cancer at an earlier stage? What is the optimal frequency of MRI screening? Are there subgroups (risk category, age, or breast density) that benefit more from MRI screening than do others? What harms are associated with MRI screening, and are there any relative or absolute contraindications to its use? In the presence of an abnormal finding seen only on MRI imaging, what is the optimal workup and follow-up after screening?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/78576/download?token=cfxmBCse)", "external_id": "cco-2051", "metadata": {"authors": "E. Warner, H. Messersmith, P. Causer, A. Eisen, R. Shumak, D. Plewes", "document_status": "Archived", "id": "15-11 Jan 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/78576/download?token=cfxmBCse", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 2, "source": "cco", "title": "Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2051"} +{"content": "## Guideline Objective\n\nTo provide a framework by which colposcopy services in Ontario can be delivered with consistent quality, in the following areas: Colposcopy training, qualification, and maintenance of competence: Accessibility to training programs Quality of training programs Requirements to qualify as a colposcopist Maintenance of competence Practice setting requirements: Group practice: hospital-based clinics and outpatient clinics located outside of hospitals Individual office-based practice Operational practices: Referral criteria Wait times Strategies to reduce drop-out rates Quality indicators and outcomes: Quality assurance Performance indicators\n\n## Patient Population\n\nHealthcare providers and administrators involved with the provision of colposcopy examination in Ontario.\n\n## Intended Guideline Users\n\nThese recommendations are intended for clinicians and institutions performing colposcopy in Ontario, and to policy makers and program planners involved in the delivery of colposcopy services. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75206/download?token=PQhUglI7)", "external_id": "cco-2096", "metadata": {"authors": "J. Murphy, N. Varela, L. Elit, A. Lytwyn, V. Wu, M. Yudin, M. Shier, S. El-Khatib , Cervical Cancer Screening Clinical Advisory Committee", "document_status": "In-Review", "id": "15-12 Jan 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/75206/download?token=PQhUglI7", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "The Organization of Colposcopy Services in Ontario: Recommended Framework", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2096"} +{"content": "## Guideline Objective\n\nThe purpose of this systematic review is to evaluate the existing evidence concerning screening of adults at average risk for CRC in the context of an organized, population-based screening program. The main objectives are to identify: The benefits and harms of screening in this population; The optimal primary CRC screening test(s) for this population; The appropriate ages of initiation and cessation for screening in this population; and The intervals at which people at average risk should be recalled for CRC screening.\n\n## Patient Population\n\nAdults at average risk for colorectal cancer.\n\n## Intended Guideline Users\n\nPrimary care providers, endoscopists, policy-makers, and program planners in Ontario.\n\n## Research Question(s)\n\nHow do different screening tests, individually or in combination, perform in average-risk people in preventing CRC-related mortality or all-cause mortality or in decreasing the incidence of CRC? Secondary outcomes include the detection of cancer or its precursors, screening participation rate, adverse effects of tests, and test characteristics, such as sensitivity, specificity, positive predictive value, negative predictive value, and proportion of false-positives or of false-negatives. Secondary Research Questions: What are the appropriate ages of initiation and cessation for screening in people at average risk for CRC? Is there a relationship between age and the effectiveness of CRC screening? What are the appropriate intervals between CRC screening tests (by test)? Is there a relationship between screening intervals and the effectiveness and risks of screening? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Guide to Average Risk Screening with the Fecal Immunochemical Test (FIT) in Ontario\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81266/download?token=cqXfLoLu)", "external_id": "cco-2101", "metadata": {"authors": "J. Tinmouth, E. Vella, N.N. Baxter, C. Dub\u00e9, M. Gould, A. Hey, N. Ismaila, B.R. McCurdy, L. Paszat", "document_status": "Current", "id": "15-14 Nov 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/81266/download?token=cqXfLoLu", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Colorectal Cancer Screening in Average Risk Populations: Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2101"} +{"content": "ID: 13-5 Apr 2012\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Program in Evidence-Based Care", "external_id": "cco-2106", "metadata": {"authors": "Program in Evidence-Based Care", "document_status": "Archived", "id": "13-5 Apr 2012", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Management of Dyspnea in Cancer Patients", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2106"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17741/download?token=ueAl8vyc)", "external_id": "cco-211", "metadata": {"authors": "R. Poon , Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2015-1 Oct 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/17741/download?token=ueAl8vyc", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2015", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/211"} +{"content": "## Guideline Objective\n\nTo summarize evidence available regarding quality indicators for colonoscopy including the definition and validation of indicators, benchmarking and targets.\n\n## Patient Population\n\nAdult patients undergoing colonoscopy in Ontario.\n\n## Intended Guideline Users\n\nThis document is intended for healthcare professionals involved in the delivery of colonoscopy to patients in Ontario and for policy makers and program planners involved in quality assurance at OH (CCO), as well as at hospitals and out-of-hospital premises where colonoscopies are performed. Colonoscopy may be performed for a variety of indications, specifically: follow-up to an abnormal FIT result, screening for those who have a family history of CRC, investigation of symptomatic patients, surveillance of those with a history of advanced adenomatous or serrated polyps, inflammatory bowel disease or CRC, and other screening.\n\n## Research Question(s)\n\nWhat evidence is available for colonoscopy quality indicators, and is there any evidence to support benchmarks for these indicators to improve patient outcomes?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81621/download?token=Tgk5q06u)", "external_id": "cco-2111", "metadata": {"authors": "J. Tinmouth, C. Zwaal, D. Baron, K. Borthwick, J. Ettinger, S. Feinberg, J. Mosko, S. Patel, R. Venkatesh, C. Walsh, C. Dube", "document_status": "Current", "id": "ES 15-5 Nov 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81621/download?token=Tgk5q06u", "type_of_content": "Guidelines & Advice, Evidence Summary", "version": "3"}, "section_count": 4, "source": "cco", "title": "Quality Assurance for Colonoscopy in Ontario Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2111"} +{"content": "ID: 15-8 Nov 2011\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: FIT Guidelines Expert Panel", "external_id": "cco-2116", "metadata": {"authors": "FIT Guidelines Expert Panel", "document_status": "Archived", "id": "15-8 Nov 2011", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Fecal Immunochemical Tests Compared With Guaiac Fecal Occult Blood Tests for Population-Based Colorectal Cancer Screening", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2116"} +{"content": "ID: 13-2 Mar 2003\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: J.S. Wu, R. Wong, M. Johnston, A. Bezjak, T. Whelan, N. Laetsch, Supportive Care Guidelines Group", "external_id": "cco-2121", "metadata": {"authors": "J.S. Wu, R. Wong, M. Johnston, A. Bezjak, T. Whelan, N. Laetsch, Supportive Care Guidelines Group", "document_status": "Archived", "id": "13-2 Mar 2003", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Radiotherapy Fractionation for the Palliation of Uncomplicated Painful Bone Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2121"} +{"content": "ID: 13-1 Aug 2003\nType of Content: Guidelines & Advice, Evidence Summary\nDocument Status: Archived\nAuthors: L. Kligman, R. Wong, M. Johnston, N. Laetsch, Supportive Care Guidelines Group", "external_id": "cco-2126", "metadata": {"authors": "L. Kligman, R. Wong, M. Johnston, N. Laetsch, Supportive Care Guidelines Group", "document_status": "Archived", "id": "13-1 Aug 2003", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "The Treatment of Lymphedema Related to Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2126"} +{"content": "ID: HBOT Jul 2013\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Hyperbaric Oxygen Therapy Working Group", "external_id": "cco-2131", "metadata": {"authors": "Hyperbaric Oxygen Therapy Working Group", "document_status": "Archived", "id": "HBOT Jul 2013", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Hyperbaric Oxygen Therapy for the Treatment and Prevention of Radionecrosis and Other Radiation-Induced Injuries in Cancer Patients", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2131"} +{"content": "ID: 21-3-9 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: A. Sun, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2136", "metadata": {"authors": "A. Sun, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-9 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Skin Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2136"} +{"content": "ID: 21-3-8 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: J. Brierley, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2141", "metadata": {"authors": "J. Brierley, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-8 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Thyroid Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2141"} +{"content": "ID: 21-3-7 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: D.P. D\u2019Souza, R.B. Rumble, A. Fyles, B. Yaremko, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2151", "metadata": {"authors": "D.P. D\u2019Souza, R.B. Rumble, A. Fyles, B. Yaremko, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-7 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Gynecological Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2151"} +{"content": "## Guideline Objective\n\nThis document summarizes the Ontario Cervical Screening Program\u2019s recommendations for cervical screening and best practice colposcopy pathways for management of abnormal cervical screening results. The supporting evidence and contextual factors (e.g., feasibility and acceptability for the Ontario context) used to develop these recommendations are also summarized in this document. Population Asymptomatic people with a cervix in Ontario ages 25 to 74 who have ever been sexually active.\n\n## Intended Guideline Users\n\nFamily physicians, other primary care providers and gynecology specialists involved in cervical screening, as well as colposcopists. Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Toolkit for Ontario Colposcopists Ontario Cervical Screening Guidelines Summary\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77811/download?token=xaWVlGZl)", "external_id": "cco-2156", "metadata": {"authors": "The Ontario Cervical Screening Program", "pdf_url": "https://www.cancercareontario.ca/en/file/77811/download?token=xaWVlGZl", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Ontario Cervical Screening Program recommendations for cervical screening and colposcopy with human papillomavirus testing in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2156"} +{"content": "## Patient Population\n\nPatients presenting in primary care settings comprise the target population. This guideline does not provide recommendations for patients in a screening program.\n\n## Intended Guideline Users\n\nFamily physicians (FPs), general practitioners, emergency room physicians, other primary care providers (PCPs) (nurse practitioners, registered nurses, and physician assistants), respirologists, thoracic surgeons, and radiologists. For the purposes of this document, we have referred to FPs, general practitioners, emergency room physicians, and other PCPs as \u2018FPs and other PCPs. The guidelines are also intended for policymakers to help ensure that resources are in place so that target wait times are achieved.\n\n## Research Question(s)\n\nIn patients presenting to primary care services with signs and/or symptoms of lung cancer, what should the referral process include? The following questions are the factors considered in answering the overall question: What signs, symptoms and other clinical features are predictive of lung cancer? What is the diagnostic accuracy of investigations for lung cancer? What major, known risk factors are predictive of lung cancer? Which factors are associated with delayed referral? Which delay factors can be attributed to patients, and which factors can be attributed to providers? Does a delay in the time to consultation affect patient outcome? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81326/download?token=DOKEIVf5)", "external_id": "cco-216", "metadata": {"authors": "L. Del Giudice, S. Young, E. Vella, M. Ash, P. Bansal, A. Robinson, R. Skrastins, Y. Ung, R. Zeldin, C. Levitt", "document_status": "Current", "id": "24-2 Jan 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/81326/download?token=DOKEIVf5", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Referral of Suspected Lung Cancer by Primary Care Practitioners", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/216"} +{"content": "## Guideline Objective\n\nTo provide recommendations regarding the safe handling of hazardous drugs by healthcare workers.\n\n## Patient Population\n\nHealthcare workers who may come into contact with hazardous drugs at any point in the medication circuit. The medication circuit includes all steps through which the drug travels, from the receiving dock to the storage facility, as well as its preparation, administration, and disposal. Exposure is possible throughout the medication circuit in the hospital or in the home setting.\n\n## Intended Guideline Users\n\nIntended users include, but are not limited to, hospital administrators, educators and managers, occupational health and safety services, pharmacy, nursing, porters, shipping and receiving, medical oncologists, and other healthcare workers. Research Questions What are the proper procedures for safe handling of hazardous drugs through the medication circuit? Are there any adverse health outcomes for healthcare workers who handle hazardous drugs? Do closed-system transfer devices reduce contamination when used to prepare chemotherapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81376/download?token=3T50ttR9)", "external_id": "cco-2161", "metadata": {"authors": "K. Kennedy, K. Vu, N. Coakley, J. Daley-Morris, L. Forbes, R. Hartzell, D. Lessels, Nursing Guideline Development Group", "document_status": "Current", "id": "GL 16-3 Mar 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/81376/download?token=3T50ttR9", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 3, "source": "cco", "title": "Safe Handling of Hazardous Drugs", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2161"} +{"content": "## Guideline Objective\n\nTo make evidence-based recommendations about APN roles (i.e., CNS, NP) for optimizing patient, provider, and health system outcomes across the cancer journey.\n\n## Patient Population\n\nPatients across the cancer journey (i.e., prevention, screening/diagnosis, treatment, survivorship/recovery, palliative care, end-of-life care).\n\n## Intended Guideline Users\n\nHealthcare administrators who plan the delivery of services in cancer and other healthcare settings Chief Nurse Executives Models of care steering committees Healthcare policy makers Registered nurses (RNs), advanced practice nurses, physicians and other allied health professionals involved in the delivery of cancer care APN educators and researchers Directors of Interprofessional Practice Professional associations (e.g., Canadian Association of Nurses in Oncology, Registered Nurses Association of Ontario)\n\n## Research Question(s)\n\nFor which patient populations and in which situations (types of needs, practice settings, phase of the cancer journey) have APN roles demonstrated equivalence or improved outcomes or reduced harms in appropriate controlled comparative studies of cancer care? What specific patient, provider, or health system outcome indicators are associated with CNS or NP roles? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Appendixes Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Foreword Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step Two: Identify Stakeholders and Recruit Participants Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step Three: Determine the Need for a New Model of Care Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step Six: Plan Implementation Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step One: Define Population and Describe Current Model of Care Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step Four: Identify Priority Problems and Goals to Improve the Model of Care Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Step Five: Define the New Model of Care and APN Role Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Resources Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Overview of the PEPPA Framework Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Introduction Designing Innovative Cancer Services and Advanced Practice Nursing Roles: Toolkit - Glossary\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/86371/download?token=6_UwU3Nl)", "external_id": "cco-2166", "metadata": {"authors": "Members of the Cancer Care Ontario Oncology Nursing Program", "document_status": "Current", "id": "16-4 Jun 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/86371/download?token=6_UwU3Nl", "type_of_content": "Guidelines & Advice, Clinical, Health System, Models of Care", "version": "2"}, "section_count": 4, "source": "cco", "title": "Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2166"} +{"content": "## Research Question(s)\n\nWhat is the optimum organization for the delivery of cancer-related thoracic surgery in Ontario? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75766/download?token=eqG1ejFF)", "external_id": "cco-2171", "metadata": {"authors": "Thoracic Surgical Oncology Expert Panel", "document_status": "In-Review", "id": "17-1 Mar 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/75766/download?token=eqG1ejFF", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 1, "source": "cco", "title": "Thoracic Surgical Oncology Standards", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2171"} +{"content": "ID: 21-3-6 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: C. Catton, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2176", "metadata": {"authors": "C. Catton, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-6 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Soft-Tissue Sarcomas", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2176"} +{"content": "ID: 21-3-5 Nov 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: A. Bezjak, R.B. Rumble, G. Rodrigues, A. Hope, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2186", "metadata": {"authors": "A. Bezjak, R.B. Rumble, G. Rodrigues, A. Hope, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-5 Nov 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2186"} +{"content": "ID: 21-3-4 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: N. Laperriere, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2191", "metadata": {"authors": "N. Laperriere, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-4 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in CNS Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2191"} +{"content": "ID: 21-3-3 Jan 2011\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: B. O\u2019Sullivan, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2196", "metadata": {"authors": "B. O\u2019Sullivan, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-3 Jan 2011", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Head and Neck Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2196"} +{"content": "## Guideline Objective\n\nHow should patients presenting to family physicians and other primary care providers (PCPs) with signs and/or symptoms of prostate cancer, including incidental prostate specific antigen (PSA) test results, be managed?\n\n## Patient Population\n\nAdult male patients presenting in primary care settings with signs, including incidental PSA results (defined as results not ordered by the attending FP or other primary care provider [PCP]), or symptoms suggestive of prostate cancer comprise the target population. This guideline does not provide recommendations for screening healthy patients or opportunistic PSA testing.\n\n## Intended Guideline Users\n\nFamily physicians (FPs), general practitioners (GPs), emergency room physicians, other PCPs (nurse practitioners, registered nurses, and physician assistants), and urologists. For the purposes of this document, we have referred to FPs, GPs, emergency room physicians, and other PCPs as \u201cFPs and other PCPs\u201d. The guidelines are also intended for policymakers to help ensure that resources are in place so that target wait times are achieved.\n\n## Research Question(s)\n\nWhat signs, symptoms, and other clinical features that present in primary care are predictive of prostate cancer? What is the diagnostic accuracy of investigations commonly considered for patients presenting with signs and/or symptoms of prostate cancer? What major, known risk factors increase the likelihood of prostate cancer in patients presenting with signs and/or symptoms of prostate cancer? Which factors are associated with delayed referral? Which delay factors can be attributed to patients, and which factors can be attributed to providers or system-related factors? Does a delay in the time to consultation affect patient outcome? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81346/download?token=MgdJm0aV)", "external_id": "cco-221", "metadata": {"authors": "S. Young, P. Bansal, E. Vella, A. Finelli, C. Levitt, A. Loblaw , Prostate Cancer Referral Expert Panel", "document_status": "In-Review", "id": "24-3 Dec 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/81346/download?token=MgdJm0aV", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Referral of Suspected Prostate Cancer by Family Physicians and Other Primary Care Providers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/221"} +{"content": "ID: 21-3-2 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: I. Dayes, R.B. Rumble, J. Bowen, P. Dixon, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2211", "metadata": {"authors": "I. Dayes, R.B. Rumble, J. Bowen, P. Dixon, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-2 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2211"} +{"content": "ID: 21-3-10 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: R.K.W. Wong, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2216", "metadata": {"authors": "R.K.W. Wong, R.B. Rumble, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-10 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Gastrointestinal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2216"} +{"content": "## Patient Population\n\nNSCLC patients in Ontario who have been clinically staged T1-4, N0-3, with no distant metastases.\n\n## Intended Guideline Users\n\nThoracic surgeons, respirologists, and medical as well as radiation oncologists who treat lung cancer.\n\n## Research Question(s)\n\nPrimary Questions: Is invasive mediastinal staging in stage cT1-4, N0-3, M0 non-small cell lung cancer (NSCLC) patients indicated under the following circumstances? Normal-sized mediastinal lymph nodes on computed tomography scan (CT), and negative positron emission tomography (PET)-CT scan in the mediastinum positive PET-CT in the mediastinum Enlarged discrete mediastinal nodes on CT (clinical N2 or N3 nodes), and negative PET-CT in the mediastinum positive PET-CT in the mediastinum Secondary Questions: What constitutes invasive mediastinal staging? What is the proper technique in performing invasive mediastinal staging? Which node stations should be biopsied? How many lymph nodes should be biopsied? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75746/download?token=Vv5IQHvR)", "external_id": "cco-2221", "metadata": {"authors": "G. Darling, J. Dickie, R. Malthaner, E. Kennedy, R. Tey, Invasive Mediastinal Staging Expert Panel", "document_status": "Current", "id": "17-6 May 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/75746/download?token=Vv5IQHvR", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Invasive Mediastinal Staging of Non-small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2221"} +{"content": "ID: 21-3-1 Oct 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: G. Bauman, R.B. Rumble, J. Chen, A. Loblaw, P. Warde, IMRT Indications Expert Panel", "external_id": "cco-2231", "metadata": {"authors": "G. Bauman, R.B. Rumble, J. Chen, A. Loblaw, P. Warde, IMRT Indications Expert Panel", "document_status": "Archived", "id": "21-3-1 Oct 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Role of IMRT in Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2231"} +{"content": "## Patient Population\n\nPatients with liver metastases from CRC who have had or will have an complete (R0) resection of the primary cancer and who are being considered for resection of the liver or liver plus extrahepatic metastasis with curative intent.\n\n## Intended Guideline Users\n\nSurgeons and medical oncologists dealing with CRC patients with liver metastases.\n\n## Research Question(s)\n\nShould surgery be considered for colorectal cancer (CRC) patients who have liver metastases plus (a) pulmonary metastases, (b) portal nodal disease, or (c) other extrahepatic metastases (EHM)? What is the role of chemotherapy in the surgical management of CRC with liver metastases in (a) patients with resectable disease in the liver, or (b) patients with initially unresectable disease in the liver that is downsized with chemotherapy (conversion)? What is the role of liver resection when one or more CRC liver metastases have radiographic complete response (RCR) following chemotherapy?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/53281/download?token=IYqP9pPl)", "external_id": "cco-2236", "metadata": {"authors": "S. Gallinger, J.J. Biagi, G.G. Fletcher, C. Nhan, L. Ruo, R.S. McLeod , Liver Resection for Colorectal Metastases Expert Panel", "document_status": "Archived", "id": "17-7 Jun 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/53281/download?token=IYqP9pPl", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Liver Resection for Colorectal Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2236"} +{"content": "## Guideline Objective\n\nTo provide the optimal strategy to assess patients diagnosed with rectal cancer prior to treatment. This includes: Investigations [chest X-ray or computed tomography (CT) thorax/abdomen/pelvis, colonoscopy, serum carcinoembryonic antigen] to assess for distant metastases and synchronous lesions in patients with rectal cancer Imaging [magnetic resonance imaging (MRI) pelvis, endoscopic ultrasound (EUS), transrectal ultrasound (TRUS), CT pelvis] for local staging of rectal cancer The optimal MRI protocol to locally stage rectal cancerThe optimal MRI criteria to locally stage rectal cancerThe optimal MRI criteria to select patients for neoadjuvant therapy The role of multidisciplinary cancer conferences (MCCs)The role of restaging MRI after neoadjuvant therapy\n\n## Patient Population\n\nNewly diagnosed patients with rectal cancer undergoing elective treatment.\n\n## Intended Guideline Users\n\nRadiologists, surgeons, radiation oncologists, medical oncologists, and pathologists.\n\n## Research Question(s)\n\nWhat investigations (chest X-ray or CT thorax/abdomen/pelvis, colonoscopy, serum carcinoembryonic antigen) should be performed to assess for distant metastases and synchronous lesions in patients with rectal cancer? What imaging (MRI pelvis, EUS, TRUS, CT pelvis) should be performed for local staging of rectal cancer? What MRI protocol has been shown to have the best accuracy to locally stage rectal cancer? What MRI criteria are necessary to locally stage rectal cancer preoperatively? Which MRI criteria should be used to select patients for neoadjuvant therapy? Does a pretreatment discussion at multidisciplinary cancer conference (MCC) improve patient outcome for patients with rectal cancer? Does a restaging MRI after neoadjuvant therapy improve patient outcomes for patients with rectal cancer?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70616/download?token=idJJc8Qi)", "external_id": "cco-2241", "metadata": {"authors": "E. Kennedy, E. Vella, D. B. MacDonald, S. Wong, R. McLeod, Preoperative Assessment for Rectal Cancer Guideline Development Group", "document_status": "Archived", "id": "17-8 Jan 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/70616/download?token=idJJc8Qi", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Optimization of Preoperative Assessment in Patients Diagnosed With Rectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2241"} +{"content": "ID: 14-1 Jan 2015\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Members of the Radiation Treatment Group", "external_id": "cco-2251", "metadata": {"authors": "Members of the Radiation Treatment Group", "document_status": "Archived", "id": "14-1 Jan 2015", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Radiopharmaceuticals in the Palliation of Painful Bone Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2251"} +{"content": "## Patient Population\n\nAdult cancer patients\n\n## Intended Guideline Users\n\nOncology healthcare professionals interacting with cancer patients during critical points of care.\n\n## Research Question(s)\n\nWhat aspects of provider-patient communication, at critical points of care, have an impact on clinical outcomes of cancer patients? The critical points of care of interest are diagnosis, recurrence, identification of metastases, and progressive disease. Outcomes of interest include psychosocial or emotional distress in patients (e.g., anxiety, depression), patient satisfaction, patient quality of life, and patient recall or understanding of information communicated by providers. The components of provider-patient communication that are the focus of this report are communication styles and approach. The clinical content and strategies related to specific clinical issues in each of the critical points of care are not the focus of this report.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17941/download?token=WHYAm5CZ)", "external_id": "cco-2256", "metadata": {"authors": "Program in Evidence-Based Care", "document_status": "Education and Information", "id": "19-2 Mar 2008", "pdf_url": "https://www.cancercareontario.ca/en/file/17941/download?token=WHYAm5CZ", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Provider-Patient Communication", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2256"} +{"content": "## Guideline Objective\n\nTo summarize the available data regarding the efficacy of plerixafor in enhancing hamatopoietic stem cell mobilization and collection before autologous stem cell transplantation and to provide recommendations on its use. Evidence on the cost-effectiveness of plerixafor was not considered in this report.\n\n## Patient Population\n\nAdult patients considered for autologous stem cell transplantation (SCT) and meeting one of the following criteria: Have not been mobilized before (i.e., the case of up front mobilization in na\u00efve patients who may or may not be at risk of being poor mobilizers) Are failing initial mobilization (based on peripheral blood CD34+ cells count before first day of apheresis, or the total number of CD34+ cells collected on the first day of apheresis) Have failed a prior mobilization attempt (i.e., are poor mobilizers) Of particular interest are outcomes focused on the ability to mobilize and collect an adequate graft to get patients to autologous SCT, such as total number of CD34+ cells collected during apheresis (the minimal required cell number for a graft is 2.0x106 CD34+ cells/kg), number of apheresis procedures, proportion of patients who proceed to autologous SCT and survival rate post-SCT).\n\n## Intended Guideline Users\n\nHealthcare physicians performing SCT in Ontario, as well as for policy makers, program planners and institutions involved in any STC program or team.\n\n## Research Question(s)\n\nDoes the administration of plerixafor in combination with granulocyte-colony stimulating factor (G-CSF) for stem cell mobilization before autologous transplantation improve the outcome of patients who have not been mobilized before, when compared with G-CSF for stem cell mobilization alone or in combination with chemotherapy? Does the administration of plerixafor in combination with G-CSF for stem cell mobilization before autologous transplantation improve the outcome of patients failing mobilization when compared with G-CSF for stem cell mobilization alone or in combination with chemotherapy? Does the administration of plerixafor in combination with G-CSF for stem cell mobilization before autologous transplantation improve the outcome of patients who have failed a prior mobilization regimen when compared with G-CSF for stem cell mobilization alone or in combination with chemotherapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75801/download?token=cs8VETh8)", "external_id": "cco-226", "metadata": {"authors": "C.T. Kouroukis, N.P. Varela, C. Bredeson, J. Kuruvilla, A. Xenocostas , Stem Cell Transplant Steering Committee", "document_status": "Current", "id": "SCT-7 Sep 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/75801/download?token=cs8VETh8", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Plerixafor for Autologous Hematopoietic Stem Cell Mobilization and Transplantation for Patients in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/226"} +{"content": "ID: 13-8 Oct 2006\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: L. Librach, N. Lloyd, V. Jarvis, D. Warr, A.R. Jadad, J. Wilson, M. Brouwers, R. Wong, Supportive Care Guidelines Group", "external_id": "cco-2266", "metadata": {"authors": "L. Librach, N. Lloyd, V. Jarvis, D. Warr, A.R. Jadad, J. Wilson, M. Brouwers, R. Wong, Supportive Care Guidelines Group", "document_status": "Archived", "id": "13-8 Oct 2006", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Use of Gabapentin and Tricyclic Antidepressants in the Treatment of Neuropathic Pain in Cancer Patients", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2266"} +{"content": "ID: 16-2 Mar 2008\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Cancer-related Pain Management Working Panel", "external_id": "cco-2271", "metadata": {"authors": "Cancer-related Pain Management Working Panel", "document_status": "Archived", "id": "16-2 Mar 2008", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Cancer-Related Pain Management: a Report of Evidence-based Recommendations to Guide Practice", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2271"} +{"content": "## Guideline Objective\n\nTo describe the role of active surveillance (AS) as a management strategy for patients with localized prostate cancer. To identify patients with prostate cancer that would most benefit from AS. To develop an evidence-based protocol for AS in localized prostate cancer and to identify the factors affecting the offer of, acceptance of, and adherence to AS. To understand the role of 5-alpha reductase inhibitors (5ARI) (e.g., finasteride and dutasteride) in patients with localized prostate cancer undergoing AS. To identify which physician is responsible for managing the AS protocol and if any other human resources required to offer AS (e.g., genitourinary pathologist, psychosocial specialist, etc.) would need specific training.\n\n## Patient Population\n\nMen with clinically localized prostate cancer (stage T1 and T2, Gleason score \u22647).\n\n## Intended Guideline Users\n\nClinicians and specialists providing care to patients with prostate cancer (i.e. urologists and radiation oncologists).\n\n## Research Question(s)\n\nHow does AS compare with immediate active treatments (e.g., RP, RT, brachytherapy, hormone therapy, cryotherapy, or high-intensity focused ultrasound) as a management strategy for patients with newly-diagnosed localized prostate cancer (T1 and T2; Gleason score \u00a37)? In patients with localized prostate cancer undergoing AS, which findings of the following tests predict increasing risk of reclassification to a higher-risk disease state? What are their test characteristics (i.e., positive and negative predictive values, sensitivities, specificities, and likelihood ratios)? PSA kinetics (e.g., velocity or doubling time) DRE - Imaging (e.g., magnetic resonance imaging [MRI] or ultrasound [US]) Prostate cancer antigen3 (PCA3) In patients with localized prostate cancer undergoing AS, how does supplementation with 5-alpha reductase inhibitors (5ARIs) (e.g., finasteride or dutasteride) compare with no supplementation? In patients with localized prostate cancer undergoing AS, how do clinical outcomes differ if treatment is managed by a: Single doctor versus a multidisciplinary team of clinicians? Urologist versus another oncologist (e.g., a radiation oncologist)? University/teaching hospital versus a community or private clinic/hospital? In patients with localized prostate cancer who are candidates for or who are undergoing AS, how does the offer, receipt, or choice of treatment and patient compliance or adherence differ based on (but not limited to) the following factors: AS protocol: order of and frequency of tests (PSA, DRE, imaging), and other test/clinical factors? Care provider(s): single versus team of doctors; urologist versus other oncologist? Care setting: clinic versus hospital? Patient factors: clinical, psychosocial? Social support: family or community? Socioeconomic or geographic variables? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/70621/download?token=N9tF85VE)", "external_id": "cco-2286", "metadata": {"authors": "C. Morash, R. Tey, C. Agbassi, L. Klotz, T. McGowan, J. Srigley, A. Evans , Active Surveillance Guideline Development Group", "document_status": "In-Review", "id": "17-9 Dec 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/70621/download?token=N9tF85VE", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Active Surveillance for the Management of Localized Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2286"} +{"content": "## Guideline Objective\n\nTo create a psychosocial care framework that can be used to direct improvements in the quality of comprehensive cancer care for patients and their families in Ontario. To provide recommendations on the best strategies for meeting the psychosocial healthcare needs of cancer patients and their families at both the provider level (psychosocial health services) and the system level (psychosocial health interventions).\n\n## Patient Population\n\nAdult cancer patients and their families.\n\n## Intended Guideline Users\n\nPractitioners and planners who care for cancer patients and their families: oncologists, palliative care physicians, family physicians, psychiatrists, psychologists, social workers, nurses, dietitians, occupational therapists, physiotherapists, speech language pathologists, spiritual care practitioners, healthcare administrators, volunteers, community organizations, and other healthcare providers.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/5081/download?token=HH4Xhttu)", "external_id": "cco-2291", "metadata": {"authors": "G. Turnbull, F. Baldassarre, P. Brown, J. Hatton-Bauer, M. Li, S. Lebel, L. Durkin, E. Green, Psychosocial Oncology Expert Panel", "document_status": "Education and Information", "id": "19-3 Oct 2010", "pdf_url": "https://www.cancercareontario.ca/en/file/5081/download?token=HH4Xhttu", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Psychosocial Healthcare for Cancer Patients and Their Families", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2291"} +{"content": "## Guideline Objective\n\nTo make recommendations with respect to the role of adjuvant systemic chemotherapy in stage II and III colon cancer patients who have undergone complete resection with curative intent.\n\n## Patient Population\n\nAdult patients with stage II and III colon cancer who have undergone complete resection with curative intent as primary therapy.\n\n## Intended Guideline Users\n\nClinicians involved in the delivery of adjuvant systemic chemotherapy for stage II and III colon cancer patients.\n\n## Research Question(s)\n\nWhat is the impact of adjuvant fluoropyrimidine-based systemic chemotherapy versus observation on disease-free survival (DFS) and OS in patients with stage II or III colon cancer who have undergone complete resection with curative intent? What is the impact of adjuvant intravenous (IV) 5-FU versus oral fluoropyrimidines on DFS and OS in patients with stage II or III colon cancer who have undergone complete resection with curative intent? a) What is the impact of adjuvant fluoropyrimidines versus fluoropyrimidines plus oxaliplatin on DFS and OS in patients with: stage II or III colon cancer who have undergone complete resection with curative intent? stage II colon cancer who have undergone complete resection with curative intent? stage III colon cancer who have undergone complete resection with curative intent? b) What is the impact on DFS and OS of the addition of oxaliplatin to fluoropyrimidine-based adjuvant chemotherapy in patients with stage II or III colon cancer who have undergone complete resection with curative intent? a) What is the impact of the addition of oxaliplatin to fluoropyrimidine-based adjuvant chemotherapy, on DFS and OS, in younger versus older (\u226470 years versus >70 years) stage II or III colon cancer patients who have undergone complete resection with curative intent? b) What is the impact of adjuvant fluoropyrimidine monotherapy, on DFS and OS, in younger versus older (\u226470 years versus >70 years) stage II or III colon cancer patients who have undergone complete resection with curative intent? What is the impact of microsatellite instabilty status on DFS and OS with the addition of adjuvant chemotherapy in stage II patients with colon cancer who have undergone complete resection with curative intent? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/73991/download?token=6JSZDfWX)", "external_id": "cco-231", "metadata": {"authors": "B. Meyers, R. Cosby, F. Quereshy, D. Jonker, Gastrointestinal Disease Site Group", "document_status": "In-Review", "id": "2-29 Feb 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/73991/download?token=6JSZDfWX", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 4, "source": "cco", "title": "Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/231"} +{"content": "## Guideline Objective\n\nTo provide guidance for the use of neoadjuvant and adjuvant systemic therapy in women with newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma (EOC).\n\n## Patient Population\n\nWomen with newly diagnosed stage II, III, or IV EOC\n\n## Intended Guideline Users\n\nGynecologic oncologists, medical oncologists, and other clinicians who are involved in the treatment of the target population in the province of Ontario Research Questions What is the most effective regimen to administer systemic therapy for women with newly diagnosed stage II, III, or IV EOC? What is the optimal regimen (dose/schedule/frequency) for women who will receive neoadjuvant therapy before interval cytoreduction? What is the optimal regimen (dose/schedule/frequency) for women who will receive adjuvant therapy after primary cytoreduction? What is the optimal regimen (dose/schedule/frequency) and most effective mode of administration (i.v. versus i.p.) for optimally debulked women (<1 cm residual disease) who will receive adjuvant therapy? Do women with BRCA mutation receiving neoadjuvant or adjuvant therapy have different optimal regimen (dose/schedule/frequency) and outcomes compared with women without BRCA mutation? Do women with different histological subtypes (low-grade serous, endometrioid, clear cell, mucinous, undifferentiated/unclassifiable), location subtypes, residues after cytoreduction, or stages receiving neoadjuvant or adjuvant therapy have different optimal regimen (dose/schedule/frequency) and outcomes? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81651/download?token=hKshFhWg)", "external_id": "cco-2311", "metadata": {"authors": "H. Hirte, R.Poon, X. Yao, T. May, J-L. Ethier, L. Petz, J. Speakman, L. Elit, The Ovarian Cancer Guideline Development Group", "document_status": "Current", "id": "GL 4-1 Jan 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/81651/download?token=hKshFhWg", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Neoadjuvant and adjuvant systemic therapy for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2311"} +{"content": "ID: 14-3 Jul 2005\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: A. Sawka, A. Driedger, S. Ezzat, C. Lochrin, G. Bauman, K. Thephamongkhol, M. Charette , Therapeutic Radiopharmaceutical Guidelines Group", "external_id": "cco-2371", "metadata": {"authors": "A. Sawka, A. Driedger, S. Ezzat, C. Lochrin, G. Bauman, K. Thephamongkhol, M. Charette , Therapeutic Radiopharmaceutical Guidelines Group", "document_status": "Archived", "id": "14-3 Jul 2005", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "I-131 Remnant Ablation after Thyroidectomy for Papillary or Follicular Thyroid Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2371"} +{"content": "## Guideline Objective\n\nThis document describes the CCO-Lung Cancer Disease Site Group endorsement of the recommendations for prophylactic cranial irradiation and consolidative radiation for patients with small cell lung cancer from \u00a9 NICE [2019] Lung cancer: diagnosis and management.\n\n## Patient Population\n\nThis guideline is intended for patients with limited- or extensive-stage small cell lung cancer who have achieved any response to induction therapy (chemotherapy or chemoradiotherapy).\n\n## Intended Guideline Users\n\nThis guideline is intended for clinicians treating patients with small cell lung cancer who have achieved any response to induction therapy (chemotherapy or chemoradiotherapy).\n\n## Research Question(s)\n\nn/a", "external_id": "cco-2396", "metadata": {"authors": "M. Taremi, E.T. Vella, S. Cheng, P.M. Ellis, R. Goffin, A. Louie, R. MacRae, Y.C. Ung, and the Lung Cancer Disease Site Group", "document_status": "In-Review", "id": "GL END 7-13-2 Nov 2019", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Recommendations for Prophylactic Cranial Irradiation and Consolidative Radiation for Patients with Small Cell Lung Cancer: Endorsement of the 2019 National Institute for Health and Care Excellence Guidance", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2396"} +{"content": "## Patient Population\n\nAdults without evidence of disease after primary, curative treatment for any stage of cancer comprise the target population. Both clinical outcomes (recurrence, surveillance) and quality of life (QoL) outcomes (quality of life, patient satisfaction) from follow-up strategies reported for patients at all levels of risk of recurrence are of interest.\n\n## Intended Guideline Users\n\nHealth professionals who are responsible for the care of adults with cancer who are clinically disease free after receiving curative treatment. Health professionals engaged in the care of adults with cancer who are clinically disease free after receiving curative treatment and who would make referrals to the appropriate care team. Administrative and system leaders responsible for implementing high-quality evidence informed survivorship services for adults with cancer who are clinically disease free after receiving curative treatment.\n\n## Research Question(s)\n\nWhat are the models described in the literature for the follow-up care of adults with cancer who have completed treatment and are clinically disease free? Are certain models favoured for survivors of specific cancer types in terms of the following: Clinical outcomes (e.g., surveillance, recurrence) Survivor quality of life outcomes (e.g., quality of life, patient satisfaction) Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/71451/download?token=L_mlFLfi)", "external_id": "cco-246", "metadata": {"authors": "J. Sussman, L.H. Souter, E. Grunfeld, D. Howell, C. Gage, S. Keller-Olaman, M. Brouwers", "document_status": "In-Review", "id": "26-1 Mar 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/71451/download?token=L_mlFLfi", "type_of_content": "Guidelines & Advice, Clinical, Health System, Models of Care", "version": "2"}, "section_count": 3, "source": "cco", "title": "Models of Care for Cancer Survivorship", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/246"} +{"content": "ID: 23-1 Mar 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Expert Steering Committee of the Project in Evidence-based Primary Prevention", "external_id": "cco-2521", "metadata": {"authors": "Expert Steering Committee of the Project in Evidence-based Primary Prevention", "document_status": "Archived", "id": "23-1 Mar 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Healthy Eating, Physical Activity, and Healthy Weights Guideline for Public Health in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2521"} +{"content": "ID: 15-6 Mar 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: J. Allard, R. Cosby, M.E. Del Giudice, E.J. Irvine, D. Morgan, J. Tinmouth , Upper GI Screening Panel", "external_id": "cco-2526", "metadata": {"authors": "J. Allard, R. Cosby, M.E. Del Giudice, E.J. Irvine, D. Morgan, J. Tinmouth , Upper GI Screening Panel", "document_status": "Archived", "id": "15-6 Mar 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Gastroscopy Following a Positive Fecal Occult Blood Test (FOBT) and Negative Colonoscopy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2526"} +{"content": "## Research Question(s)\n\nShould primary care providers routinely perform total-body skin examination on members of the general population to screen for melanoma, basal cell carcinoma, and squamous cell carcinoma of the skin? Should primary care providers routinely counsel members of the general population to perform skin self-examination for early detection of melanoma, basal cell carcinoma, and squamous cell carcinoma of the skin? Should individuals at high risk for melanoma, basal cell carcinoma, and squamous cell carcinoma of the skin be offered surveillance by a physician, including total-body skin examination and counselling to perform skin self-examination? What characteristics should clinicians assess in order to determine risk for melanoma, basal cell carcinoma, and squamous cell carcinoma of the skin? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/3336/download?token=3yAI2HKV)", "external_id": "cco-2536", "metadata": {"authors": "L. From, L. Marrett, C. Rosen, C. Zwaal, M. Johnston, K. Bak, G. Sibbald, J. Fong, V. Mai", "document_status": "Education and Information", "id": "15-1 Jun 2007", "pdf_url": "https://www.cancercareontario.ca/en/file/3336/download?token=3yAI2HKV", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Screening for Skin Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2536"} +{"content": "Version: 2\nID: 12-8 Jun 2013\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: N. Iscoe, V. Bramwell, M. Charette, T. Oliver, B. Zanke, Systemic Treatment Disease Site Group", "external_id": "cco-2556", "metadata": {"authors": "N. Iscoe, V. Bramwell, M. Charette, T. Oliver, B. Zanke, Systemic Treatment Disease Site Group", "document_status": "Archived", "id": "12-8 Jun 2013", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Liposomal Anthracyclines in the Management of HIV-positive Kaposi's Sarcoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2556"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/71516/download?token=K7eLCGBH)", "external_id": "cco-256", "metadata": {"authors": "E. Kennedy, C. Zwaal, T. Asmis, C. Cho, J. Galica, A. Ginty, A. Govindarajan and the Colorectal Cancer Survivorship Guideline Development Group Guideline Group/Expert Panel", "document_status": "In-Review", "id": "GL 26-2 Mar 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/71516/download?token=K7eLCGBH", "type_of_content": "Guidelines & Advice, Clinical, Health System, Models of Care", "version": "3"}, "section_count": 1, "source": "cco", "title": "Follow-up Care, Surveillance Protocols and Secondary Prevention Measures for Survivors of Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/256"} +{"content": "ID: DIBrCa Apr 2012\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Diagnostic Imaging Guidelines Panel", "external_id": "cco-2561", "metadata": {"authors": "Diagnostic Imaging Guidelines Panel", "document_status": "Archived", "id": "DIBrCa Apr 2012", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Diagnostic Imaging in Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2561"} +{"content": "ID: DICRC Sep 2012\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Diagnostic Imaging Guidelines Panel", "external_id": "cco-2566", "metadata": {"authors": "Diagnostic Imaging Guidelines Panel", "document_status": "Archived", "id": "DICRC Sep 2012", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Cross-Sectional Imaging in Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2566"} +{"content": "ID: HPVTest Apr 2006\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: HPV Self-collection Guidelines Panel", "external_id": "cco-2571", "metadata": {"authors": "HPV Self-collection Guidelines Panel", "document_status": "Archived", "id": "HPVTest Apr 2006", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Self-collected Samples for Testing of Oncogenic Human Papillomavirus", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2571"} +{"content": "ID: DILung Apr 2012\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Program Evidence-Based Care", "external_id": "cco-2576", "metadata": {"authors": "Program Evidence-Based Care", "document_status": "Archived", "id": "DILung Apr 2012", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Cross-Sectional Diagnostic Imaging in Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/2576"} +{"content": "## Guideline Objective\n\nThe primary objective of this guideline is to develop recommendations for the optimal management of patients with lung cancer after curative-intent treatment.\n\n## Patient Population\n\nThe target population includes adult patients with small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC) after curative-intent treatment.\n\n## Intended Guideline Users\n\nThis guideline is targeted to thoracic surgeons, medical and radiation oncologists specializing in lung cancer, radiologists, primary care providers, respirologists, nurses, and psychosocial care providers. Research Questions What are the benefits and harms of different types of clinicians providing follow-up care? What are the benefits and harms of using patient-reported outcome tools or measures in providing follow-up care? What are the benefits and harms of pneumococcal, influenza, and COVID-19 vaccinations? What are the benefits and harms of smoking cessation interventions? Which signs/symptoms/ risk factors/ comorbidities should be managed to improve their quality of life, risk of recurrence, survival, or risk of other primary cancers? What are the late toxicities after any treatment (surgical, radiotherapy, chemotherapy, immunotherapy) that should be managed to improve their quality of life? What are the benefits and harms of the treatment/ management strategies for signs/symptoms/risk factors/ comorbidities/ late toxicities? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/73526/download?token=vKktjeMp)", "external_id": "cco-261", "metadata": {"authors": "Y. Shargall, E.T. Vella, L. Del Giudice, S. Kulkarni, P.M. Ellis , C. Dennie, R. MacRae, Y.C. Ung, Lung Cancer Survivorship Guideline Development Group", "document_status": "Current", "id": "26-3 Feb 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/73526/download?token=vKktjeMp", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Follow-up and Surveillance of Curatively Treated Lung Cancer Patients", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/261"} +{"content": "## Guideline Objective\n\nTo develop recommendations related to the frequency by which prostate-specific antigen (PSA) levels should be tested in men after curative-intent treatment for prostate cancer and to define the most appropriate diagnostic testing if biochemical (BC) recurrence occurs. The secondary objective is to develop recommendations that address psychosocial issues, sexual health, fatigue, urinary health, and bowel health outcomes associated with treatment for prostate cancer.\n\n## Patient Population\n\nProstate cancer patients who have undergone curative-intent treatment. For prostate cancer patients who are on active surveillance, please refer to PEBC Guideline 17-9.\n\n## Intended Guideline Users\n\nRadiation oncologists specializing in prostate cancer, family physicians, urologists, nurses, allied health professionals, and any other care provider involved in follow-up care of prostate cancer.\n\n## Research Question(s)\n\nIn survivors who have received curative-intent treatment for prostate cancer: What is the appropriate timing for PSA testing? After biochemical recurrence, what diagnostic tests are effective at detecting progression or occurrence of metastasis and how do they affect patient management? At what PSA threshold are these tests effective? What are the most common symptoms of clinical recurrence? What are the rates and level of distress for common late side-effects of prostate cancer treatment? What interventions are available to manage late treatment effects? Is there a relationship between the model of care in terms of care, provider, setting, and availability of patient navigator or mentor, and the effective detection and management of progresion or metastatic disease? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Prostate Cancer Follow-Up Care Clinical Guidance Summary\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/78796/download?token=rnKJ4k_L)", "external_id": "cco-266", "metadata": {"authors": "A. Matthew, L.H. Souter, R.H. Breau, C. Canil, M. Haider, L. Jamnicky, R. Morash, D. Smith, M. Surchin, A. Loblaw , Prostate Cancer Follow-up Expert Panel", "document_status": "In-Review", "id": "26-4 Jun 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/78796/download?token=rnKJ4k_L", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Follow-up Care and Psychosocial Needs of Survivors of Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/266"} +{"content": "## Patient Population\n\nThese recommendations apply to women with DCIS, including women with DCIS with microinvasion (DCIS-M) (< 1 mm through the duct).\n\n## Intended Guideline Users\n\nIntended users of this guideline are clinicians and other healthcare professionals involved in the management of patients with DCIS.\n\n## Research Question(s)\n\nWhat is the optimal surgical treatment for patients with DCIS when considering DFS, recurrence, and significant complications after surgery (i.e. bleeding or infection)? a) What margin width minimizes the risk of recurrence, complications after surgery (i.e. bleeding, infection) and increases disease free survival in patients with DCIS receiving BCS? b) After initial surgery of BCS or MX with suboptimal margin width (close or positive), should re-excision be considered to improve DFS, recurrence or reduce complications after surgery requiring reoperation within 30 days (i.e. bleeding or infection)? Should molecular profile testing be added to clinical evaluation to guide the use of any adjuvant therapy in patients with DCIS? In DCIS patients who have undergone BCS or MX, should breast irradiation be offered to improve DFS and reduce recurrence with acceptable adverse events of irradiation? In DCIS patients who have undergone BCS or MX, what is the role of endocrine therapy in the management of DCIS to improve DFS and reduce recurrence and contralateral events with acceptable treatment adverse events? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81826/download?token=46UE_YYC)", "external_id": "cco-276", "metadata": {"authors": "M. Brackstone, LD Durocher-Allen, N. Califaretti, A. Eisen, S. Knowles, A. Koch, A. Salim, T. Plexman, DCIS Expert Panel", "document_status": "Current", "id": "GL1-10 Mar 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/81826/download?token=46UE_YYC", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 3, "source": "cco", "title": "Management of Ductal Carcinoma in Situ of the Breast", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/276"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/83341/download?token=A5tddXYw)", "external_id": "cco-281", "metadata": {"authors": "M.A. Haider, J. Brown, J. Chin, A. Loblaw, N. Perlis, N. Schieda, and the MPMRI in the Diagnosis of Clinically Significant Prostate Cancer Guideline Development Group", "document_status": "In-Review", "id": "GL 27-2 Feb 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/83341/download?token=A5tddXYw", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Multiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/281"} +{"content": "## Guideline Objective\n\nThe primary objective was to make recommendations regarding the most effective intensive systemic treatment of acute myeloid leukemia (AML) in adult patients. A secondary objective was to make recommendations regarding use of patient characteristics to determine appropriate treatment.\n\n## Patient Population\n\nThe target population is adult patients with AML (excluding acute promyelocytic leukemia) who are deemed suitable for intensive treatment.\n\n## Intended Guideline Users\n\nThe intended users are hematologists, oncologists, nurses, and pharmacists.\n\n## Research Question(s)\n\nWhat is the most effective systemic induction treatment for adults with previously untreated AML who can tolerate intensive treatment? What is the most effective systemic post-remission treatment (consolidation and/or maintenance, excluding stem cell transplant) for adults with previously untreated AML? What is the most effective systemic treatment (reinduction, consolidation, maintenance; not including stem cell transplant) for adults with relapsed or refractory AML who can tolerate intensive treatment? Which patient characteristics are most important when making treatment decisions? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/44226/download?token=omJzeLy-)", "external_id": "cco-28266", "metadata": {"authors": "A.C. Schuh, G.G. Fletcher, B. Leber, M. Sabloff, Systemic Treatment Disease Site Group", "document_status": "In-Review", "id": "12-9 Jan 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/44226/download?token=omJzeLy-", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Systemic Treatment of Acute Myeloid Leukemia (AML)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/28266"} +{"content": "## Guideline Objective\n\nThe objective of this evidence summary is to systematically review the available evidence with respect to the following two topics in the treatment of acute lymphoblastic/lymphocytic leukemia (ALL): - The use of pediatric-inspired regimens in the adolescent and young adult (AYA) population. - The use of tyrosine kinase inhibitors (TKIs) in adult patients with Philadelphia chromosome-positive (Ph+) ALL.\n\n## Patient Population\n\nThe purpose of this evidence summary is to inform care decisions regarding the use of ALL pediatric regimens in the treatment of AYAs with ALL.\n\n## Intended Guideline Users\n\nThis evidence summary is targeted for all people involved in systemic therapy treatment of patients with ALL.\n\n## Research Question(s)\n\nCompared with adult regimens, is there a benefit in the use of pediatric-inspired regimens for the management of non-pediatric patients with ALL? In the management of Ph+ ALL patients, does the addition of a TKI to the treatment regimen improve patient outcomes?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/58756/download?token=2qieL5Yh)", "external_id": "cco-28271", "metadata": {"authors": "M. Sabloff, C. Agbassi, K. Howson-Jan, Systemic Treatment Disease Site Group", "document_status": "Archived", "id": "12-16 Jun 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/58756/download?token=2qieL5Yh", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Systemic Therapy in Acute Lymphoblastic Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/28271"} +{"content": "## Guideline Objective\n\nTo determine the breadth and scope of palliative care guidelines that are available in the public domain\n\n## Patient Population\n\nThe target population of the guideline is any individual requiring palliative care.\n\n## Intended Guideline Users\n\nClinicians and staff involved in the delivery of palliative care.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/53316/download?token=sT4UT9ac)", "external_id": "cco-28286", "metadata": {"authors": "T. Walton, N. Coakley, M. Boyd, A. Jakda, L. Phillips", "document_status": "Archived", "id": "18-3 Jul 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/53316/download?token=sT4UT9ac", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Guidelines for Palliative Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/28286"} +{"content": "## Guideline Objective\n\nThe objective of this evidence summary was to examine evidence regarding outcomes associated with different doses of leucovorin (LV) for the treatment of colorectal cancer (CRC) patients.\n\n## Patient Population\n\nPatients with CRC, any stage, and treatment in the adjuvant or advanced setting, as part of a trial that compares different doses of LV in combination with 5-FU chemotherapy.\n\n## Intended Guideline Users\n\nClinicians and pharmacists involved in the prescription and preparation of LV with 5-FU chemotherapy. Cancer Care Ontario (CCO) Systemic Treatment Program\n\n## Research Question(s)\n\nWhat is the effect of altering the dose of LV for patients with CRC in terms of overall survival, progression-free survival (PFS), disease-free survival, response rate, and adverse events/toxicity, given a constant dose of 5-fluorouracil (5-FU)?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/44261/download?token=QA8iUta0)", "external_id": "cco-28291", "metadata": {"authors": "J.J. Biagi, N. Coakley, C. Earle, C. Erlichman, A. Fields", "document_status": "Archived", "id": "12-17 Feb 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/44261/download?token=QA8iUta0", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "The Use of Leucovorin in Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/28291"} +{"content": "## Guideline Objective\n\nScope of Standards: Multidisciplinary care is the hallmark of high-quality cancer management and is demonstrated in activities such as multidisciplinary consultation and clinics, morbidity and mortality conferences, and multidisciplinary cancer conferences. The crucial element is the multidisciplinary cancer conference (or tumour board), which is defined as a regularly scheduled multidisciplinary conference. The intent of the multidisciplinary cancer conference (MCC) is to prospectively review individual cancer patients and make recommendations on best management, keeping in mind that individual physicians are responsible for making the ultimate treatment decision.\n\n## Patient Population\n\nAll cancer patients in Ontario.\n\n## Research Question(s)\n\nWhat are the standards for the structure and function of a multidisciplinary cancer conference in Ontario? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Video: The Value of MCCs in Transforming Cancer Care Opens in a new window Virtual Multidisciplinary Cancer Conferences: Example Virtual Multidisciplinary Cancer Conferences: The Role of Technology in Achieving Success Thoracic Multidisciplinary Cancer Conferences: Example MCC Terms of Reference Patient Case Presentation Agenda: Template The Role of Nurses as Key Members of Multidisciplinary Cancer Conferences Multidisciplinary Cancer Conferences OHIP Billing Code: Frequently Asked Questions Accreditation Information Package for Continuing Professional Development Educational Pamphlet Disease Site Attendance Criteria and Patient Discussion Guidance Setup Checklist Sign-In-Sheet: Template Using Technology to Facilitate Multidisciplinary Cancer Conferences: Example Record: Template Coordinator Job Description: Template Community of Practice: Frequently Asked Questions Multidisciplinary Cancer Conferences: Frequently Asked Questions Environmental Scan and Assessment: Technology Enablers of CCO's MCC Standards Documenting the Multidisciplinary Cancer Conference Process: Advice\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/326/download?token=c0Rx6Tel)", "external_id": "cco-286", "metadata": {"authors": "F. Wright, C. De Vito, B. Langer, A. Hunter , Multidisciplinary Cancer Conference Standards Expert Panel", "document_status": "Current", "id": "MCC Jun 2006", "pdf_url": "https://www.cancercareontario.ca/en/file/326/download?token=c0Rx6Tel", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Multidisciplinary Cancer Conference Standards", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/286"} +{"content": "## Guideline Objective\n\nTo develop provincial standards that define the organizational and practice-setting features expected of a diagnostic assessment program (DAP). These standards represent one of a series of strategies that are needed to achieve the overall goal of improved rapid access to diagnosis. These standards apply to the organization of DAPs and include the full spectrum of multidisciplinary diagnostic assessment leading to treatment.\n\n## Intended Guideline Users\n\nThis guidance is directed towards practicing clinical teams and clinical and administrative leaders, including regional cancer program leaders and Local Health Integration Network (LHIN) leaders, who contribute to and are accountable for improving the access to and quality of care.\n\n## Research Question(s)\n\nWhat are the optimal organizational and practice setting features of a cancer diagnostic assessment program for Ontario? Areas of interest included the organization, process, and evaluative measures.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/48141/download?token=zxh02NLI)", "external_id": "cco-296", "metadata": {"authors": "M. Brouwers, J. Crawford, P. Elison, W.K. Evans, A. Gagliardi, D. Holmes, J. Lacourciere, D. Lo, V. Mai, S. McNair, T. Minuk, T.K. Oliver, L. Rabeneck, C. Rand, J. Ross, J. Smylie, J. Srigley, H. Stern, M. Trudeau , Diagnostic Assessment Programs Standards Panel", "document_status": "Archived", "id": "DAP Jun 2007", "pdf_url": "https://www.cancercareontario.ca/en/file/48141/download?token=zxh02NLI", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 3, "source": "cco", "title": "Organizational Standards for Diagnostic Assessment Programs", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/296"} +{"content": "## Guideline Objective\n\nThe Cancer Care Ontario Patient Education Program Committee in collaboration with the Program in Evidence-Based Care (PEBC) has reviewed the National Cancer Institute\u2019s (NCI) guidelines, Guidelines on Establishing Comprehensive Cancer Patient Education Services, from the Cancer Patient Education Network (CPEN) and endorses the adoption of the Guidelines, with some revision, for use in Ontario.\n\n## Intended Guideline Users\n\nAdministrators of Regional Cancer Programs, Regional Vice Presidents, and patient education experts to facilitate the rollout of a provincial work plan for patient education services. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74026/download?token=8AjmLY5g)", "external_id": "cco-301", "metadata": {"authors": "Patient Education Program Committee", "document_status": "Archived", "id": "20-1 Aug 2006", "pdf_url": "https://www.cancercareontario.ca/en/file/74026/download?token=8AjmLY5g", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Establishing Comprehensive Cancer Patient Education Services", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/301"} +{"content": "## Guideline Objective\n\nThe purpose of this document is to promote optimal utilization of oncology advanced practice nursing (APN) roles in the Ontario healthcare system through improved stakeholder and employer understanding about the purpose and characteristics of these roles.\n\n## Intended Guideline Users\n\nNurses, adminstrators, researchers\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/30106/download?token=AlU7v-ie)", "external_id": "cco-3166", "metadata": {"document_status": "Current", "id": "GL-C50-06 Jan 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/30106/download?token=AlU7v-ie", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Clarifying the Roles of Clinical Nurse Specialists and Nurse Practitioners in Delivery of Cancer Care in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3166"} +{"content": "## Guideline Objective\n\nCancer Care Ontario struck the Ontario Neuroendocrine Expert Panel to develop recommendations for the organization and delivery of radionuclide (RN) therapy for NET patients in Ontario. The work was supported by Cancer Care Ontario\u2019s Program in Evidence-Based Care (PEBC) division, who performed a formal search for evidence to support these guidelines, and for existing guidelines in other jurisdictions. Data sources available to Cancer Care Ontario were also used to provide information on current patterns of care.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19061/download?token=yYbYfWfn)", "external_id": "cco-3171", "metadata": {"authors": "Expert Panel", "document_status": "Current", "id": "GL-C50-01 Jan 2011", "pdf_url": "https://www.cancercareontario.ca/en/file/19061/download?token=yYbYfWfn", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Radionuclide Therapy for Patients with Neuroendocrine Tumors (NETs) in Ontario: Expert Panel Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3171"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to make recommendations, based on data from randomized controlled trials (RCTs), regarding treatment strategies for cure and/or organ preservation in patients with locally advanced nonmetastatic (Stage III to IVB) squamous cell carcinoma of the head and neck (LASCCHN). The treatment strategies assessed are those that utilize systemically administered drugs in combination or in sequence with radiation and/or surgery.\n\n## Patient Population\n\nPatients with LASCCHN being considered for curative intent treatment\n\n## Intended Guideline Users\n\nClinicians and other healthcare professionals involved in the management of LASCCHN\n\n## Research Question(s)\n\nIn patients with unresected squamous cell carcinoma of the head and neck, what are the chemotherapy regimens that, administered concurrently with conventional or intensified radiotherapy, are superior or equivalent to other regimens on important outcomes such as tumour response rate, survival rate, and organ preservation with fewer toxicity/adverse events? In postoperative patients with squamous cell carcinoma of the head and neck, what is the optimal chemotherapy regimen that can be administered concurrently with conventional radiotherapy? Compared to chemoradiotherapy, can targeted agents or radiosensitizers improve or maintain outcomes, with reduced adverse events/toxicity, when used alone or in addition to primary radiotherapy in the treatment of patients with squamous cell carcinoma of the head and neck? In patients with squamous cell carcinoma of the head and neck, what are the induction chemotherapy regimens that are superior or equivalent to others on important outcomes such as tumour response rate, survival rate, and organ preservation with fewer toxicity/adverse events? What are the subgroups of patients with squamous cell carcinoma of the head and neck that would benefit more than others from postoperative systemic therapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81896/download?token=EFokHt5H)", "external_id": "cco-31711", "metadata": {"authors": "E. Winquist, C. Agbassi, B. Meyers, J. Yoo, K. Chan, The Head and Neck Disease Site Group", "document_status": "In-Review", "id": "5-11 Jan 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/81896/download?token=EFokHt5H", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Systemic Therapy in the Curative Treatment of Head and Neck Squamous Cell Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31711"} +{"content": "## Guideline Objective\n\nTo evaluate the effectiveness of therapies targeting bone across all stages of prostate cancer\n\n## Patient Population\n\nMen with prostate cancer\n\n## Intended Guideline Users\n\nHealthcare professionals, health care administrators, medical or radiation oncologists who treat genitourinary cancer, urologists, radiologists, nuclear medicine physicians, geriatricians, primary care physicians, and osteoporosis experts.\n\n## Research Question(s)\n\nCan therapeutic interventions reduce osteoporosis-related outcomes in men with prostate cancer receiving androgen deprivation therapy (ADT)? Can therapeutic interventions prevent bone metastases in men with prostate cancer? Can bone-targeted therapies reduce the incidence of SREs, reduce pain, or improve quality of life in men with prostate cancer metastatic to bone? Can bone-targeted therapies improve overall survival in men with established prostate cancer and bone metastases? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/79956/download?token=cH3VvqDS)", "external_id": "cco-31716", "metadata": {"authors": "Members of the Expert Panel on Bone Health and Bone-Targeted Therapies for Prostate Cancer", "document_status": "Current", "id": "3-14 Jun 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/79956/download?token=cH3VvqDS", "type_of_content": "Guidelines & Advice", "version": "3"}, "section_count": 4, "source": "cco", "title": "Bone Health and Bone-Targeted Therapies for Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31716"} +{"content": "## Guideline Objective\n\nThe objective of this work is to provide guidance on identifying which patients with breast cancer who are undergoing mastectomy are candidates for reconstruction, use of nipple-sparing mastectomy (NSM), the best timing of reconstruction (immediate or delayed), whether radiotherapy (RT) should influence timing, the choice between prepectoral versus subpectoral implants, and use of acellular dermal matrix (ADM) and autologous fat grafting as part of the reconstruction process. For this document, \u201creconstruction\u201d refers to immediate or delayed reconstruction of the breast mound, not including aesthetic flat closure.\n\n## Patient Population\n\nPatients diagnosed with non-metastatic breast cancer who will undergo therapeutic mastectomy and are considering or decided on reconstructive surgery. For purposes of this document, reconstruction includes both immediate and delayed reconstruction with implants and/or autologous tissue but does not include aesthetic flat closure.\n\n## Intended Guideline Users\n\nSurgeons (general surgeons, surgical oncologists, plastic surgeons), radiation oncologists, and other clinicians involved in conducting mastectomies or in post-mastectomy reconstruction and adjuvant treatment. Members of the Breast Cancer Advisory Committee, Ontario Health (Cancer Care Ontario), and others involved in the review and update of the Breast Cancer Pathway Map.\n\n## Research Question(s)\n\nWhat is the effect of patient factors (smoking status, body mass index, breast size, age), comorbidities (diabetes, hypertension), or oncologic factors (previous breast surgery, previous radiotherapy (RT) to the breast/chest, inflammatory breast cancer, skin involvement) on post-mastectomy breast reconstruction outcomes? a) In patients with breast cancer undergoing therapeutic mastectomy, is there a difference in outcomes in immediate versus delayed reconstruction for patients who do not receive RT? b) In patients with breast cancer undergoing therapeutic mastectomy, is there a difference in outcomes in immediate versus delayed reconstruction for patients who receive RT? a) In patients with breast cancer who are candidates for SSM/NSM and reconstruction, is there a difference in outcomes between NSM and SSM? b) In patients with breast cancer, do oncologic outcomes for NSM vary according to the criteria used in selecting patients for NSM (e.g., tumour to nipple distance) or how nipple/areolar involvement is assessed (e.g., clinical examination, mammography, MRI, other imaging, biopsy of areola/nipple/nipple core, frozen/intraoperative or permanent section)? c) In patients with breast cancer and NSM, what surgical factors have been reported that influence Does the use of prepectoral implants for postmastectomy breast construction result in differences in outcomes than subpectoral implants? After therapeutic mastectomy, do outcomes differ for breast reconstruction using human-derived ADM, synthetic absorbable matrix, or no scaffolding/matrix? Are there differences in outcomes between different human ADMs or different synthetic absorbable matrices? What are the benefits and risks of autologous fat grafting (lipofilling) as an adjunct to breast reconstruction? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Breast Cancer Reconstruction Surgery\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/79936/download?token=foNp1bpT)", "external_id": "cco-31721", "metadata": {"authors": "Toni Zhong, Glenn G Fletcher, Muriel Brackstone, Simon Frank, Renee Hanrahan, Vivian Miragias, Christiaan Stevens, Danny Vesprini, Alyssa Vito, Frances C Wright, The Breast Reconstruction Expert Panel", "document_status": "Current", "id": "GL 17-10 v2 Mar 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/79936/download?token=foNp1bpT", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Postmastectomy Breast Reconstruction in Patients with Non-Metastatic Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31721"} +{"content": "## Guideline Objective\n\nTo define self-management education interventions, and essential components or elements, with respect to cancer. More specifically, to identify self-management education interventions that have been shown to support patients with cancer in developing the skills needed for effective self-management of disease, and self-management of the acute or immediate, long-term, and late harmful effects of cancer treatment, while avoiding preventable complications and improving quality of life.\n\n## Patient Population\n\nThe target population consists of adult patients 18 years and older in the treatment or recovery/survivorship phases of the cancer journey.\n\n## Intended Guideline Users\n\nThis evidence summary is targeted for healthcare providers involved in the development of programs to enhance patient education and self-management support, and clinicians and researchers.\n\n## Research Question(s)\n\nWhat is the effectiveness of self-management education interventions in reducing physical symptoms and emotional distress in adult patients with cancer? What components or elements of each self-management education intervention are associated with the strength of its effectiveness? Are there patient characteristics that are associated with each effect found?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/78476/download?token=i9SWqbsh)", "external_id": "cco-31726", "metadata": {"authors": "D. Howell, T. Harth, J. Brown, C. Bennett, S. Boyko, Patient Education Program Committee", "document_status": "Archived", "id": "20-3 Jan 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/78476/download?token=i9SWqbsh", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Self-Management Education for Patients with Cancer: Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31726"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the choice of surgery, radiation therapy (RT), or the combination of surgery plus RT for survival and local control in patients with localized Ewing\u2019s sarcoma of bone following neoadjuvant chemotherapy. To determine the appropriate surgical planning imaging (pre-chemotherapy magnetic resonance imaging [MRI] or post-chemotherapy MRI) to identify optimum resection margins in patients with localized Ewing\u2019s sarcoma who undergo surgery following neoadjuvant chemotherapy.\n\n## Patient Population\n\nPatients of any age diagnosed with localized Ewing's sarcoma of bone who have completed neoadjuvant chemotherapy for the first objective Patients of any age diagnosed with localized Ewing's sarcoma of bone who will undergo surgical management following neoadjuvant chemotherapy for the second objective\n\n## Intended Guideline Users\n\nGeneral surgeons, orthopaedic oncology surgeons, medical oncologists, radiation oncologists, pathologists, radiologists and other clinicians who are involved in the treatment of the target patients in the province of Ontario.\n\n## Research Question(s)\n\nAmong the options of surgery alone, RT alone, and the combination of RT plus surgery, which is the optimum treatment strategy to improve clinical outcomes (i.e., overall survival [OS], relapse-free survival [RFS]/progression-free survival [PFS]/event-free survival [EFS]/disease-free survival [DFS]/local control, toxicities/complications, and patient-reported outcomes) in patients with localized Ewing\u2019s sarcoma of bone following neoadjuvant chemotherapy? Between pre-chemotherapy MRI and post-chemotherapy MRI, which surgical planning imaging is the most appropriate to plan an optimal resection (e.g., negative margins) in patients with localized Ewing\u2019s sarcoma of bone who undergo surgical resection following neoadjuvant chemotherapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74376/download?token=0ClNmWyI)", "external_id": "cco-31731", "metadata": {"authors": "J. Werier, X. Yao, J. Caudrelier, G. Di Primio, M. Ghert, A. Gupta, R. Kandel, S. Verma, Sarcoma Disease Site Group", "document_status": "Current", "id": "11-6 Feb 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/74376/download?token=0ClNmWyI", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Optimal Treatment Strategies for Localized Ewing's Sarcoma of Bone after Neoadjuvant Chemotherapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31731"} +{"content": "ID: 21-1 Apr 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: A. Whitton, P. Warde, M. Sharpe, T.K. Oliver, K. Bak, K. Leszczynski, S. Etheridge, K. Fleming, E. Gutierrez, L. Favell, N. Assasi, E. Green", "external_id": "cco-31741", "metadata": {"authors": "A. Whitton, P. Warde, M. Sharpe, T.K. Oliver, K. Bak, K. Leszczynski, S. Etheridge, K. Fleming, E. Gutierrez, L. Favell, N. Assasi, E. Green", "document_status": "Archived", "id": "21-1 Apr 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Organizational Standards for the Delivery of Intensity Modulated Radiation Therapy (IMRT) in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31741"} +{"content": "## Guideline Objective\n\nThese recommendations suggest various imaging strategies for the definitive treatment of cervical cancer utilizing intracavitary brachytherapy. In this document, best practice recommendations will be outlined, discussing the roles of various imaging modalities and stratifying them in terms of clinical evidence for cervix brachytherapy. The necessary resources required to implement each strategy successfully will be documented. In doing so, these recommendations provide a long-term direction for image guided brachytherapy (IGBT) of cervical cancer in the province of Ontario.\n\n## Intended Guideline Users\n\nProviders (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19066/download?token=bX5MFpyx)", "external_id": "cco-3176", "metadata": {"authors": "Ontario Gynaecological Community of Practice of the Radiation Treatment Program of Cancer Care Ontario", "document_status": "Current", "id": "GL-C50-16 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/19066/download?token=bX5MFpyx", "type_of_content": "Guidelines & Advice, Health Technology Assessment"}, "section_count": 2, "source": "cco", "title": "Imaging Strategies for Definitive Intracavitary Brachytherapy of Cervical Cancer - Recommendation Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3176"} +{"content": "## Guideline Objective\n\nTo update clinical guidance on the use of multigene profiling assays in individuals with early-stage invasive breast cancer.\n\n## Patient Population\n\nIndividuals diagnosed with early-stage invasive breast cancer for whom further information is needed for prognosis and treatment decision making. In this guideline, early-stage invasive breast cancer is defined as stage I to III breast cancers that are surgically operable and do not have evidence of inflammatory, locally recurrent or distant metastatic disease with pT1-T3, pN0-N1a based on surgical pathologic staging.\n\n## Intended Guideline Users\n\nThis guideline is targeted for clinicians and policy makers involved in the diagnosis and treatment of breast cancer.\n\n## Research Question(s)\n\nWhat is the clinical utility (i.e., the ability of a test to provide information that is useful to direct treatment and ultimately improve patient outcomes) of multigene profiling assays (i.e., Oncotype DX, Prosigna, EndoPredict, MammaPrint, Breast Cancer Index) for patients with early-stage invasive breast cancer for: a) chemotherapy in the adjuvant setting? b) extended endocrine therapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/80126/download?token=qkr4obze)", "external_id": "cco-31766", "metadata": {"authors": "Members of the Multigene Profiling Assays in Early-Stage Breast Cancer Expert Panel", "document_status": "Current", "id": "GL MOTAC-4 Jun 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/80126/download?token=qkr4obze", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "Clinical Utility of Multigene Profiling Assays in Invasive Early-Stage Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31766"} +{"content": "## Guideline Objective\n\nTo determine when adjuvant radiation therapy (RT) should be considered for stage I-III melanoma patients following resected curative treatment.\n\n## Patient Population\n\nPatients diagnosed with stage I-III cutaneous melanoma who have received curative resection of their melanoma. The target population includes both patients diagnosed with primary melanoma and those with recurrence at the primary site or nodal recurrence.\n\n## Intended Guideline Users\n\nAll members of the multidisciplinary melanoma team, including radiation oncologists, medical oncologists, surgeons, and dermatologists.\n\n## Research Question(s)\n\nIs adjuvant RT to the primary site appropriate after resected curative treatment for primary melanoma? In patients with melanoma? In patients with desmoplastic/neurotropic melanoma? In patients with primary melanoma with satellites? Is adjuvant RT to the regional nodal basin appropriate after resected curative treatment in patients at high risk for regional recurrence of melanoma? Is adjuvant RT appropriate after resected curative treatment for in-transit primary melanomas? Is adjuvant RT appropriate after curatively resected treatment for recurrent melanoma? For recurrence at the primary site? For in-transit recurrence? For recurrence within the lymph node basin? Does a standard RT fractionation schedule provide equivalent disease control compared with a hypofractionated schedule? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69721/download?token=amJRPIcT)", "external_id": "cco-31771", "metadata": {"authors": "A. Sun, L.H. Souter, T.P. Hanna, A.M. Joshua, E. McWhirter, S. Rajagopal, T. Petrella, F. Wright, Melanoma Disease Site Group", "document_status": "In-Review", "id": "8-9 Jan 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/69721/download?token=amJRPIcT", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "The Use of Adjuvant Radiation Therapy for Curatively Resected Cutaneous Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31771"} +{"content": "## Guideline Objective\n\nTo update the 2015 guideline of the Program in Evidence-Based Care (PEBC) Ontario Health (Cancer Care Ontario) to provide guidance for managing surveillance of patients with stage I, II, III, or resectable IV melanoma who are clinically disease-free after treatment with curative intent (following the definition of American Joint Committee on Cancer [AJCC] Pathological Prognostic Stage Groups in the 2017 Cancer Staging Manual, the 8th edition).\n\n## Patient Population\n\nThese recommendations apply to patients with stage I, II, III, or resectable IV melanoma who are clinically disease-free after treatment with curative intent. Pathological staging is according to the 8th edition AJCC staging system (Appendix 1) [1].\n\n## Intended Guideline Users\n\nIntended users of this guideline are medical oncologists, dermatologists, surgical oncologists, radiation oncologists, family doctors, and other clinicians who are involved in the follow-up care of patients with melanoma in the province of Ontario.\n\n## Research Question(s)\n\nFor adult patients (\u226518 years old) with stage I, II, III, or resectable IV melanoma who are clinically disease-free after receiving curative-intent treatment: Which follow-up evaluations (i.e., clinical follow-up, laboratory tests, photo-surveillance, dermoscopy and imaging) are optimal to improve patient outcomes (e.g., survival, recurrence, side effect from imaging examinations, and patient-reported outcomes)? At what frequency should these evaluations be performed to improve patient outcomes? Which follow-up evaluations (i.e., clinical follow-up, photo-surveillance, and dermoscopy) are optimal to detect a new primary melanoma and improve patient outcomes? At what frequency should these evaluations be performed to detect new primary melanomas and improve patient outcomes? When can these patients be transitioned to primary care for follow-up? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81506/download?token=IBPmWMlc)", "external_id": "cco-31776", "metadata": {"authors": "S. Rajagopal, X. Yao, W. Abadir, T. Baetz, A. Easson, G. Knight, E. McWhirter, C. Nessim, C.F. Rosen, A. Sun, F.C. Wright, T. Petrella, Melanoma Disease Site Group", "document_status": "Current", "id": "8-7 Mar 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81506/download?token=IBPmWMlc", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Surveillance of Patients with Stage I, II, III, or Resectable IV Melanoma Who Were Treated with Curative Intent", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31776"} +{"content": "## Guideline Objective\n\nThe objective of this evidence summary is to outline and summarize the evidence regarding existing healthcare provider tools and/or practices that address the processes for ACP or GoCD.\n\n## Patient Population\n\nAll\n\n## Intended Guideline Users\n\nHealthcare providers who engage in ACP or GoCD with their patients or should engage in ACP or GoCDs with their patients.\n\n## Research Question(s)\n\nWhat tools enable providers to introduce advance care planning or goals of care discussions? What tools enable providers to facilitate advance care planning or goals of care discussions? What tools are best suited for documentation of advance care planning or goals of care discussions?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/53311/download?token=MAfcrwRQ)", "external_id": "cco-31796", "metadata": {"authors": "J. Myers, R. Cosby, D. Gzik, I. Harle, D. Harrold, N. Incardona, T. Walton", "document_status": "Archived", "id": "18-2 Sep 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/53311/download?token=MAfcrwRQ", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Provider Tools for Advance Care Planning and Goals of Care Discussions", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31796"} +{"content": "## Guideline Objective\n\nThis report recommends the adoption of a standard nomenclature system. A concise summary of the nomenclature is tabulated in Appendix B.\n\n## Intended Guideline Users\n\nProviders (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19071/download?token=m5IURaux)", "external_id": "cco-3181", "metadata": {"authors": "Head and Neck Community of Practice of the Radiation Treatment Program of CCO", "document_status": "Current", "id": "GL-C50-12 Feb 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/19071/download?token=m5IURaux", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Contouring Nomenclature - Recommendation Report (Head and Neck Cancer)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3181"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17776/download?token=4ImRtHT1)", "external_id": "cco-31846", "metadata": {"authors": "R. Poon, The Program in Evidence-Based Care Disease Site Group Reviewers, Ontario PET Steering Committee", "document_status": "Current", "id": "pet 2016-1 Nov 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/17776/download?token=4ImRtHT1", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2016", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31846"} +{"content": "## Guideline Objective\n\nThis recommendation report is intended for head and neck radiation therapy treatment utilizing intensity modulated radiation therapy. As written, this report is applicable to 2 Gy per fraction treatments, with target coverage goals for a prescription of 70 Gy in 35 fractions to the high dose target volume, with intermediate dose and low dose disease target volumes receiving 63 Gy and 56 Gy, respectively, in 35 fractions.\n\n## Intended Guideline Users\n\nProviders (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19076/download?token=VCibkTws)", "external_id": "cco-3186", "metadata": {"authors": "Head and Neck Community of Practice of the Radiation Treatment Program of CCO", "document_status": "Current", "id": "GL-C50-13 Feb 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/19076/download?token=VCibkTws", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Dose Objectives for Head and Neck IMRT Treatment Planning - Recommendation Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3186"} +{"content": "## Guideline Objective\n\nTo make recommendations with respect to systemic therapy for the treatment of patients with pancreatic neuroendocrine tumours (pNETs) and midgut neuroendocrine tumours (midgut NETs).\n\n## Patient Population\n\nAdults with a diagnosis of advanced and metastatic pNETs and midgut NETs that have been deemed unresectable after assessment by a neuroendocrine specialist in a multidisciplinary setting. Patients with neuroendocrine carcinomas (NECs) (i.e., poorly differentiated), malignant neuroblastoma, pituitary tumours, thymic tumours, goblet cell carcinoma, bronchial NETs, paragangliomas, mixed NETs, pheochromocytoma, small cell lung cancer, and thyroid cancer are excluded.\n\n## Intended Guideline Users\n\nAll clinicians involved in the treatment of patients with pNETs and midgut NETs. Research Questions Which of the anti-neoplastic systemic therapies (Table 4-1) is the most effective in improving clinical outcomes (i.e., PFS, OS) and quality of life while minimizing adverse events in patients with unresectable advanced or metastatic pNETs? Which of the anti-neoplastic systemic therapies (Table 4-1) is the most effective in improving clinical outcomes (i.e., PFS, OS) and quality of life while minimizing adverse events in patients with unresectable advanced or metastatic midgut NETs? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74266/download?token=8EZkLUfn)", "external_id": "cco-31861", "metadata": {"authors": "K. Zbuk, D. Sivajohanathan, T. Asmis, C. Cho, J. Hallet, D. Laidley, S. Singh, R. Wong, Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL 2-21 Mar 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/74266/download?token=8EZkLUfn", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Systemic therapy for unresectable advanced or metastatic pancreatic and midgut neuroendocrine tumours", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31861"} +{"content": "## Patient Population\n\nThese recommendations apply to adult patients with clinically resectable or resected stage II or III rectal cancer.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management or referral of adult patients with rectal cancer. Research Questions Following appropriate preoperative staging tests, should patients with resectable clinical stage II or III rectal cancer be offered preoperative radiotherapy (RT) (with or without chemotherapy [CT])? What is the role of postoperative RT and/or CT for patients with resected stage II or III rectal cancer who have not received preoperative RT, in terms of improving survival and delaying local recurrence? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/56196/download?token=tu47IDON)", "external_id": "cco-31891", "metadata": {"authors": "Gastrointestinal Cancer Disease Site Group", "document_status": "In-Review", "id": "2-4 Mar 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/56196/download?token=tu47IDON", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 2, "source": "cco", "title": "Preoperative or Postoperative Therapy for the Management of Patients with Stage II or III Rectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/31891"} +{"content": "## Guideline Objective\n\nRepresentatives from Cancer Care Ontario, University Health Network, and other centres in the Greater Toronto Area (GTA) struck a Steering Committee to develop recommendations to: Ensure adequate access to, capacity and sustainability for acute leukemia services in the GTA throughout the patient treatment journey Advance the quality and safety of acute leukemia services\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19081/download?token=nipCHrHT)", "external_id": "cco-3191", "metadata": {"authors": "Acute Leukemia Steering Committee", "document_status": "Current", "id": "GL-C50-02 Jan 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/19081/download?token=nipCHrHT", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Adult Acute Leukemia Services Plan for the Greater Toronto Area - Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3191"} +{"content": "## Guideline Objective\n\nTo recognize the needs in the provision of sarcoma care and to optimize care and resource utilization, Cancer Care Ontario struck an expert panel of physicians, allied health workers and administrators. Together, they developed recommendations for the organization of the management of adult sarcoma patients in Ontario. The work was supported by Cancer Care Ontario\u2019s Program in Evidence-based Care (PEBC), which performed a formal search for evidence to support these guidelines, and for existing guidelines in other jurisdictions. Data sources available to Cancer Care Ontario were mined to provide information on patterns of care and case costing.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19086/download?token=FYu8NJ_n)", "external_id": "cco-3196", "metadata": {"authors": "Expert Panel on Sarcoma", "document_status": "Current", "id": "GL-C50-04-V2 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/19086/download?token=FYu8NJ_n", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 2, "source": "cco", "title": "Adult Sarcoma Management in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3196"} +{"content": "## Guideline Objective\n\nThe goal of this guideline is to: reduce unwanted variation in patient care regarding imaging facilitate timely, streamlined access to appropriate imaging endorse existing relevant, high quality, evidence-based guidelines for cancer imaging from other jurisdictions and avoid costly duplication of effort to develop new guidelines\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19091/download?token=I2xjnfj6)", "external_id": "cco-3201", "metadata": {"document_status": "Current", "id": "GL-C50-11 Jan 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/19091/download?token=I2xjnfj6", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Lung Cancer Imaging Guidelines: Integration with the Lung Cancer Diagnosis and Staging Clinical Pathway - Full Document", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3201"} +{"content": "## Intended Guideline Users\n\nSurgeons, Admininstrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19096/download?token=T9Vx726-)", "external_id": "cco-3211", "metadata": {"authors": "Cancer Surgery Expert Panel", "document_status": "Current", "id": "GL-C50-03 Apr 2006", "pdf_url": "https://www.cancercareontario.ca/en/file/19096/download?token=T9Vx726-", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 1, "source": "cco", "title": "Target Wait Times for Cancer Surgery in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3211"} +{"content": "## Intended Guideline Users\n\nOncology clinicians (oncologists, nurses, pharmacists), IM/IT leaders/staff, decision-support, administration Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Systemic Treatment Computerized Prescriber Order Entry (ST CPOE): Best Practice Guideline for Intravenous and Oral Chemotherapy Executive Summary Systemic Treatment Computerized Prescriber Order Entry (ST CPOE): Best Practice Guideline for Intravenous and Oral Chemotherapy Computer Prescriber Order Entry (CPOE) for Systemic Treatment: Best Practice Guideline - R\u00e9sum\u00e9 (brochure en Fran\u00e7ais) Computer Prescriber Order Entry (CPOE) for Systemic Treatment: Best Practice Guideline - Executive Summary Brochure\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/41046/download?token=cGhMNjr6)", "external_id": "cco-3221", "metadata": {"authors": "V. Kukreti et al", "document_status": "Current", "id": "GL-C50-26 Feb 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/41046/download?token=cGhMNjr6", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Systemic Treatment Computerized Prescriber Order Entry (ST CPOE): Best Practice Guideline for Intravenous and Oral Chemotherapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3221"} +{"content": "## Guideline Objective\n\nRadiation oncology peer review is the evaluation of components of a radiation treatment plan by a second radiation oncologist. Intended Guideline Objectives Providers (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19111/download?token=jCuhXt6d)", "external_id": "cco-3246", "metadata": {"authors": "Provincial Radiation Treatment Program", "document_status": "Current", "id": "GL-C50-10 May 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/19111/download?token=jCuhXt6d", "type_of_content": "Guidelines & Advice, Health System", "version": "1"}, "section_count": 1, "source": "cco", "title": "Radiation Oncology Peer Review Guidance Document", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3246"} +{"content": "## Guideline Objective\n\nThe goal of this recommendation report is to raise awareness of safety straps, to facilitate knowledge transfer and exchange regarding the current implementation of safety straps in centres as well as providing individuals in decision-making roles for RCCs in Ontario with support for an implementation strategy for safety straps.\n\n## Intended Guideline Users\n\nProviders (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists; Medical Records; Administrators)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19121/download?token=gFTi_izi)", "external_id": "cco-3276", "metadata": {"authors": "Ontario Radiation Therapy Community of Practice (RThCoP), Radiation Therapy Professional Advisory Committee (RTPAC)", "document_status": "Current", "id": "GL-C50-22 Oct 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/19121/download?token=gFTi_izi", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Implementation Strategy for Radiation Therapy Safety Straps", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3276"} +{"content": "## Patient Population\n\nFemale patients who are being considered for or are receiving systemic therapy for early-stage invasive breast cancer. The preferred definition of early breast cancer in this guideline is invasive cancers Stage I\u2212IIA (T1N0\u22121, T2N0). Studies with cancer described as operable (no other description of stage) and some studies with both Stage I\u2212IIA and operable Stage IIB\u2212IIIA (sometimes considered locally advanced) are included.\n\n## Intended Guideline Users\n\nClinicians (medical, radiation, and surgical oncologists and general practitioners) who participate in the care of patients with early breast cancer who are suitable for or receiving systemic therapy.\n\n## Research Question(s)\n\nWhat is the optimal adjuvant systemic therapy for female patients with early-stage operable breast cancer, when patient and disease factors are considered? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/41926/download?token=SlHLmSTr)", "external_id": "cco-331", "metadata": {"authors": "A. Eisen, G.G. Fletcher, S. Gandhi, M. Mates, O.C. Freedman, S.F. Dent, M.E. Trudeau , Early Breast Cancer Systemic Therapy Consensus Panel", "document_status": "In-Review", "id": "1-21 Sep 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/41926/download?token=SlHLmSTr", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Optimal Systemic Therapy for Early Female Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/331"} +{"content": "## Guideline Objective\n\nRadiation/electromagnetic interference (EMI) may adversely affect the operation of electronic infusion pumps during the delivery of radiation treatment and compromise patient care. It is important to provide recommendations for clinical practice regarding this issue.\n\n## Intended Guideline Users\n\nProviders (Radiation Oncologists, Radiation Therapists, Treatment Planners, Medical Physicists; Medical Records; Administrators) Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/19126/download?token=8Qo6b-m1)", "external_id": "cco-3311", "metadata": {"authors": "Radiation Treatment Program, Nursing and Psychosocial Oncology Program, Systemic Treatment Program", "document_status": "Current", "id": "GL-C50-29 Mar 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/19126/download?token=8Qo6b-m1", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Use of Continuous Infusion Pumps During Radiation Treatment: Recommendation Report (March 2012)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3311"} +{"content": "## Guideline Objective\n\nThis document provides guidance on the key features, functionalities and components of an Oncology aEMR which are required to support integrated cancer care and treatment. The core document is comprised of three distinct, yet interconnected chapters which can be used as stand-alone resources or in conjunction with the information contained throughout the documents.\n\n## Intended Guideline Users\n\nClinicians, program and operational leadership, health information technology professionals, clinical informatics staff, health system planners\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19131/download?token=KiCFqz4c)", "external_id": "cco-3331", "metadata": {"authors": "Dr. Vishal Kukreti, Sara Lankshear, Arthur Manzon, Nancy Wolf, Shafiq Habib, Nadia Solimani, Bill O\u2019Brien, Yaron Derman, Tim Yardley, Dr. Yuval Bitan, Dr. Tony Easty", "document_status": "Current", "id": "GL-C50-14 Mar 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/19131/download?token=KiCFqz4c", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Ontario Oncology Information System Standards: Defining its Meaningful Use", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3331"} +{"content": "## Guideline Objective\n\nThe objective of this document is to describe recommended entry and transfer of care criteria for lung Diagnostic Assessment Programs (DAPs) in Ontario.\n\n## Intended Guideline Users\n\nRespirologists, thoracic surgeons, radiologists, oncologists, family physicians, general practitioners, emergency department physicians, and other primary care providers (e.g. nurse practitioners, registered nurses, physician assistants, etc.)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/39296/download?token=lgk7xERH)", "external_id": "cco-3356", "metadata": {"authors": "Gail Darling, Melissa Kaan, Sabrina Padewski, Marla Ash, Brigitta Bokkers, Marcio Gomes, Mark Landis, Susan Lee, Judy Linton, Beth Lowcock, Michael Coughlin, Kasia Czarnecka-Kujawa, Bill Geddie, Rosalyn Juergens, Anna Kone, Patricia Marchand, Debora Prokopich Buzzi, Anita Riddall, Jonathan Wan", "document_status": "Education and Information", "id": "GL-C50-23-V1 Dec 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/39296/download?token=lgk7xERH", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 2, "source": "cco", "title": "Recommendation Report: Entry and Transfer of Care Criteria for Lung Diagnostic Assessment Programs (DAPs) in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/3356"} +{"content": "## Patient Population\n\nFemale patients with locally advanced breast cancer (LABC). For purposes of this guideline, LABC includes Stages IIB and IIIABC and inflammatory cancer, as defined in the AJCC Cancer Staging Manual, 6th edition. Most studies in the evidentiary base (see Section 2) included heterogeneous populations spanning Stages IIB \u2013 IIIC and sometimes included inflammatory breast cancer. Very few studies dealt only with Stage III or specific subgroups such as patients with T3N0 cancer. As most of the major studies did not report results separately for patients with Stage IIB and Stage III cancers, the evidence did not support recommendations based on a narrower definition of LABC or subdivided by stage. Although some people do not consider Stage IIB to be locally advanced, there is an increasing trend to treat less bulky disease (Stage IIB) in a similar manner, including neoadjuvant therapy; therefore, the recommendations may also be applicable to this group.\n\n## Intended Guideline Users\n\nSurgeons, and medical and radiation oncologists specializing in breast cancer.\n\n## Research Question(s)\n\nIn female patients with locally advanced breast cancer with good response to neoadjuvant therapy, what is the role of breast-conserving surgery (BCS) compared with mastectomy? a. In female patients with locally advanced breast cancer who have had a mastectomy is radiotherapy indicated? b. In female patients with locally advanced breast cancer does locoregional irradiation result in higher survival and lower recurrence rates compared with breast/chest wall irradiation alone? c. In female patients with locally advanced breast cancer and pathologically complete response to neoadjuvant therapy is radiotherapy indicated? In female patients with locally advanced breast cancer who receive neoadjuvant chemotherapy is sentinel lymph node biopsy (SLNB) or axillary dissection the most appropriate axillary staging procedure? Is SLNB indicated before neoadjuvant chemotherapy rather than at the time of surgery? How should female patients with locally advanced breast cancer who do not respond to initial neoadjuvant therapy be treated? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/52406/download?token=DxSrH_B2)", "external_id": "cco-336", "metadata": {"authors": "M. Brackstone, G.G. Fletcher, I.S. Dayes,, Y. Madarnas, S.K. SenGupta, S. Verma , Breast Cancer Disease Site Group", "document_status": "In-Review", "id": "1-19 Sep 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/52406/download?token=DxSrH_B2", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Locoregional Therapy of Locally Advanced Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/336"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as breast cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31696/download?token=GDNuPMpO)", "external_id": "cco-356", "metadata": {"authors": "B. Mullen, G.G. Fletcher, S. SenGupta, S. Verma, L. Elavathil, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-1 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31696/download?token=GDNuPMpO", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/356"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as gastrointestinal cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31701/download?token=4CDXBWgg)", "external_id": "cco-361", "metadata": {"authors": "A. Pollett, G.G. Fletcher, D. Hurlbut, P. Karanicolas, M. Khalifa, C. Streutker, J. Srigley", "document_status": "Archived", "id": "22-2-2 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31701/download?token=4CDXBWgg", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Gastrointestinal Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/361"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/67576/download?token=JCwxAaOG)", "external_id": "cco-366", "metadata": {"authors": "T. Asmis, L. Souter, C. Agbassi, K. Dennis, T. Elfiki, J. Hallet, S. Berry", "document_status": "In-Review", "id": "GL 2-26 Aug 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/67576/download?token=JCwxAaOG", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 1, "source": "cco", "title": "Systemic Therapy for Advanced Gastric and Gastro-Esophageal Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/366"} +{"content": "Type of Content: Guidelines & Advice", "external_id": "cco-36681", "metadata": {"type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "View Survivorship Guidelines", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/36681"} +{"content": "Type of Content: Guidelines & Advice", "external_id": "cco-36686", "metadata": {"type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "View Survivorship Guidelines", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/36686"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as genitourinary cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31706/download?token=sTLYgog0)", "external_id": "cco-371", "metadata": {"authors": "J. Srigley, G.G. Fletcher, J. Barkin, R.H. Breau, A. Loblaw, M. Moussa, L. Sugar, A. Pollett", "document_status": "Archived", "id": "22-2-3 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31706/download?token=sTLYgog0", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Genitourinary Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/371"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the use of bisphosphonates and other bone-modifying agents as adjuvant therapy for patients with breast cancer.\n\n## Patient Population\n\nPatients with early or locally advanced (non-metastatic) breast cancer\n\n## Intended Guideline Users\n\nMedical oncologists and other clinicians involved in post-surgical (adjuvant) treatment of patients with breast cancer Research Questions Does administration of bisphosphonates or other bone-modifying agents as adjuvant treatment in patients with breast cancer reduce metastasis and/or recurrence and improve survival? Does effectiveness depend on patient or disease characteristics, especially age or menopausal status (natural or induced menopause)? Do effectiveness and adverse effects differ according to which bisphosphonate or bone-modifying agent is used? What doses, duration of administration, and route (intravenous, oral) are optimal? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81816/download?token=Ceoh72p-)", "external_id": "cco-37761", "metadata": {"authors": "Sukhbinder Dhesy-Thind, Glenn G Fletcher, Phillip S Blanchette, Mark J Clemons, Sonal Gandhi, Rasna Gupta, Mihaela Mates, Ted Vandenberg", "document_status": "Current", "id": "GL 1-22-A Jul 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/81816/download?token=Ceoh72p-", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37761"} +{"content": "## Guideline Objective\n\nThis clinical practice guideline was produced jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO). It updates earlier CCO and ASCO guidelines on adjuvant chemotherapy and radiation therapy for patients with non-small-cell lung cancers (NSCLCs). This clinical practice guidelines addresses two principal questions in the treatment of patients with completely resected NSCLCs: the overall survival benefit and role of adjuvant systemic therapy, including chemotherapy and newer targeted therapy and immunotherapy options, and adjuvant radiation therapy. The joint guideline is published in the Journal of Clinical Oncology (JCO) and can be accessed directly from the link \"Full Report\" below. ASCO updated selected recommendations in 2022 in their Amended recommendations (Rapid update) Opens in a new window . This document is meant to be used together with the original guideline (Full Report). An assessment conducted in November 2024 by the OH-CCO Lung Cancer Disease Site Group ARCHIVED Guideline 7-A-2016-3 due to the rapidly changing treatment landscape. It is no longer considered current, pending future work.\n\n## Patient Population\n\nPatients with completely resected stage I to IIIA NSCLCs (completely resected, defined as no macroscopic disease and uninvolved resection margins pathologically after surgery).\n\n## Intended Guideline Users\n\nSurgical oncologists, medical oncologists, radiation oncologists, and other clinicians who treat patients in the target population. Research Questions This clinical practice guideline addresses two overarching clinical questions: What is the benefit of adjuvant systemic therapy in patients with completely resected stage I to IIIA NSCLCs? What is the benefit of adjuvant radiation therapy in patients with completely resected stage I to IIIA NSCLCs?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17351/download?token=TNin-6xR)", "external_id": "cco-37771", "metadata": {"authors": "Mark G. Kris, Laurie E. Gaspar, Jamie E. Chaft, Erin B. Kennedy, Christopher G. Azzoli, Peter M. Ellis, Steven H. Lin, Harvey I. Pass, Rahul Seth, Frances A. Shepherd, David R. Spigel, John R. Strawn, Yee C. Ung, Michael Weyant", "document_status": "Archived", "id": "GL-7-A-2016-3 Apr 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/17351/download?token=TNin-6xR", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non\u2013Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37771"} +{"content": "## Guideline Objective\n\nThis clinical practice guideline was produced jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO). It updates the 2012 CCO guideline on brachytherapy for patients with prostate cancer. The update provides evidence-based recommendations for different patient risk groups, and specifies the most effective forms of brachytherapy. The joint guideline is published in the Journal of Clinical Oncology (JCO) and can be accessed directly from the link \"Full Report\" below.\n\n## Patient Population\n\nPatients with newly diagnosed prostate cancer who require or choose active treatment and are not considering, or are not suitable for, active surveillance.\n\n## Intended Guideline Users\n\nRadiation oncologists, urological surgeons, and other clinicians who provide care for patients defined by the target population. Research Questions In patients with newly diagnosed prostate cancer, what is the efficacy of brachytherapy alone for clinical outcomes compared with external beam radiation therapy (EBRT) alone or radical prostatectomy (RP) alone? In patients with newly diagnosed prostate cancer, what is the efficacy of brachytherapy combined with EBRT for clinical outcomes compared with brachytherapy alone, EBRT alone, or RP alone? Among the isotopes used for low\u2013dose rate (LDR) brachytherapy (eg, iodine-125 [125I], palladium-103 [103Pd], and cesium-131 [131Cs]), which isotope maximizes clinical outcomes when used in patients with newly diagnosed prostate cancer?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17356/download?token=ylHmGXQM)", "external_id": "cco-37776", "metadata": {"authors": "Joseph Chin, R. Bryan Rumble, Marisa Kollmeier, Elisabeth Heath, Jason Efstathiou, Tanya Dorff, Barry Berman, Andrew Feifer, Arthur Jacques, D. Andrew Loblaw, American Society of Clinical Oncology", "document_status": "In-Review", "id": "GL-3-A-2016-1 Mar 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/17356/download?token=ylHmGXQM", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Brachytherapy for Patients With Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37776"} +{"content": "## Guideline Objective\n\nThe endorsed guideline will be used to develop quality indicators and to set targets for delivering well follow-up care to breast cancer survivors in Ontario.\n\n## Intended Guideline Users\n\nCCO\u2019s Position Statement on Guidelines for Breast Cancer Well Follow-Up Care is intended for healthcare providers across the province. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/46541/download?token=iFVfUBjV)", "external_id": "cco-37786", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/46541/download?token=iFVfUBjV", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Cancer Care Ontario\u2019s Position Statement on Guidelines for Breast Cancer Well Follow-Up Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37786"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17791/download?token=ZAT1R_Ps)", "external_id": "cco-37826", "metadata": {"authors": "R. Poon , The Program in Evidence-Based Care Disease Site Group Reviewers, Ontario PET Steering Committee", "document_status": "Current", "id": "2016-2 Apr 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/17791/download?token=ZAT1R_Ps", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2016", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37826"} +{"content": "## Guideline Objective\n\nTo provide a synthesis and summary of evidence surrounding the clinical utility of positron emission tomography (PET) imaging in patients with anal canal cancer.\n\n## Patient Population\n\nAdult patients diagnosed with anal canal cancer.\n\n## Intended Guideline Users\n\nThis recommendation report is intended to guide the Ontario PET Steering Committee in their decision making with respect to the development of indications. This recommendation report may also be useful to inform clinicians who are involved in the management of patients with anal canal cancer. Research Questions What benefit to clinical management does PET or PET/CT contribute to the initial staging of anal canal cancer? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response of anal canal cancer? What benefit to clinical management does PET or PET/CT contribute when the recurrence of anal canal cancer is suspected or proven? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/48031/download?token=LvvnuyxW)", "external_id": "cco-37831", "metadata": {"authors": "A. Mahmud, R. Poon, D. Jonker", "document_status": "Current", "id": "PET 17 Jan 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/48031/download?token=LvvnuyxW", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "PET Imaging in Anal Canal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37831"} +{"content": "## Patient Population\n\nPatients suspected of PNS, with positive or negative onconeural antibodies, who had negative conventional imaging prior to PET scan.\n\n## Intended Guideline Users\n\nThis evidence summary is intended to guide the Ontario PET Steering Committee in their decision making with respect to the development of indications. This evidence summary may also be useful to inform clinicians who are involved in the management of patients with PNS. Research Questions What is the diagnostic accuracy of PET or PET/CT in detecting occult malignancies in patients with PNS?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/36721/download?token=KKHAgskH)", "external_id": "cco-37846", "metadata": {"authors": "C. Harlos, R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 18 May 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/36721/download?token=KKHAgskH", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 2, "source": "cco", "title": "PET Imaging in Paraneoplastic Neurological Syndromes", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37846"} +{"content": "## Guideline Objective\n\nTo develop recommendations on the optimal surgical management of gastric cancer in Ontario.\n\n## Patient Population\n\nThese recommendations apply to adult men and women with Stage I to IV gastric cancer who are being considered for surgery. Gastroesophageal junction tumours and early gastric cancers are excluded because they require additional considerations.\n\n## Intended Guideline Users\n\nIntended users of this guidance document are surgeons, gastroenterologists, medical oncologists, radiation oncologists, and the multidisciplinary team who treat gastric cancer. Research Questions What is/are the optimal techniques(s) to adequately stage gastric cancer? What is the optimal technique of gastric cancer surgery with curative intent with respect to: D2 lymph node dissection? D1 lymph node dissection? The minimal number of lymph nodes needed to be dissected for curative-intent resection? The minimal gross margin for curative-intent resection? Laparoscopic versus open resection? What are the indications for surgery for Stage IV gastric cancer in: Asymptomatic patients? Symptomatic patients? What is the relationship between surgical volumes and outcomes? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81011/download?token=XMTRYVwq)", "external_id": "cco-37866", "metadata": {"authors": "N. Coburn, R. Cosby, L. Klein, G. Knight, R. Malthaner, J. Mamazza, D. Mercer, J. Ringash, Surgical Management of Gastric Cancer Guideline Development Group", "document_status": "Current", "id": "2-19 Jan 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/81011/download?token=XMTRYVwq", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Staging and Surgical Approaches in Gastric Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37866"} +{"content": "## Guideline Objective\n\nTo recommend systemic therapy options for women with recurrent epithelial ovarian cancer including fallopian tube and primary peritoneal cancers.\n\n## Patient Population\n\nThe target population comprises women with recurrent epithelial ovarian cancer who have previously received platinum-based chemotherapy. Specific subgroups of interest are identified based on response to therapy.\n\n## Intended Guideline Users\n\nThe intended users of this guideline are gynecologic oncologists or medical oncologists in the province of Ontario. Research Questions What is the optimal systemic therapy for women with recurrent ovarian cancer who have previously received platinum-based chemotherapy? Accordingly, the following comparisons were considered: any systemic therapy option vs. another; and any systemic therapy option vs. placebo. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81061/download?token=7E3cDPQm)", "external_id": "cco-37871", "metadata": {"authors": "J. Francis, N. Coakley, L. Elit, E.B. Kennedy, H. Mackay, The Gynecologic Cancer Disease Site Group", "document_status": "In-Review", "id": "4-3 Jul 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/81061/download?token=7E3cDPQm", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 3, "source": "cco", "title": "Systemic Therapy for Recurrent Epithelial Ovarian Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/37871"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as gynecologic cancer should or should not have a routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31716/download?token=8CHkgp7G)", "external_id": "cco-381", "metadata": {"authors": "M. Khalifa, G.G. Fletcher, B. Chapman, D. Daya, J. Dodge, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-4 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31716/download?token=8CHkgp7G", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Gynecologic Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/381"} +{"content": "## Guideline Objective\n\nThe primary objective of this report is to determine the optimal targeted therapies for locally advanced or metastatic renal cell cancer (mRCC). The secondary objective is to determine whether a combination of targeted agents is better than any single targeted agent.\n\n## Patient Population\n\nAdult patients with inoperable locally advanced or mRCC.\n\n## Intended Guideline Users\n\nOncologists who treat patients with RCC. Research Questions What are the optimal targeted therapies for locally advanced or mRCC? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/34706/download?token=N3B7Y2_q)", "external_id": "cco-38226", "metadata": {"authors": "S. Hotte, J. Brown, C. Canil, U. Emmenegger, C. Walker-Dilks, E. Winquist, Genitourninary Disease Site Group", "document_status": "In-Review", "id": "3-8-4 May 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/34706/download?token=N3B7Y2_q", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "The Use of Targeted Therapies in Patients with Inoperable Locally Advanced or Metastatic Renal Cell Cancer: Updated Guideline 2017", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38226"} +{"content": "## Guideline Objective\n\nTo inform Canadian health authorities, program leaders, administrators and healthcare providers about the optimal strategies and interventions for the prevention, screening, assessment and management of cancer-related sleep disturbances (insomnia and chronic insomnia) in adult cancer populations. Initial screening for sleep disturbances can be done using the Edmonton Symptom Assessment System Revised (ESAS-r) and the Canadian Problem Checklist.\n\n## Intended Guideline Users\n\nProfessional healthcare providers engaged in the care of adults with cancer. It is also intended to support Canadian health authorities, program leaders and administrators in developing policies and procedures related to survivorship care for individuals with cancer. The guideline is interprofessional in focus, and the recommendations are applicable to direct care providers (e.g., nurses, social workers and family practitioners) in diverse care settings. The scope of practice for different professions may vary according to governmental or professional regulatory standards, and users of this guideline are expected to exercise skill and judgement to determine if the application of the recommendations is within their scope of practice. It is not the intent of this guideline to make recommendations for specialist practitioners (i.e., respirologists, psychologists, psychiatrists and sleep medicine experts). Depending on the factors associated with the sleep disturbance, additional guidance documents should be accessed for further information on specific conditions (e.g., fatigue, pain or depression guidelines). Users may wish to adapt this guideline to fit their local healthcare processes, resources and context as part of knowledge translation and evidence implementation.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18931/download?token=JnVWe-VY)", "external_id": "cco-38461", "metadata": {"authors": "D. Howell, T.K. Oliver, S. Keller-Olaman, J. Davidson, S. Garland, C. Samuels, J. Savard, C. Harris, M. Aubin, K. Olson, J. Sussman, J. MacFarlane, C. Taylor, Canadian Partnership Against Cancer, Canadian Association of Psychosocial Oncology", "document_status": "Education and Information", "pdf_url": "https://www.cancercareontario.ca/en/file/18931/download?token=JnVWe-VY", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "A Pan-Canadian Practice Guideline: Prevention, Screening, Assessment and Treatment of Sleep Disturbances in Adults with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38461"} +{"content": "## Guideline Objective\n\nThis document updates the previous guidelines issued by the Canadian Task Force on Preventive Health Care (2001). The absence of current Canadian recommendations, the recent controversy over the best way to screen for breast cancer among women at average risk of the disease, the availability of new technologies such as magnetic resonance imaging (MRI) and a recent review of the evidence were the basis for selecting this topic for an update by the revitalized Canadian Task Force on Preventive Health Care. Recommendations are presented for the use of mammography, MRI, breast self-examination and clinical breast examination to screen for breast cancer among women at average risk of disease (defined as those with no previous breast cancer, no history of breast cancer in a first-degree relative, no known mutations in the BRCA1/BRCA2 genes or no previous exposure of the chest wall to radiation). Recommendations are provided separately for women aged 40\u201349, 50\u201369 and 70\u201374 years and are aimed at clinicians and policy-makers. The recommendations are intended to inform both organized and opportunistic screening.\n\n## Patient Population\n\nWomen at average risk of disease (defined as those with no previous breast cancer, no history of breast cancer in a first-degree relative, no known mutations in the BRCA1/BRCA2 genes or no previous exposure of the chest wall to radiation), ages 40\u201349, 50\u201369 and 70\u201374 years\n\n## Intended Guideline Users\n\nClinicians and policy-makers Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Breast Screening Guidelines Summary Ontario Breast Screening Program: Guidelines Summary Ontario Breast Screening Program: Information for Healthcare Providers\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18961/download?token=jaJ0Qzlr)", "external_id": "cco-38486", "metadata": {"authors": "CMAJ, Canadian Task Force on Preventive Health Care", "pdf_url": "https://www.cancercareontario.ca/en/file/18961/download?token=jaJ0Qzlr", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Recommendations on screening for breast cancer in average-risk women aged 40\u201374 years", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38486"} +{"content": "## Guideline Objective\n\nThe Ontario Breast Screening Program (OBSP) has operated since 1990 to deliver a population-based breast cancer screening program of biennial mammography for unaffected women age 50 to 74 years and was expanded in July 2011 to screen women age 30 to 69 years at high risk for breast cancer (including those with a previous history of breast cancer) with annual MRI screening in addition to digital mammography. The objective of this study was to evaluate screening performance measures among women screened in the first year of the OBSP High Risk Screening Program.\n\n## Patient Population\n\nWomen ages 30 to 69 years at high risk for breast cancer\n\n## Intended Guideline Users\n\nClinicians and policy-makers\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18966/download?token=A7li6C9C)", "external_id": "cco-38491", "metadata": {"authors": "A.M. Chiarelli, M.V. Prummel, D. Muradali, V. Majpruz, M. Horgan, J.C. Carroll, A. Eisen, W.S. Meschino, R.S. Shumak, E. Warner, L. Rabeneck, Journal of Clinical Oncology", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/18966/download?token=A7li6C9C", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Effectiveness of Screening With Annual Magnetic Resonance Imaging and Mammography: Results of the Initial Screen From the Ontario High Risk Breast Screening Program", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38491"} +{"content": "## Guideline Objective\n\nTo describe the association between mammographic density in the baseline mammogram and the subsequent risk of breast cancer. We studied the association according to the method of cancer detection and over time.\n\n## Patient Population\n\nWomen with dense breasts\n\n## Intended Guideline Users\n\nClinicians and policy-makers Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Breast Density Fact Sheet\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18956/download?token=UvNu2MOe)", "external_id": "cco-38496", "metadata": {"authors": "N.F. Boyd, H. Guo, L.J. Martin, L. Sun, J. Stone, E. Fishell, R.A. Jong, G. Hislop, A. Chiarelli, S. Minkin, M.J. Yaffe, New England Journal of Medicine", "pdf_url": "https://www.cancercareontario.ca/en/file/18956/download?token=UvNu2MOe", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Mammographic Density and the Risk and Detection of Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38496"} +{"content": "## Guideline Objective\n\nThis report by the Institute for Clinical Evaluative Sciences aims to: Summarize the current state of health status and system utilization among cancer patients that are complex, and through a review of the literature establish certain indicators that could best evaluate the integration of care among complex cancer patients Contribute to Cancer Care Ontario's capability to improve patient care experiences and health outcomes Empower health providers to ensure that care is optimized and occurs in a setting that provides both the best care for complex patients and value to the health system Along with summarizing the results of a literature review on indicators of the integration of care in various health systems, this report highlights the analysis of patient utilization data to understand the trajectories of care for cancer patients.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18971/download?token=Al4zmoz0)", "external_id": "cco-38501", "metadata": {"authors": "Institute for Clinical Evaluative Sciences", "pdf_url": "https://www.cancercareontario.ca/en/file/18971/download?token=Al4zmoz0", "type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "Integrating Care for Cancer Patients: An evidence-informed analysis", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38501"} +{"content": "## Guideline Objective\n\nThe recommendations were developed by Cancer Care Ontario and a panel of experts in gastroenterology, pathology and colorectal surgery to provide endoscopists and primary care providers with evidence-based recommendations for surveillance colonoscopy. The recommendations are designed to ensure that the benefits of surveillance colonoscopies outweigh the potential harms for people who undergo the procedure.\n\n## Patient Population\n\nAsymptomatic people with polyps requiring surveillance colonoscopy\n\n## Intended Guideline Users\n\nEndoscopists, primary care providers Research Questions What are the recommended surveillance intervals based on findings at the initial and subsequent colonoscopy? These recommendations are also available in French: Recommandations de Contr\u00f4leCancerColorectal pour la surveillance apr\u00e8s polypectomie (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Post-Polypectomy Surveillance Recommendations Summary Post-Polypectomy Surveillance Recommendations Frequently Asked Questions for Healthcare Providers Recommendations for Post-Polypectomy Surveillance Tool\n\nFull report: [Recommandations de Contr\u00f4leCancerColorectal pour la surveillance apr\u00e8s polypectomie](https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CCCRecommendationsForPostPolypectomySurveillance-FR.pdf)", "external_id": "cco-38506", "metadata": {"authors": "C. Dub\u00e9, B.R. McCurdy, T. Bronstein, A. Pollett, N.N Baxter, D. Morgan, J. Tinmouth", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CCCRecommendationsForPostPolypectomySurveillance-FR.pdf", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "ColonCancerCheck Recommendations for Post-Polypectomy Surveillance", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38506"} +{"content": "## Guideline Objective\n\nA group of experts from across Ontario developed consensus-based recommendations on the development and maintenance of oncology regimens. These recommendations apply to both intravenous and oral cancer medications, as well as clinical trial regimens for cancer.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19006/download?token=veykZYGa)", "external_id": "cco-38541", "metadata": {"authors": "CCO Drug Formulary", "document_status": "Current", "id": "GL-C50-25 Feb 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/19006/download?token=veykZYGa", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Best Practice Recommendations for Regimen Development and Maintenance", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38541"} +{"content": "## Guideline Objective\n\nPharmacists in the community have minimal to no access to patient medical records; thus, this checklist was developed as a tool to \u00a0assist with the clinical verification of take-home cancer drug prescriptions in community pharmacies.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19016/download?token=B1nN-Cnr)", "external_id": "cco-38551", "metadata": {"authors": "CCO Drug Formulary, PPO Working Group", "document_status": "Current", "id": "GL-C50-17 Jan 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/19016/download?token=B1nN-Cnr", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Cancer Care Ontario\u2019s Focus on Take-Home Cancer Drugs and Community Practice", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38551"} +{"content": "## Guideline Objective\n\nThis checklist was developed as a tool to assist with the clinical verification of take-home cancer drug prescriptions at cancer centres and pharmacies where patient information is easily accessible.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19021/download?token=isUmPbGE)", "external_id": "cco-38556", "metadata": {"authors": "CCO Drug Formulary, PPO Working Group", "document_status": "Current", "id": "GL-C50-18 Jan 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/19021/download?token=isUmPbGE", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Clinical Verification of Cancer Drug Prescriptions Checklist: Cancer Centres and Specialty Pharmacies", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38556"} +{"content": "## Guideline Objective\n\nOptimal prevention and safe management of febrile neutropenia (FN) in the outpatient setting, when clinically appropriate, can help to keep vulnerable patients from experiencing severe complications requiring hospitalization. The objective of this guideline is to provide clinicians with updated recommendations for prevention of FN and new guidelines for the outpatient management of FN in adult cancer patients receiving systemic treatment in Ontario.\n\n## Patient Population\n\nCancer patients who are receiving myelosuppressive systemic treatment.\n\n## Intended Guideline Users\n\nAll health care providers involved in caring for cancer patients who are receiving myelosuppressive systemic treatment (oncologists/hematologists, nurses, pharmacists, emergency room clinicians, etc.). Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Neutropenia (Low Neutrophil Count)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/63496/download?token=TkDmj-eh)", "external_id": "cco-38561", "metadata": {"authors": "Andrea Crespo, Leta Forbes, Kathy Vu, Daniela Gallo-Hershberg, Katherine Enright, Mona Abdallah, Michela Febbraro, Tiffany Gowanlock, Kardi Kennedy, Charles Lim, Sabrina Liu, Taylor Mackenzie, Jennifer Newton, Silvana Spadafora, Jordan Zeppieri", "document_status": "Current", "id": "GL-C50-27 Nov 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/63496/download?token=TkDmj-eh", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Prevention and Outpatient Management of Febrile Neutropenia in Adult Cancer Patients: Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38561"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to provide clinicians with updated recommendations for prevention and management of chemotherapy-induced nausea and vomiting (CINV) in adult patients, and promote standardized evidence-informed best practices across Ontario. This update to the 2013 Antiemetic Report is based on current literature, ASCO, NCCN and MASCC/ESMO guidelines, and expert consensus of the Antiemetic Working Group. It includes updates to the recommendations for single-day and multiple-day IV chemotherapy, discussion around cannabinoids, new recommendations for oral chemotherapy and breakthrough CINV, and changes to emetic classification of certain chemotherapy regimens.\n\n## Patient Population\n\nAdult patients receiving systemic treatment.\n\n## Intended Guideline Users\n\nClinicians involved in the care of patients receiving systemic treatment (Physicians, Pharmacists, Nurses) Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Emetic Risk of Single Oral Agents in Adults Emetic Risk of Single Intravenous Agents in Adults Changes to Emetic Risk of Chemotherapy Regimens in Adults\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/49566/download?token=sVDajTLI)", "external_id": "cco-38571", "metadata": {"authors": "Sarah Salama, Kathy Vu, David Warr, Leta Forbes, Daniela Gallo-Hershberg, Carlo De Angelis, Stephanie Brule, Dayna Comfort, Lisa Randall, Julie Williams", "document_status": "Current", "id": "GL-C50-09 Jun 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/49566/download?token=sVDajTLI", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "2019 Antiemetic Recommendations for Chemotherapy-Induced Nausea and Vomiting: A Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38571"} +{"content": "## Guideline Objective\n\nThis document outlines the key criteria that are recommended on a PPO for oral chemotherapy take home prescriptions.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19036/download?token=SCSA2iD6)", "external_id": "cco-38576", "metadata": {"authors": "CCO Drug Formulary, PPO Working Group", "document_status": "Current", "id": "GL-C50-21 Jul 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/19036/download?token=SCSA2iD6", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Recommended Criteria of a Pre-printed Order (PPO): Oral Chemotherapy Take-home Prescriptions", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38576"} +{"content": "## Patient Population\n\nAdult patients (age \u226518 years) with a primary diagnosis of biopsy-proven squamous cell cancer of the anal canal, including basaloid, cloacogenic, and transitional cell tumours. These recommendations do not apply to patients who have previously undergone resection of their tumour. The management of patients who later develop extra-pelvic metastases is not considered in this guideline.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management or referral of adult patients with squamous cell cancer of the anal canal.\n\n## Research Question(s)\n\nDoes the addition of chemotherapy (CT) to radiotherapy (RT) improve outcome for patients with squamous cell cancer of the anal canal? What are the optimal CT drugs for the treatment of patients with squamous cell cancer of the anal canal? Does the use of induction CT before concurrent CT and RT improve outcome for patients with squamous cell cancer of the anal canal? What is the best management for patients with squamous cell cancer of the anal canal who are human immunodeficiency virus (HIV) positive? Outcomes of interest are colostomy rate, local failure, survival, disease-free survival, acute and late adverse effects, and quality of life. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81001/download?token=Ubv5xmlX)", "external_id": "cco-386", "metadata": {"authors": "K. Spithoff, B. Cummings, D. Jonker, J. Biagi, Gastrointestinal Cancer Disease Site Group", "document_status": "In-Review", "id": "2-8 Feb 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/81001/download?token=Ubv5xmlX", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Management of Squamous Cell Cancer of the Anal Canal", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/386"} +{"content": "## Guideline Objective\n\nThese recommendations were developed to address the safe handling of oral anti cancer drugs (OACDs) in community pharmacies across the medication lifecycle, from manufacturer packaging to waste management and incident reporting.\n\n## Intended Guideline Users\n\nPharmacists\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/19046/download?token=Wt1WjrAG)", "external_id": "cco-38606", "metadata": {"authors": "CCO Systemic Treatment, Canadian Association of Provincial Cancer Agencies", "document_status": "Current", "id": "GL-C50-30 Feb 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/19046/download?token=Wt1WjrAG", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Recommendations for the Safe Use and Handling of Oral Anti-Cancer Drugs (OACDs) in Community Pharmacy: A Pan-Canadian Consensus Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38606"} +{"content": "## Guideline Objective\n\nTrastuzumab emtansine (Kadcyla\u00ae) and trastuzumab (Herceptin\u00ae) have look alike/sound alike names. They are not the same product and are not interchangeable. This document outlines recommendations made by the CCO Systemic Treatment to ensure safety.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/20621/download?token=YefRk5uA)", "external_id": "cco-38611", "metadata": {"authors": "CCO Systemic Treatment", "document_status": "Current", "id": "GL-C50-15 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/20621/download?token=YefRk5uA", "type_of_content": "Drug Safety, Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Kadcyla\u00ae Trastuzumab Emtansine Safety Reminder", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38611"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to establish a standardized set of recommendations for providing person-centred care in the delivery of adult oncology services in Ontario.\n\n## Intended Guideline Users\n\nThis guideline provides guidance for use by all clinicians and staff within adult oncology service settings, and for use by patients (and/or family members and caregivers) and their care providers to inform the provision of person-centred care.\n\n## Patient Population\n\nThis guideline is intended for adults (18 years and older) in Ontario using oncology services and for their care providers. Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools About the Person-Centred Care Guideline\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/19156/download?token=h4sHQY1M)", "external_id": "cco-38631", "metadata": {"authors": "R. Biddy, C. Griffin, N. Johnson, G. Larocque, H. Messersmith, L. Moody, H. Shamji, C. Stevens, C. Zwaal, S. Singh, Person-Centred Care Guideline Expert Panel", "document_status": "Current", "id": "GL-C50-20 May 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/19156/download?token=h4sHQY1M", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Person-Centred Care Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/38631"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as head and neck cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31721/download?token=s6XdXaax)", "external_id": "cco-391", "metadata": {"authors": "B. Mullen, G.G. Fletcher, K. Kwan, B.P. Ordonez, E. Winquist, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-5 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31721/download?token=s6XdXaax", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Head and Neck Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/391"} +{"content": "## Patient Population\n\nAdult patients (\u226518 years old) with unresectable metastatic colorectal cancer.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management of patients with unresectable, metastatic colorectal cancer treated with palliative intent.\n\n## Research Question(s)\n\nWhat is the impact of different strategies of sequential and combination chemotherapy on efficacy (including overall survival), toxicity and quality of life in unresectable metastatic colorectal cancer treated with palliative intent? The cytotoxic agents covered in this guideline include initial fluoropyrimidine (5-FU or capecitabine) either alone or in combination, irinotecan and oxaliplatin.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/80976/download?token=nV062fZl)", "external_id": "cco-396", "metadata": {"authors": "T. Asmis, S. Berry, R. Cosby, K. Chan, N. Coburn, M. Rother , Gastrointestinal Disease Site Group", "document_status": "Archived", "id": "2-5 Jan 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/80976/download?token=nV062fZl", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Strategies of Sequential Therapies in Unresectable, Metastatic Colorectal Cancer Treated with Palliative Intent", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/396"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as hematologic cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31731/download?token=_prKpVyK)", "external_id": "cco-401", "metadata": {"authors": "D. Good, G.G. Fletcher, S. Joshi, V. Kukreti, C. Ross, A. Schuh, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-6 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31731/download?token=_prKpVyK", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Hematologic Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/401"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as lung cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31746/download?token=6fyLcvsj)", "external_id": "cco-406", "metadata": {"authors": "A.H. Boag, G.G. Fletcher, C.B. Falkson, D.M. Hwang, D.P. Jones, N.B. Leighl, H.S. Sekhon, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-7 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31746/download?token=6fyLcvsj", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/406"} +{"content": "## Guideline Objective\n\nThe objective of this evidence review was to determine the effectiveness of focal tumour ablation, including radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation therapy (CAT) for the treatment of patients with localized renal cell carcinoma (RCC) by providing a systematic literature review that will be one of the six components of the Recommendation Report being developed by the Interventional Oncology Steering Committee. The additional components to their report are demand forecasting, costing analysis, jurisdictional review, system capacity, and current state.\n\n## Patient Population\n\nPatients with localized, non-metastatic renal cell carcinoma.\n\n## Intended Guideline Users\n\nInterventional radiologists, radiation oncologists, urological surgeons, medical oncologists, and healthcare professionals caring for patients with RCC.\n\n## Research Question(s)\n\nWhat is the effectiveness of focal ablation for the treatment of patients with RCC? What are the toxicities associated with focal ablation for RCC? What patient populations are most likely to benefit from focal ablation for RCC?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/83176/download?token=KDvGHuU-)", "external_id": "cco-4101", "metadata": {"authors": "J. Kachura, F. Baldassarre, A. Kielar, M. Baerlocher, The Interventional Oncology Steering Committee", "document_status": "Archived", "id": "FA3 Aug 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/83176/download?token=KDvGHuU-", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Focal Tumour Ablation for Renal Cell Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/4101"} +{"content": "## Guideline Objective\n\nTo provide a systematic literature review that will be one of the six components of the Recommendation Report of the Interventional Oncology Steering Committee (other components will include demand forecasting, costing analysis, jurisdictional review, system capacity, literature review, and current state, summary available at www.cancercare.on.ca/fta Opens in a new window .)\n\n## Patient Population\n\nPatients with early-stage, primary lung cancer or lung metastases.\n\n## Intended Guideline Users\n\nClinicians (radiologists, thoracic surgeons, medical and radiation oncologists, and respirologists) involved in the delivery of focal tumour ablation for lung cancer patients.\n\n## Research Question(s)\n\nThese research questions were developed to direct the search for available evidence on focal tumour ablation for early-stage primary lung cancer and lung metastases: What is the effectiveness of focal tumour ablation for the treatment of patients with early-stage primary lung cancer or lung metastases? What are the complications associated with focal tumour ablation for early-stage primary lung cancer or lung metastases? What patient populations are most likely to benefit from focal tumour ablation for early-stage primary lung cancer or lung metastases?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/83161/download?token=LS1-okFj)", "external_id": "cco-4106", "metadata": {"authors": "J. Kachura, F. Baldassarre, S. Athreya, M. Midia, R. Malthaner, The Interventional Oncology Steering Committee", "document_status": "Current", "id": "FA4 Aug 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/83161/download?token=LS1-okFj", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Focal Tumour Ablation: Early-stage Primary Lung Cancer and Lung Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/4106"} +{"content": "## Patient Population\n\nAdult patients (\u226518 years old) with inoperable, advanced (Stage IV) colorectal cancer.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management of patients with advanced colorectal cancer.\n\n## Research Question(s)\n\nWhat is the impact of intermittent strategies of administering systemic therapy on length and quality of survival in patients with untreated, unresectable metastatic colorectal cancer? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/80981/download?token=eec6aPH8)", "external_id": "cco-411", "metadata": {"authors": "S. Berry, R. Cosby, T. Asmis, K. Chan, M.K. Krzyzanowska, N. Hammad, Gastrointestinal Disease Site Group", "document_status": "In-Review", "id": "2-6 Sep 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/80981/download?token=eec6aPH8", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Continuous versus Intermittent Chemotherapy Strategies in Inoperable, Advanced Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/411"} +{"content": "## Guideline Objective\n\nDue to the potential harms of screening, including over-diagnosis and over-treatment, Cancer Care Ontario does not support an organized, population-based screening program for prostate cancer. We will continue to watch for new evidence on prostate cancer screening.\n\n## Intended Guideline Users\n\nHealthcare providers across Ontario Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Questions and Answers about the Prostate Cancer Screening with the Prostate-Specific Antigen Test Key Messages for Primary Care Providers about Prostate Cancer Screening with the Prostate-Specific Antigen Test PSA Test Decision Grid\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/27841/download?token=8TIOSule)", "external_id": "cco-42981", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/27841/download?token=8TIOSule", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Position Statement on Prostate Cancer Screening using the Prostate-Specific Antigen (PSA) Test", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/42981"} +{"content": "## Guideline Objective\n\nThe Plan provides an overview of how adult services are defined and how they should be organized and delivered in Ontario. This Plan sets the stage to achieve a vision of care in Ontario where there will be strong networks of service providers that deliver coordinated care across the province.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators 2026 Update to Appendix C The document referred to as Appendix C in this plan (Consensus Pathology Recommendations for Complex Malignant Hematology) has been replaced by an updated recommendations document, Acute Leukemia: Consensus Pathology Recommendations for Diagnosis and Monitoring. Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Acute Leukemia: Consensus Pathology Recommendations for Diagnosis and Monitoring Appendix A \u2013 Patient Education Pathway for Acute Myeloid Leukemia Appendix B \u2013 Complex Malignant Hematology Models of Care: Recommendations for Changes in the Roles and Composition of the Multidisciplinary Team and the Setting of Care to Improve Access for Patients in Ontario\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/20661/download?token=aJYPxcsX)", "external_id": "cco-43046", "metadata": {"authors": "Leukemia Provincial Planning Working Group, Cancer Care Ontario", "document_status": "Current", "id": "GL-C50-34 Aug 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/20661/download?token=aJYPxcsX", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Acute Leukemia Provincial Plan", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43046"} +{"content": "## Guideline Objective\n\nTo address the needs of CMH patients, Cancer Care Ontario undertook a quality improvement initiative to support timely access to high quality, coordinated CMH services, guided by the following core objectives: - Ensure patients have timely access to high quality care in appropriate settings, as close to home as possible; - Support providers to collaborate and align around best practices, and have a manageable workload; and, - Optimize use of healthcare resources.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/20671/download?token=mbUS1yMi)", "external_id": "cco-43051", "metadata": {"authors": "Complex Malignant Hematology Models of Care Working Group", "document_status": "Current", "id": "GL-C50-31 Mar 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/20671/download?token=mbUS1yMi", "type_of_content": "Guidelines & Advice, Health System, Models of Care, Recommendation Report"}, "section_count": 2, "source": "cco", "title": "Complex Malignant Hematology Models of Care: Recommendations for Changes in the Roles and Composition of the Multidisciplinary Team and the Setting of Care to Improve Access for Patients in Ontario \u2013 March 2017", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43051"} +{"content": "## Guideline Objective\n\nTo provide direction for the standardization of laboratory services for diagnosis, treatment and follow-up of patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndromes, high-grade lymphoma and aplastic anemia. These recommendations provide guidance for the classification, diagnosis, work-up, turn-around-time and minimal residual disease testing for leukemia patients.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/20676/download?token=mw7aDCy7)", "external_id": "cco-43061", "metadata": {"authors": "Pathology Complex Malignant Hematology Working Group", "document_status": "Archived", "id": "GL-C50-28 Dec 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/20676/download?token=mw7aDCy7", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 2, "source": "cco", "title": "Consensus Pathology Recommendations for Complex Malignant Hematology \u2013 December 2016", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43061"} +{"content": "## Guideline Objective\n\nThis report follows the companion piece Expert Panel Report: Adult Sarcoma Management in Ontario.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/20681/download?token=6EZAVCT4)", "external_id": "cco-43071", "metadata": {"authors": "Expert Panel on Sarcoma", "document_status": "Current", "id": "GL-C50-05 Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/20681/download?token=6EZAVCT4", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Managing System Pressures for Sarcoma Service Delivery in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43071"} +{"content": "## Guideline Objective\n\nRegional Cancer Programs across the province worked together to develop multidisciplinary programs focused on ensuring equitable access to high-quality sarcoma care for all Ontarians. Host Sarcoma Services Provider Sites, Partner Sarcoma Services Provider Sites and partner regions were identified. Under the guidance of the Sarcoma Services Steering Committee, a Provincial Sarcoma Services Plan was put into place with three regional programs \u2014 led by Toronto, Hamilton and Ottawa \u2014 and defined service delivery expectations.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/74111/download?token=iDvLZEo3)", "external_id": "cco-43076", "metadata": {"authors": "Sarcoma Services Steering Committee", "document_status": "Current", "id": "GL-C50-24 Jan 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/74111/download?token=iDvLZEo3", "type_of_content": "Guidelines & Advice, Health System", "version": "3"}, "section_count": 2, "source": "cco", "title": "Provincial Sarcoma Services Plan", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43076"} +{"content": "## Guideline Objective\n\nIn order to implement the recommendations of the Focal Tumour Ablation in Ontario: Recommendations Report 2015, Regional Cancer Programs worked together to submit service plans focused on ensuring equitable access for all Ontarians. A Provincial Plan for Focal Tumour Ablation Services was developed under the guidance of the Interventional Oncology Steering Committee. This plan organizes resources and supports the provision of services so that all patients have coordinated access to high quality, expert, multidisciplinary care. The plan has been updated to reflect the addition of new Focal Tumour Ablation services and service providers, as well as clarification on multidisciplinary care requirements.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Plan provincial pour les services sp\u00e9cialis\u00e9s dans l\u2019ablation focalis\u00e9e des tumeurs\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/58196/download?token=JUUDBdWk)", "external_id": "cco-43086", "metadata": {"authors": "Interventional Oncology Steering Committee", "document_status": "Current", "id": "GL-C50-32 Jan 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/58196/download?token=JUUDBdWk", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Provincial Plan for Focal Tumour Ablation Services", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43086"} +{"content": "## Guideline Objective\n\nTo harmonize post-transplant immunization recommendations for patients undergoing autologous or allogeneic stem cell transplantation.\n\n## Patient Population\n\nPatients undergoing an autologous or allogeneic stem cell transplant.\n\n## Intended Guideline Users\n\nPatients undergoing autologous or allogeneic hematopoietic stem cell transplantation. Primary care for patients undergoing autologous or allogeneic hematopoietic stem cell transplantation.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/52366/download?token=MhMzqOqN)", "external_id": "cco-43096", "metadata": {"authors": "Stem Cell Transplant Steering Committee", "document_status": "Archived", "id": "43096 Feb 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/52366/download?token=MhMzqOqN", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 3, "source": "cco", "title": "Immunization Following Stem Cell Transplant in Adults: Position Statement", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43096"} +{"content": "## Guideline Objective\n\nTo provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC).\n\n## Patient Population\n\nMen with metastatic castration-resistant prostate cancer.\n\n## Research Question(s)\n\nIn men with metastatic castration-resistant prostate cancer (mCRPC), which systemic therapies improve cancer- or patient-related outcomes? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/43711/download?token=A6SgCT7o)", "external_id": "cco-431", "metadata": {"authors": "E. Basch, D.A. Loblaw, T.K. Oliver, C. Bennett, M. Carducci, R. Chen, J. Frame, K. Garrels, S. Hotte, M. Kattan, R. Nam, D. Raghavan, F. Saad, M.E. Taplin, C. Walker-Dilks, J. Williams, E. Winquist, T. Wooten, K. Virgo, CCO-ASCO Joint Castration Resistant Prostate Cancer Expert Panel Genitourinary Cancer Disease Site Group", "document_status": "In-Review", "id": "3-15 Sep 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/43711/download?token=A6SgCT7o", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Systemic Therapy in Men with Metastatic Castration-Resistant Prostate Cancer: American Society of Clinical Oncology and Cancer Care Ontario Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/431"} +{"content": "## Guideline Objective\n\nTo update, in collaboration with Cancer Care Ontario (CCO), key recommendations of the American Society of Clinical Oncology (ASCO) guideline on the Role of Bone-Modifying Agents (BMA) in Metastatic Breast Cancer. This focused update addressed the new data on intervals between dosing and the role of bone-modifying agents in control of bone pain.\n\n## Patient Population\n\nPatients with bone metastases from breast cancer\n\n## Intended Guideline Users\n\nMedical oncologists, radiation oncologists, surgical oncologists, oncology nurses, advanced practice providers, patients, patient advocates, caregivers, and oncology pharmacists Research Questions What are the best intervals between dosing of zoledronic acid? What is the role of bone-modifying agents in control of pain secondary to bone metastases?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/20981/download?token=TCVIzn0t)", "external_id": "cco-43266", "metadata": {"authors": "Catherine Van Poznak, Mark R. Somerfield, William E. Barlow, J. Sybil Biermann, Linda D. Bosserman, Mark J. Clemons, Sukhbinder K. Dhesy-Thind, Melissa S. Dillmon, Andrea Eisen, Elizabeth S. Frank, Reshma Jagsi, Rachel Jimenez, Richard L. Theriault, Theodore A. Vandenberg, Gary C. Yee, Beverly Moy, ASCO-CCO Update Committee", "document_status": "Current", "id": "GL-1-A-2016-2 Oct 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/20981/download?token=TCVIzn0t", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Role of Bone-Modifying Agents in Metastatic Breast Cancer: An American Society of Clinical Oncology\u2013Cancer Care Ontario Focused Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43266"} +{"content": "## Guideline Objective\n\nThis evidence summary was developed to assist the Patient Reported Outcomes and Symptom Management Program of CCO in revising the pain algorithm. This algorithm is based on a review of guidelines until January 2009, and used the Scottish Intercollegiate Guidelines Network (SIGN) 106 guideline on cancer pain\u00a0as its basis. The current evidence summary was also created as a source of information for the Ontario Palliative Care Network (OPCN).\n\n## Patient Population\n\nPatients with cancer or other diseases requiring palliative care.\n\n## Intended Guideline Users\n\nThe intended users of this evidence summary are staff of the Patient Reported Outcomes and Symptom Management Program of CCO and staff of the Ontario Palliative Care Network. This evidence summary may also be of interest to physicians and nurses dealing with cancer or palliative care symptom management. Research Questions What are the most appropriate treatments for alleviation of pain in patients with cancer or in patients receiving palliative care? What are the most appropriate methods to assess or evaluate pain in patients with cancer or in patients receiving palliative care?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70446/download?token=XdEtajOB)", "external_id": "cco-43271", "metadata": {"authors": "Mona Sawhney, Glenn G Fletcher, Jill Rice, Judy Watt-Watson, Trish Rawn", "document_status": "Archived", "id": "18-4 Sep 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/70446/download?token=XdEtajOB", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Guidelines on Management of Pain in Cancer and/or Palliative Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43271"} +{"content": "## Guideline Objective\n\nThe Molecular Oncology and Testing Advisory Committee of Cancer Care Ontario endorses the recommendations of Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology, published by the American College of Medical Genetics and Genomics (ACMG) regarding inherited cancers, as modified by the endorsement process described in this document. This endorsement project was sponsored by MOTAC. The endorsed guideline will be used for the interpretation of sequence variants.\n\n## Intended Guideline Users\n\nThis guideline is intended for molecular geneticists, clinical geneticists, molecular pathologists and genetic counsellors across the province.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70466/download?token=deY2U3g7)", "external_id": "cco-43301", "metadata": {"authors": "H. Feilotter, D. Sivajohanathan, T. Graham, V.M. Siu, M. Speevak, T. Stockley, Molecular Oncology and Testing Advisory Committee", "document_status": "Current", "id": "GL-END MOTAC 5 Aug 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/70466/download?token=deY2U3g7", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Hereditary Cancers Guideline: An Endorsement of the 2015 Standards and Guidelines for the Interpretation of Sequence Variants", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43301"} +{"content": "## Guideline Objective\n\nTo determine whether breast cancer survivors can be included in an organized screening program, and to determine the appropriateness and feasibility of conducting surveillance imaging on specific populations of women with PHBC, including individuals who have undergone implant-based reconstructions, reconstructions using autologous tissue flaps, such as the TRAM flaps, or nipple-sparing or skin-sparing mastectomies, or women who have undergone unilateral or bilateral mastectomy without reconstruction\n\n## Patient Population\n\nBreast cancer survivors\n\n## Intended Guideline Users\n\nBreast screening experts\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/75296/download?token=NbsVk9Kn)", "external_id": "cco-43306", "metadata": {"authors": "Derek Muradali, Anna M Chiarelli, Erin B Kennedy, Andrea Eisen, Prevention and Screening", "document_status": "Archived", "id": "15-15 Sep 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/75296/download?token=NbsVk9Kn", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Breast Screening for Survivors of Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43306"} +{"content": "## Guideline Objective\n\nThe goal of this guideline was to provide recommendations for the treatment of patients with clinical stage III non-small cell lung cancer.\n\n## Patient Population\n\nPatients with Clinical Stage III Non-Small Cell Lung Cancer.\n\n## Intended Guideline Users\n\nThe intended users are oncologists and thoracic surgeons involved in the treatment of patients with stage III NSCLC. Research Questions Should neoadjuvant chemoradiation plus surgery vs. neoadjuvant chemotherapy plus surgery be used in patients with potentially resectable stage III N2 NSCLC? Should neoadjuvant chemoradiation plus surgery vs. neoadjuvant chemoradiation and no surgery be used in patients with potentially resectable stage III N2 NSCLC? Should patients with unresectable clinical stage III NSCLC who have not progressed following completion of concurrent chemoradiation be considered for consolidation immunotherapy vs. concurrent chemoradiation alone?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/69636/download?token=YQ47Jzxm)", "external_id": "cco-43311", "metadata": {"authors": "A. Robinson, E.T. Vella, P.M. Ellis, R. Goffin, W. Hanna, D. Maziak, A. Swaminath, Y.C. Ung, Lung Cancer Disease Site Group", "document_status": "In-Review", "id": "GL END 7-3 Apr 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/69636/download?token=YQ47Jzxm", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 3, "source": "cco", "title": "Recommendations for the Treatment of Patients with Clinical Stage III Non-Small Cell Lung Cancer: Endorsement of the 2019 National Institute for Health and Care Excellence Guidance and the 2018 Society for Immunotherapy of Cancer Guidance", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43311"} +{"content": "## Guideline Objective\n\nThis document synthesizes knowledge on integrated care planning and outlines an evidence-informed approach to planning integrated cancer care. The Ontario Cancer Plan IV specifically identifies \u201cintegrated care plans\u201d as a means to facilitate communication and coordination of care across multiple professionals and organizations. By 2019, it is expected that standardized integrated care plans will be available for selected disease sites, treatments and patient populations across care settings. To achieve this objective, a common understanding is needed of the content and functions of an integrated care plan as well as how these plans are developed, implemented and maintained over time and across professionals and settings. In support of this objectives, CCO developed an evidence-informed approach to integrated care planning, including the development and use of integrated care plans, for patients with cancer on the basis of a scoping review of the academic literature and with stakeholder consultations. The results of this work are captured in a 70-page report. CCO then further consulted the Program in Evidence-Based Care (PEBC) regarding the methodology and content of the report, and how to optimize its dissemination. PEBC validated the rigor of the work, and recommended to translate the report into a concise position statement supplemented by a video to facilitate uptake by managers and clinicians. As such, the the report\u2019s key messages have been distilled into this position statement and a five-minute video aimed at CCO programs and regional stakeholders.\n\n## Intended Guideline Users\n\nClinicians, CCO staff, Health Care Administrators, managers\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/21051/download?token=GXPqcD0-)", "external_id": "cco-43321", "metadata": {"authors": "Erin Arthurs, MSc, Jenna M. Evans, PhD, Anum Irfan Khan, MA, Vishal Kukreti, MD, FRCPC, MSc, Sharon Gradin, R.N. BScN, PMP, Marnie MacKinnon, BPE", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/21051/download?token=GXPqcD0-", "type_of_content": "Guidelines & Advice, Position Statement"}, "section_count": 2, "source": "cco", "title": "Integrated Care Planning \u2013 An Evidence-Informed Approach to Designing and Delivering Coordinated, Continuous & Person-Centred Care for Cancer Patients", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43321"} +{"content": "## Guideline Objective\n\nThis document summarizes the Ontario Cervical Screening Program\u2019s guidance for vaginal vault testing. The guidance includes information on who to consider testing, which test to use, when to test, how to manage HPV-negative and HPV-positive results, and who should not be tested. The supporting evidence and contextual factors used to develop this guidance are also summarized in this document. Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Vaginal Vault Testing\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77816/download?token=2BsGmFUT)", "external_id": "cco-43336", "metadata": {"authors": "Ontario Cervical Screening Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/77816/download?token=2BsGmFUT", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Ontario Cervical Screening Program: Guidance for Vaginal Vault Testing", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/43336"} +{"content": "## Patient Population\n\nAdult patients with stage I testicular seminoma\n\n## Research Question(s)\n\nWhat is the optimal post-orchidectomy management strategy for stage I testicular seminoma? Outcomes of interest include cancer-specific survival, long-term toxicity (including second malignancy), and quality of life. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/64601/download?token=z7f_eqVn)", "external_id": "cco-441", "metadata": {"authors": "P. Chung, L.A. Mayhew, P. Warde, E. Winquist, H. Lukka , Genitourinary Cancer Disease Site Group", "document_status": "In-Review", "id": "3-18 Mar 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/64601/download?token=z7f_eqVn", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "Management of Stage I Seminoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/441"} +{"content": "## Guideline Objective\n\nThe purpose of this guideline is to provide recommendations for the optimal organization of gynecologic oncology services in Ontario and to improve access to multidisciplinary care and appropriate treatment, thereby improving outcomes for patients.\n\n## Patient Population\n\nThe target population refers to all patients that should receive their definitive treatment at a Gynecologic Oncology Centre (GOC ) or an Affiliated Centre (AC). The target patient population includes people in Ontario who are suspected of having or have a confirmed diagnosis of gynecologic malignancy or have an ovarian/adnexal neoplasm with an O-RADS\u2122 score of 4 and 5, or High-Risk equivalent.\n\n## Intended Guideline Users\n\nThis guideline is intended for use in Ontario by hospital and cancer centre facility partners, policy makers and clinicians involved in the care of gynecologic cancer patients. Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/83226/download?token=sTQ0yLV0)", "external_id": "cco-446", "metadata": {"authors": "R. Kupets, S. E. Ferguson, A. Hodgson, Z. Kassam, M. Milosevic, C. Reade, P. Stotland, A. Hunter, S. MacDonald, C. Zwaal, S. McNair, F. C Wright, Organizational Guideline for Gynecologic Oncology Services Expert Panel", "document_status": "Current", "id": "GL 4-11 Mar 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/83226/download?token=sTQ0yLV0", "type_of_content": "Guidelines & Advice, Clinical, Health System, Models of Care", "version": "2"}, "section_count": 3, "source": "cco", "title": "Organizational Guideline for Gynecologic Oncology Services in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/446"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis or epilepsy with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17786/download?token=EaG3tMsP)", "external_id": "cco-451", "metadata": {"authors": "R. Poon, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2015-2 May 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/17786/download?token=EaG3tMsP", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2015", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/451"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as cutaneous melanoma or other skin cancer should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31761/download?token=VwfvJdWL)", "external_id": "cco-456", "metadata": {"authors": "S. Joshi, G.G. Fletcher, D. Ghazarian, J. Jambrosic, D. Kam, S. Rajagopal, J. Toye, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-8 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31761/download?token=VwfvJdWL", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Cutaneous Melanoma and Other Skin Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/456"} +{"content": "## Patient Population\n\nPatients with suspected or diagnosed cancers.\n\n## Intended Guideline Users\n\nThis evidence summary is intended to guide the Ontario PET Steering Committee in their decision-making with respect to expanding the use of PET/MRI for approved indications. This document may also be useful to inform clinicians who are seeking information about the clinical value of PET/MRI for oncologic applications.\n\n## Research Question(s)\n\nIs the accuracy of the PET data obtained with PET/MRI comparable to that of PET/CT, regarding the diagnosis and staging, assessment of treatment response, detection and restaging of recurrence, or evaluation of metastasis?\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74771/download?token=GLe-CCce)", "external_id": "cco-461", "metadata": {"authors": "A. Singnurkar, R. Poon, U. Metser", "document_status": "Current", "id": "ES PET 16 Apr 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/74771/download?token=GLe-CCce", "type_of_content": "Guidelines & Advice, Clinical, Evidence Summary", "version": "2"}, "section_count": 3, "source": "cco", "title": "Comparison of PET/CT and PET/MR Imaging in Oncology", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/461"} +{"content": "## Guideline Objective\n\nTo report the available data regarding the posttreatment follow-up and surveillance of patients with lymphoma treated with curative intent.\n\n## Patient Population\n\nAll asymptomatic adolescent (\u226515 years) and adult survivors of lymphoma who have completed curative-intent treatment and undergo routine follow-up for lymphoma; these patients may or may not be followed by an oncologist.\n\n## Intended Guideline Users\n\nAll people involved in clinical follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment including hematologists, medical and radiation oncologists, radiologists, family physicians, nurses, and administrators and policy makers.\n\n## Research Question(s)\n\nThree research questions were developed to direct the search for available evidence on the follow-up of asymptomatic survivors of lymphoma who have received curative-intent treatment. What clinical activities have been shown to be effective at detecting clinical recurrence or further hematological neoplasm? What is the appropriate frequency and timing for the clinical activities that have been shown to be effective at detecting clinical recurrence or further hematological neoplasm (malignancy)? What surveillance procedures have been shown to be effective at detecting therapy-related secondary malignancies following treatment for lymphoma?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70661/download?token=LcNBlbwt)", "external_id": "cco-471", "metadata": {"authors": "J. Sussman, N. Varela, M. Cheung, L. Hicks, D. Kraftcheck, J. Mandel, G. Fraser, L. Jimenez-Juan, A. Boudreau, S. Sajkowski, R. McQuillan", "document_status": "Current", "id": "26-5 Apr 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/70661/download?token=LcNBlbwt", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Follow-up Care for Survivors of Lymphoma who have Received Curative-Intent Treatment", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/471"} +{"content": "## Guideline Objective\n\nTo provide guidance on the most appropriate follow-up strategy for patients with cervical cancer who are clinically disease-free after receiving primary treatment. This guideline is an update of a previous version, which was published in 2009. The update was initiated when the members of the Program in Evidence-Based Care (PEBC) Gynecologic Cancer Disease Site Group become aware of new publications related to follow-up for the target population. The Disease Site Group members wanted to determine whether this new evidence would result in modifications to the existing recommendations.\n\n## Patient Population\n\nWomen who are clinically disease free and asymptomatic after receiving potentially curative primary treatment for cervical cancer. This guideline does not apply to the follow-up of women who have been treated for cervical precancer.\n\n## Intended Guideline Users\n\nClinicians involved in the care and follow-up of women who have received treatment for cervical cancer.\n\n## Research Question(s)\n\nWhat is the most appropriate follow-up strategy for patients with cervical cancer who are clinically disease free after receiving primary treatment? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/79501/download?token=6lykU9-S)", "external_id": "cco-476", "metadata": {"authors": "Members of the Follow-up for Cervical Cancer Expert Panel,", "document_status": "Current", "id": "4-16 May 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/79501/download?token=6lykU9-S", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "Follow-up for Cervical Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/476"} +{"content": "## Guideline Objective\n\nTo provide an evidence summary on PET imaging in the care of HL patients undergoing first-line curative-intent treatment.\n\n## Patient Population\n\nPatients aged \u226516 years with HL at any stage of disease who are undergoing first-line curative-intent treatment.\n\n## Intended Guideline Users\n\nClinicians involved in the care of HL patients.\n\n## Research Question(s)\n\nThe following research questions were developed to direct the search for available evidence on HL: What is the ideal timing and reporting of FDG-PET/CT or FDG-PET? For HL patients during treatment? (i.e., interim PET) i. Interim defined as scans performed during first-line curative-intent treatment (i.e., single modality or combined-modality therapy) For HL patients following chemotherapy \u00b1 radiation therapy? (i.e., end-of-therapy or final PET) i. End-of-treatment PET defined as scans performed immediately upon the completion of treatment (i.e., immediate post-treatment or end of treatment). What are the clinical activities that should be performed following an end-of-therapy PET(+) scan? Clinical activities are defined as the number of PET scans, number of CT scans, biopsy, and change in treatment.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/621/download?token=T_vLhuTz)", "external_id": "cco-481", "metadata": {"authors": "T. Baetz, J. Dudebout, J. Salerno, J. Dobranowski, E. Eisenhauer, D. Langer, L. Jimenez-Juan, U. Metser, M. O'Malley, A. Singnurkar", "document_status": "Current", "id": "27-4 Mar 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/621/download?token=T_vLhuTz", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Positron Emission Tomography in Hodgkin Lymphoma Patients Undergoing Curative-Intent Treatment", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/481"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as central nervous system (CNS) tumours should or should not have a routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31766/download?token=vXx9djeB)", "external_id": "cco-486", "metadata": {"authors": "A. Boag, G.G. Fletcher, S. Croul, G. Jansen, J. Perry, A. Pollett, J. Srigley", "document_status": "Archived", "id": "22-2-9 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31766/download?token=vXx9djeB", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Central Nervous System (CNS) Tumours", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/486"} +{"content": "## Guideline Objective\n\nThis document is meant to describe those situations in which one chemotherapy drug is used for another of a similar class and mechanism of action. The two most common reasons for drug substitution include convenience for the patient (i.e., oral versus intravenous administration) and avoidance of toxicities that would aggravate a pre-existing condition (e.g., substitution of a less neurotoxic drug in a patient with diabetic neuropathy). The decision to substitute one chemotherapy drug for another should always be undertaken in the best interests of the patient and not compromise treatment outcomes.\n\n## Intended Guideline Users\n\nThis guidance document is intended to be used by clinicians (physicians, pharmacists, nurses).\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/25421/download?token=-NWBqieS)", "external_id": "cco-48601", "metadata": {"authors": "Evidence-informed Working Group, Systemic Treatment-QBP team", "document_status": "Current", "id": "GL-C50-33 Aug 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/25421/download?token=-NWBqieS", "type_of_content": "Guidelines & Advice, Clinical", "version": "1"}, "section_count": 2, "source": "cco", "title": "Guidance on the Substitution of Systemic Therapy Agents", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/48601"} +{"content": "## Guideline Objective\n\nThese recommendations lay out the framework for serving the focal tumour ablation needs of patients in Ontario. These recommendations were formed by consensus of the Focal Tumour Ablation Advisory Committee and are based on best available evidence, the current practice in Ontario, and guidance from other jurisdictions and experts in the field.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/25926/download?token=vdUoc-S8)", "external_id": "cco-48981", "metadata": {"authors": "Focal Tumour Ablation Advisory Committee", "document_status": "Current", "id": "GL-C50-19 Jan 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/25926/download?token=vdUoc-S8", "type_of_content": "Guidelines & Advice, Clinical, Health System"}, "section_count": 2, "source": "cco", "title": "Focal Tumour Ablation in Ontario: Recommendations Report 2015", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/48981"} +{"content": "## Research Question(s)\n\nWhat types of specimens suspected to be or diagnosed as bone or soft tissue cancers (sarcoma) should or should not have routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31776/download?token=d6r4Ae6O)", "external_id": "cco-491", "metadata": {"authors": "G.G. Fletcher, A. Pollet, S. Popovic, J. Srigley, S. Verma, B. Wehrli, R. Kandel", "document_status": "Archived", "id": "22-2-10 Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31776/download?token=d6r4Ae6O", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Best Practices for Pathology Secondary Review: Bone and Soft Tissue Cancers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/491"} +{"content": "## Guideline Objective\n\nTo determine the most effective therapy for primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL) including primary intra-ocular lymphoma (PIOL).\n\n## Patient Population\n\nAdult patients (\u226518 years of age) with PCNS DLBCL including PIOL.\n\n## Intended Guideline Users\n\nThis guideline is intended for clinicians involved in the management of PCNS lymphoma in Ontario, and for policy makers and program planners involved in stem cell transplant and systemic and radiation therapy. Research Questions What is/are the optimal chemotherapy regimen(s) for the first-line treatment of PCNS DLBCL? Does chemotherapy combined with radiation therapy improve the outcome of patients with PCNS DLBCL when compared with chemotherapy alone, and if so, what is the optimal radiation dose and schedule? Does HD-CT plus ASCT improve the outcome of patients with PCNS DLBCL when compared with standard-dose chemotherapy with or without radiation therapy in the: Front-line setting In the setting of relapsed/refractory disease Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75791/download?token=bnqhHBNN)", "external_id": "cco-49406", "metadata": {"authors": "G. Fraser, N.P. Varela, J. Dudebout, J. Greenspoon, L. Hicks, N. Laperriere, A. Prica, T. Kouroukis, Primary Central Nervous System Lymphoma Guideline Development Group", "document_status": "Current", "id": "GL SCT-8 Oct 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/75791/download?token=bnqhHBNN", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Management of Primary Central Nervous System Diffuse Large B-Cell Lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/49406"} +{"content": "## Guideline Objective\n\nThe objective of this guideline was to make recommendations with respect to thoracic radiotherapy and first-line chemotherapy in the treatment of non-resected patients with small cell lung cancer (SCLC).\u00a0The systemic treatment recommendations have been superseded by the recommendations in the ASCO guideline Opens in a new window . Please refer to the ASCO recommendations. The radiotherapy recommendations remain current.\n\n## Patient Population\n\nIn keeping with recommendations from the International Association for the Study of Lung Cancer and Cancer Care Ontario, we have transitioned to the use of TNM staging rather than the Veterans Affairs staging of LS versus ES. The target population for this guideline are adult patients with non-resected LS (stage I, II, and III) and ES (stage IV) SCLC who can safely receive definitive radiation.\n\n## Intended Guideline Users\n\nClinicians involved in the treatment of non-resected adult patients with LS (stage I, II, and III) and ES (stage IV) SCLC. Research Questions For non-resected patients with ES SCLC, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for chemotherapy and thoracic radiotherapy versus chemotherapy alone? For non-resected patients with LS SCLC or ES SCLC undergoing chemotherapy, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for early versus late thoracic radiotherapy? For non-resected patients with LS SCLC or ES SCLC undergoing chemotherapy, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for sequential versus concurrent thoracic radiotherapy? For non-resected patients with LS SCLC or ES SCLC, what is the optimal dose and schedule of radiation with respect to overall survival, quality of life, and toxicity? For non-resected patients with LS SCLC or ES SCLC, are there differences in the relative benefits and harms of chemotherapy combinations studied? For non-resected patients with LS SCLC or ES SCLC, what is the optimal dose and schedule of chemotherapy with respect to overall survival, quality of life, and toxicity Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81476/download?token=lP9jLNjG)", "external_id": "cco-49411", "metadata": {"authors": "Members of the Lung Cancer Disease Site Group", "document_status": "Current", "id": "7-13 Sep 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/81476/download?token=lP9jLNjG", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Initial Management of Small Cell Lung Cancer (Limited and Extensive Stage) and the Role of Thoracic Radiotherapy and First-Line Chemotherapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/49411"} +{"content": "## Guideline Objective\n\nTo determine whether sentinel lymph node biopsy (SLNB) can safely and effectively identify women with node-negative, early-stage vulvar cancer and can be used as an alternative to inguinofemoral lymph node dissection (IFLD). To provide guidance with respect to the appropriate techniques and procedures in SLNB for women with early-stage vulvar cancer. These include: Selecting appropriate patients Determining the appropriate technique learning curve and maintenance which tracer to inject whether lymphoscintigraphy should be used where and when to inject role of intraoperative frozen-section analysis role of ultrastaging and the use of immunohistochemistry Management of patients with positive sentinel lymph nodes\n\n## Patient Population\n\nWomen in Ontario with early-stage (T1 or T2, <4 cm) squamous cell cancer of the vulva\n\n## Intended Guideline Users\n\nGynecologic oncologists and other clinicians involved in the surgical management of early-stage vulvar cancer\n\n## Research Question(s)\n\nFor patients with stage I or II vulvar cancer and using IFLD as the reference standard: What are the detection and false-negative rates of SLNB? What is the recurrence rate after a negative SLNB test compared with the recurrence rate after a negative IFLD test? What are the complication rates after SLNB compared with the complication rates after IFLD? Which patient characteristics affect detection or false-negative rates of SLNB or recurrence or complication rates after SLNB? What is the impact of the learning curve on detection or false-negative rates of SLNB or recurrence or complication rates after SLNB? What is the diagnostic accuracy of frozen-section analysis of SLNB? What is the diagnostic accuracy of SLNB using ultrastaging? What social and ethical issues are associated with SLNB? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81666/download?token=IzRhCxYu)", "external_id": "cco-496", "metadata": {"authors": "A. Covens, C. Reade, E.B. Kennedy, E. Vella, W. Jimenez, T. Le, Gynecologic Cancer Disease Site Group", "document_status": "In-Review", "id": "4-17 Jan 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/81666/download?token=IzRhCxYu", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Sentinel Lymph Node Biopsy in Vulvar Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/496"} +{"content": "## Patient Population\n\nAdult patients diagnosed with advanced stage or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas) or uterine papillary serous carcinoma.\n\n## Research Question(s)\n\nWhat are the chemotherapeutic and hormonal therapy options for women with advanced or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas)? What are the chemotherapeutic options for women with advanced or recurrent uterine papillary serous carcinoma? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/58681/download?token=DAyCPKgN)", "external_id": "cco-501", "metadata": {"authors": "Members of the Gynecology Cancer Disease Site Group, Gynecology Cancer Disease Site Group", "document_status": "In-Review", "id": "4-8 Jul 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/58681/download?token=DAyCPKgN", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 2, "source": "cco", "title": "Systemic Therapy for Advanced or Recurrent Endometrial Cancer and Advanced or Recurrent Uterine Papillary Serous Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/501"} +{"content": "## Intended Guideline Users\n\nPhysicians and healthcare administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/39476/download?token=K-NeZZKe)", "external_id": "cco-50101", "metadata": {"authors": "Kyphoplasty and Vertebroplasty Working Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/39476/download?token=K-NeZZKe", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Guidance for Kyphoplasty and Vertebroplasty for Cancer Patients in Ontario: Recommendations Report 2017", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/50101"} +{"content": "## Guideline Objective\n\nThis document gives the background/rationale and general methods for the development of the 10 site-specific evidence summaries that are part of this series. Each site-specific evidence summary contains a summary of the relevant evidence and recommendations. In this series of documents, secondary pathology review is defined as review of pathology specimens by a second pathologist that is usually initiated at the request of the patient or treating clinician, multidisciplinary case conference (MCC) process, quality control protocol, or as standard practice to review all cases at a cancer centre prior to treatment. Consultation or review at the request of the primary pathologist or prior to finalization of the primary pathologist\u2019s report is\u00a0not included in this definition. The recommendations in this series of reports do not address the special circumstance in which the primary pathologist was considered to be an expert or subspecialist in the area of pathology relevant to the specimens examined.\n\n## Research Question(s)\n\nFor what type of specimens and under what circumstances should specimens suspected to be or diagnosed as cancer have (or not have) routine secondary pathology review?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/31781/download?token=6QvhKLov)", "external_id": "cco-506", "metadata": {"authors": "J.R. Srigley, G.G. Fletcher, A.H. Boag, S.B. Joshi, M.A. Khalifa, B. Mullen, A. Pollett", "document_status": "Archived", "id": "22-2-M Jun 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/31781/download?token=6QvhKLov", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 2, "source": "cco", "title": "Best Practices for Oncologic Pathology Secondary Review: Methods and Overview", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/506"} +{"content": "## Guideline Objective\n\nAlign Ontario Health (Cancer Care Ontario)\u2019s Sarcoma Services Host Sites, Gynecological Oncology Centres (GOCs) and general gynecologists in the care of gynecological sarcomas, Improve awareness about the optimal care of pelvic sarcomas amongst general gynecologists and pathologists, Guide the investigation and management of suspected pelvic and extra-pelvic gynecologic sarcomas using the recommended care pathway, and Provide guidance on how to best direct patients who may have suspicious pelvic sarcoma.\n\n## Intended Guideline Users\n\nCommunity and hospital gynecologists, gynecologic oncologists and gynecologic and sarcoma health care providers, including radiologists, pathologists and surgeons.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/28451/download?token=J8YhLuX6)", "external_id": "cco-50866", "metadata": {"authors": "Sarcoma Services Advisory Committee Members", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/28451/download?token=J8YhLuX6", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "Guidance for the Management of Gynecologic Sarcomas in Ontario: Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/50866"} +{"content": "## Guideline Objective\n\nTo provide guidance on the optimal surgical excision margins and use of sentinel lymph node biopsy (SLNB) in adults diagnosed with cutaneous melanoma located on the trunk, extremities, and head and neck.\n\n## Patient Population\n\nThese recommendations apply to adults (>18 years) diagnosed with truncal, extremity, or head and neck non-metastatic cutaneous melanoma.\n\n## Intended Guideline Users\n\nIntended users of this guideline include general surgeons, otolaryngologists, head and neck surgeons, surgical oncologists, dermatologists, and plastic surgeons that provide care for patients with melanoma. Additionally, all clinicians and healthcare providers who are involved in the management or referral of patients with cutaneous melanoma are intended users of these recommendations. Research Questions In patients with non-metastatic cutaneous melanoma with clinically node-negative or node-positive disease of the trunk or extremities, what are the optimal primary clinical margins of excision for melanoma? In patients with distant metastases following a diagnosis of melanoma of the trunk or extremities, what are the optimal primary clinical margins of excision for cutaneous melanoma? Should patients with clinically node-negative cutaneous melanoma of the trunk and extremities undergo SLNB for melanoma? In patients with non-metastatic cutaneous melanoma with clinically node-negative or node-positive disease of the head and neck, what are the optimal primary margins of excision for melanoma? In patients with distant metastases following a diagnosis of melanoma of the head and neck, what are the optimal primary margins of excision for cutaneous melanoma? Should patients with clinically node-negative cutaneous melanoma of the head and neck undergo SLNB for melanoma? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69666/download?token=bBopZRIZ)", "external_id": "cco-51116", "metadata": {"authors": "F. Wright, L.H. Souter, S. Kellett, A. Easson, C. Murray, J. Toye, D. McCready, C. Nessim, D. Ghazarian, N. Look Hong, S. Johnson, D. Goldstein, T. Petrella, Melanoma Disease Site Group", "document_status": "Current", "id": "8-2 Nov 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/69666/download?token=bBopZRIZ", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Primary Excision Margins and Sentinel Lymph Node Biopsy in Cutaneous Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/51116"} +{"content": "## Guideline Objective\n\nTo update a previous guideline on chemotherapy options for women with recurrent, metastatic, or persistent cervical cancer. The primary outcomes of interest are overall survival rate and quality of life. Other outcomes of interest include response rate, progression-free survival rate, and adverse effects. Second-line or higher therapy options are outside the scope of this guideline.\n\n## Patient Population\n\nWomen with metastatic, recurrent, or persistent cervical cancer for whom systemic therapy is indicated. This includes women with squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix.\n\n## Intended Guideline Users\n\nGynecologic oncologists or oncologists treating gynecologic cancers in the province of Ontario.\n\n## Research Question(s)\n\nWhat are the systemic therapy options for women with recurrent, metastatic, or persistent cervical cancer? The primary outcomes of interest are overall survival rate and quality of life. Other outcomes of interest include response rate, progression-free survival rate, and adverse effects. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/52781/download?token=xTwH3eaz)", "external_id": "cco-516", "metadata": {"authors": "H. Hirte, E.B. Kennedy, M. Fung-Kee-Fung, L. Elit , Gynecologic Cancer Disease Site Group", "document_status": "Current", "id": "4-20 Nov 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/52781/download?token=xTwH3eaz", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Systemic Therapy for Recurrent, Metastatic, or Persistent Cervical Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/516"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: Diagnosis and staging Assessment of treatment response? Detection and restaging of recurrence Evaluation of metastasis. Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/29696/download?token=EuepG53n)", "external_id": "cco-51856", "metadata": {"authors": "R. Poon, Program in Evidence-Based Care Disease Site Group Reviewers, Ontario PET Steering Committee", "document_status": "Current", "id": "pet 2017-1 Dec 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/29696/download?token=EuepG53n", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2017", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/51856"} +{"content": "## Guideline Objective\n\nThis recommendation report addresses \u201cbest practices\u201d for prostate needle biopsies and provides guidance on the spectrum of prostate needle biopsy practices, including patient preparation, biopsy techniques, specimen submission to the laboratory, processing of the biopsy specimen, information to include on the requisition and pathology report, and operational issues. Indications for prostate needle biopsy are outside the scope of this document. The report aims to reduce variability in practice across the province, optimize needle biopsy technique and processing, and improve patient care.\n\n## Patient Population\n\nMen with suspected prostate cancer and those with prostate cancer who are being followed in an active surveillance program.\n\n## Intended Guideline Users\n\nProviders involved in any aspect of prostate biopsy practices, including urologists, radiologists, radiation oncologists, pathologists and individuals responsible for ensuring necessary resources. Research Questions Who should order prostate needle biopsies? What is the optimal pre-biopsy preparation and peri-biopsy management for patients having a prostate needle biopsy, including: patient consent, management of patients on antiplatelet and anticoagulant medication, bowel preparation, antibiotic prophylaxis and analgesia? What is the optimal prostate needle biopsy technique? How should the biopsy specimen be submitted to the laboratory? What is the optimal pathology processing technique and reporting? What expertise should individuals have who perform prostate needle biopsy? What are the necessary facility requirements to perform prostate needle biopsy?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/30226/download?token=6O7HgPps)", "external_id": "cco-51986", "metadata": {"authors": "Surgical Oncology Program in conjunction with the Prostate Biopsy Expert Panel", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/30226/download?token=6O7HgPps", "type_of_content": "Guidelines & Advice, Clinical, Health System", "version": "1"}, "section_count": 3, "source": "cco", "title": "Performance of Needle Biopsy of the Prostate for Men with Suspected or Established Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/51986"} +{"content": "## Patient Population\n\nAdult patients with previously untreated early (T1) glottic cancers.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management or referral of adult patients with early (T1) glottic cancer.\n\n## Research Question(s)\n\nIn patients with early (T1) glottic cancer, what is the role of endolaryngeal surgery (with or without laser) versus radiation therapy, in terms of survival, locoregional control, laryngeal preservation rates and voice outcomes? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81871/download?token=v6WWXtXH)", "external_id": "cco-521", "metadata": {"authors": "J. Yoo, C. Lacchetti, A. Hammond, R. Gilbert, Head and Neck Cancer Disease Site Group", "document_status": "Current", "id": "5-2 Oct 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81871/download?token=v6WWXtXH", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "The Role of Endolaryngeal Surgery (With or Without Laser) versus Radiotherapy in the Management of Early (T1) Glottic Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/521"} +{"content": "## Guideline Objective\n\nTo describe evidence-based indications for Mohs micrographic surgery (MMS); To assess Mohs outcomes such as cure rates and recurrence rates, as well as quality of life (QOL) and complications; To assess whether volume of patients treated affects outcomes of MMS.\n\n## Patient Population\n\nAdults with a diagnosis of skin cancer.\n\n## Intended Guideline Users\n\nClinicians involved in the assessment and treatment of patients with skin cancer. Research Questions Does MMS provide better outcomes than WLE in patients with skin cancer? Cure rates, recurrence rates QOL Complications, cosmesis In patients with skin cancer, what are the clinical characteristics or indications that identify groups of patients who derive greater benefit from MMS? Does MMS provide better outcomes than radiation in patients with skin cancer? Cure rates, recurrence rates QOL Complications, cosmesis Does WLE provide better outcomes than radiation in patients with skin cancer? Cure rates, recurrence rates QOL Complications, cosmesis Does surgical volume of MMS predict for better outcomes in patients with skin cancer? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69781/download?token=71nvtba5)", "external_id": "cco-52161", "metadata": {"authors": "C. Murray, D. Sivajohanathan, T. Hanna, S. Bradshaw, N. Solish, B. Moran, R. Hekkenberg, A. Wei, T. Petrella, The Melanoma Disease Site Group", "document_status": "Current", "id": "GL 8-11 Jan 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/69781/download?token=71nvtba5", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Patient Indications for Mohs Micrographic Surgery", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/52161"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to provide clinical practice recommendations for the treatment of non-metastatic muscle-invasive bladder cancer (MIBC). Our recommendations are based on the 2017 American Urological Association (AUA) \u201cTreatment of Non-Metastatic Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline\u201d.\n\n## Patient Population\n\nPatients with non-metastatic MIBC.\n\n## Intended Guideline Users\n\nPrimary care providers, urologists, radiation and medical oncologists, and other healthcare providers involved in the management of non-metastatic MIBC.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60771/download?token=wtxdRDKM)", "external_id": "cco-52171", "metadata": {"authors": "A. Finelli, T. Flood, G. Kulkarni, S. Hotte, M. O\u2019Malley, The Genitourinary Cancer Advisory Committee", "document_status": "In-Review", "id": "GL-END 3-21 Jan 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/60771/download?token=wtxdRDKM", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Cancer Care Ontario Bladder Cancer Guideline: An Endorsement of the 2017 American Urological Association Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA, ASCO, ASTRO, SUO Guide", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/52171"} +{"content": "## Guideline Objective\n\nThe objective of this Expert Recommendation Report is to present expert panel recommendations on the use of APNs in the delivery of cancer services in Ontario, providing unpublished emerging practice evidence to fill in the gaps in the published PEBC APN Guideline.\n\n## Intended Guideline Users\n\nAPNs, nurses, physicians and other inter-professionals involved in the delivery of cancer care Chief Nurse Executives Directors of Nursing and Inter-professional Practice Educators and researchers Healthcare administrators who plan the delivery of cancer services Healthcare policy makers Professional associations (e.g., Canadian Association of Nurses in Oncology, Registered Nurses Association of Ontario)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/32171/download?token=fJ9g7ai5)", "external_id": "cco-52201", "metadata": {"authors": "Ontario Oncology Advanced Practice Nursing Community of Practice, Cancer Care Ontario", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/32171/download?token=fJ9g7ai5", "type_of_content": "Guidelines & Advice, Evidence Summary", "version": "1"}, "section_count": 2, "source": "cco", "title": "Expert Recommendation Report on Clinical Nurse Specialist and Nurse Practitioner Roles in the Delivery of Adult Cancer Services in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/52201"} +{"content": "## Guideline Objective\n\nTo investigate the effectiveness of radiotherapy with curative intent in patients with early stage non-small cell lung cancer (NSCLC) who are medically inoperable.\n\n## Patient Population\n\nAdult patients with potentially curable, early stage (Stage I or II) NSCLC (without nodal involvement or metastases), and who are deemed medically inoperable or refuse surgery.\n\n## Intended Guideline Users\n\nRadiation planning and treatment providers, oncologists, thoracic surgeons, respirologists, diagnostic assessment groups, and other healthcare providers involved with lung cancer. NOTE: Stereotactic body radiation therapy (SBRT) and stereotactic ablative radiation therapy are considered synonymous for the purposes of this guideline and will be referred to as SBRT from this point on.\n\n## Research Question(s)\n\nWhat is the effectiveness of radiotherapy with curative intent in patients with early stage NSCLC who are unable to undergo surgery? What are the most effective dose/fractionation schedules for curative intent radiotherapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/64887/download?token=thkLJasz)", "external_id": "cco-526", "metadata": {"authors": "C.B. Falkson, E. Vella, E. Yu, M. El-Mallah, Y.C. Ung, P.M. Ellis, R. Mackenzie", "document_status": "In-Review", "id": "7-21 May 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/64887/download?token=thkLJasz", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Radiotherapy with Curative Intent in Patients with Early Stage, Medically Inoperable, Non-Small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/526"} +{"content": "## Guideline Objective\n\nImmune checkpoint inhibitor medications are associated with unique immune-related adverse effects (irAEs) that can range from bothersome to life-threatening. Symptoms vary in their onset time, can progress quickly, and may occur months after treatment discontinuation. Early identification of irARs and appropriate management can improve patients\u2019 quality of life and safety. The objective of this guideline is to provide user-friendly guidance for the management of irAEs. It contains the following: A description of irAEs associated with immune checkpoint inhibitor medications. Practical guidance on the general management of irAEs. Detailed algorithms that describe the assessment and management of ten specific irAEs. General considerations for patients on immune checkpoint inhibitor medications.\n\n## Intended Guideline Users\n\nAll clinicians involved in the care of cancer patients who are receiving immune checkpoint inhibitor medications. Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Immune Checkpoint Inhibitor Side Effect Toolkit\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/39391/download?token=Thzk5Jp9)", "external_id": "cco-52976", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/39391/download?token=Thzk5Jp9", "type_of_content": "Guidelines & Advice, Clinical", "version": "1"}, "section_count": 2, "source": "cco", "title": "Immune Checkpoint Inhibitor Toxicity Management Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/52976"} +{"content": "## Guideline Objective\n\nTo examine effective strategies/interventions to manage sexual function side effects as a result of cancer diagnosis and/or treatment with the aim of decreasing distress, and improving quality of life for cancer survivors and their partners.\n\n## Patient Population\n\nAdult men and women (and partners) of all sexual orientations living with cancer of any type. For the purposes of this guideline, men and women who were previously treated for a childhood cancer were not included.\n\n## Intended Guideline Users\n\nHealthcare practitioners such as oncologists, radiation therapists, urologists, gynaecologists, primary care providers, surgeons, nurses, physiotherapists, social workers, counsellors, psychologists and psychiatrists.\n\n## Research Question(s)\n\nWhat is the effectiveness of pharmacological interventions, psychosocial counselling, or devices to manage sexual problems after cancer treatment? More specifically, we examined issues in men and in women separately. Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Intimacy and Sex: A guide for people with cancer and their partners Intimit\u00e9 et sexualit\u00e9: Un guide pour les personnes atteintes de cancer et leurs partenaires\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/53346/download?token=Ltv2nHz2)", "external_id": "cco-531", "metadata": {"authors": "L. Barbera, C. Zwaal, D. Elterman, K. McPherson, W. Wolfman, A. Katz, A. Matthew, Interventions to Address Sexual Problems in People with Cancer Expert Panel", "document_status": "In-Review", "id": "19-6 Apr 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/53346/download?token=Ltv2nHz2", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Interventions to Address Sexual Problems in People with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/531"} +{"content": "## Guideline Objective\n\nTo provide guidance for the management of lower-risk myelodysplastic syndromes (MDS) using systemic therapy. Therapies include, but are not limited to: Hematopoiesis growth factors (i.e., erythropoiesis-stimulating agents [ESA] such as erythropoietin [EPO], granulocyte colony-stimulating factors [G-CSF], romiplostim, and eltrombopag) Lenalidomide in deletion 5q (del[5q]) MDS Lenalidomide in non-del(5q) MDS Hypomethylating agents (5-azacytidine [AZA] and decitabine [DAC]) Iron chelation therapy Immunosuppressive therapy (i.e., cyclosporine [CsA] and anti-thymocyte globulin [ATG])\n\n## Patient Population\n\nAdult patients (age \u226518 years) with lower-risk MDS, (i.e., International Prognostic Scoring System [IPSS] risk score \u22641.0, and IPSS (revised) score \u22643.5)\n\n## Intended Guideline Users\n\nClinicians involved in the care of patients with MDS: hematologists, medical oncologists, oncology nurses, and oncology pharmacists. Research Questions In patients with low-risk MDS, what is the efficacy of hematopoiesis-stimulating agents, thrombopoietin receptor agonists, immunomodulatory agents, hypomethylating agents, iron chelation, immunosuppressive agents, and other/novel agents? What adverse events are associated with the use of hematopoiesis-stimulating agents, thrombopoietin receptor agonists, immunomodulatory agents, hypomethylating agents, iron chelation, immunosuppressive agents, and other/novel agents? Which patients are more or less likely to benefit from treatment with hematopoiesis-stimulating agents, thrombopoietin receptor agonists, immunomodulatory agents, hypomethylating agents, iron chelation, immunosuppressive agents, and other/novel agents? What are the optimal dose and schedule, and treatment duration for the aforementioned treatments? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/52831/download?token=kaxpMfWP)", "external_id": "cco-53186", "metadata": {"authors": "R. Buckstein, F. Baldassarre, D. Maze, A. Schuh, M. Cheung, Hematology Disease Site Group", "document_status": "In-Review", "id": "6-13 Mar 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/52831/download?token=kaxpMfWP", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Systemic therapy for the treatment of adult patients with lower-risk myelodysplastic syndromes", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53186"} +{"content": "## Guideline Objective\n\nTo promote a consistent identity for PSO; To provide recommendations around the components of service and providers of service for high-quality and equitable PSO services within a Regional Cancer Program; and To articulate the relationships and important linkages between PSO and other programs and services within Regional Cancer Programs that provide or support psychosocial care.\n\n## Intended Guideline Users\n\nThe primary target audiences for this report are clinicians and administrators from the Regional Cancer Programs and Cancer Care Ontario. The secondary audiences are patients and families, community-based organizations, and provincial and federal organizations.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/33576/download?token=S9QSuqt0)", "external_id": "cco-53191", "metadata": {"authors": "Psychosocial Oncology Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/33576/download?token=S9QSuqt0", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 2, "source": "cco", "title": "Recommendations for the Delivery of Psychosocial Oncology Services in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53191"} +{"content": "## Guideline Objective\n\nTo identify molecular tests that improve the classification of non-gastrointestinal stromal tumour (non-GIST) soft tissue sarcomas (STS) Identify genetic tests that are of prognostic significance in non-GIST STS Identify genetic tests that inform treatment decisions based on the type of non-GIST STS\n\n## Patient Population\n\nFor Objective 1: Adult patients (\u226518 years) with suspected non-GIST STS For Objective 2: Adult patients with non-GIST STS For Objective 3: Adult patients with non-GIST STS\n\n## Intended Guideline Users\n\nPathologists, general surgeons, orthopedic oncology surgeons, medical oncologists, and other clinicians who are involved in the treatment of the target patients in the province of Ontario. Research Questions Does genetic testing enable accurate typing of non-GIST STS? Specifically, can it be used to differentiate sarcomas from benign and/or locally aggressive tumours, and does it change management and further improve patient outcomes in adult patients with non-GIST STS? Are there genetic tests that predict patient prognosis (including OS, PFS, local control rate, patient-reported outcomes, etc.) in adult patients with non-GIST STS? Are there genetic tests that identify subgroups of adult patients who would derive greater benefit from specific treatments targeting non-GIST STS?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60781/download?token=UDGpcbe1)", "external_id": "cco-53401", "metadata": {"authors": "R.A. Kandel, X. Yao, B.C. Dickson, M. Ghert, S. Popovic, B.M. Purgina, S. Verma, J. Werier, Sarcoma Disease Site Group", "document_status": "Archived", "id": "GL 11-12 Apr 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/60781/download?token=UDGpcbe1", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Molecular Analyses in the Diagnosis, Prognosis, and Selection of Therapy in non-GIST Soft Tissue Sarcomas", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53401"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59586/download?token=YGhNc6Ni)", "external_id": "cco-53531", "metadata": {"authors": "Oncology Nursing Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/59586/download?token=YGhNc6Ni", "type_of_content": "Guidelines & Advice, Position Statement", "version": "2"}, "section_count": 1, "source": "cco", "title": "Position Statements for Nursing Practice in Cancer Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53531"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/33636/download?token=hJie5D1i)", "external_id": "cco-53536", "metadata": {"authors": "R. Poon and the Program in Evidence-Based Care Disease Site Group Reviewers, Ontario PET Steering Committee", "document_status": "Current", "id": "PET 2017-2 May 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/33636/download?token=hJie5D1i", "type_of_content": "Guidelines & Advice, Evidence Summary", "version": "n/a"}, "section_count": 1, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2017", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53536"} +{"content": "## Guideline Objective\n\nThe Head and Neck Disease Site Group (DSG) has recognized a need for guidance regarding the organization and delivery of healthcare services for patients with head and neck cancer, including specific recommendations for the organization of care, the human and physical resources required, and appropriate treatment approaches that should be considered for this population of patients.\n\n## Patient Population\n\nAdult patients who present with symptoms of, or have been diagnosed with, head and neck mucosal malignancies, including salivary and advanced skin, but not thyroid, cancer.\n\n## Intended Guideline Users\n\nAdministrators responsible for developing and implementing new head and neck cancer programs, as well as oncology healthcare professionals who interact with head and neck cancer patients during the full continuum of care from diagnosis to post-treatment follow-up and rehabilitation.\n\n## Research Question(s)\n\nOrganization of Care What minimum requirements are necessary for the organization and delivery of multidisciplinary care to patients with head and neck mucosal malignancies? Areas of interest include healthcare teams and unique infrastructure. What are the recommended staff requirements and expertise required by medical/surgical and allied healthcare professionals to provide optimal care for head and neck patients? Areas of interest include minimum volumes and training to optimize patient outcomes. Clinical Management What is the optimum clinical management recommended for patients with tumours of the head and neck?", "external_id": "cco-536", "metadata": {"authors": "R. Gilbert, M. Devries-Aboud, E. Winquist, J. Waldron, M. McQuestion, Head and Neck Disease Site Group", "document_status": "Archived", "id": "5-3 Dec 2009", "type_of_content": "Guidelines & Advice, Health System"}, "section_count": 4, "source": "cco", "title": "The Management of Head and Neck Cancer in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/536"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/33791/download?token=x4qerEvk)", "external_id": "cco-53631", "metadata": {"authors": "C. Dub\u00e9, D. Armstrong, A. Barkun, N.N. Baxter, N. Chiba, M. Hatcher, B.R. McCurdy, B. Miller, C. Simone, J. Tinmouth, D. Morgan", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/33791/download?token=x4qerEvk", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Gastroscopy Standards and Quality Indicators for Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53631"} +{"content": "## Guideline Objective\n\nThis evidence summary was developed to assist the Patient Reported Outcomes and Symptom Management Program of CCO in revising the algorithms on nausea and vomiting (2010) and on loss of appetite (2012).\n\n## Patient Population\n\nThe target population is adult patients with cancer experiencing symptoms of nausea, vomiting, anorexia, or cachexia. Acute symptoms induced by the current cancer treatment (chemotherapy, radiotherapy) were not the primary focus but major guidelines on this topic have also been included.\n\n## Intended Guideline Users\n\nThe intended users of this evidence summary are staff of the Patient Reported Outcomes and Symptom Management Program. This evidence summary may also be of interest to physicians and nurses dealing with cancer or palliative care symptom management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60571/download?token=ficWVIOA)", "external_id": "cco-53886", "metadata": {"authors": "Glenn G. Fletcher, Martin R. Chasen, Lynne Penton", "document_status": "Current", "id": "ES SMG-2 Jun 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/60571/download?token=ficWVIOA", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Guidelines on Management of Nausea and Vomiting and on Loss of Appetite, Anorexia, and Cachexia in Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53886"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to make recommendations with respect to the role of primary tumour location (PTL) in the selection of epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) and vascular endothelial growth factor (VEGF) inhibitors (first-line/second-line) in addition to chemotherapy for the treatment of unresectable metastatic colorectal cancer (mCRC).\n\n## Patient Population\n\nThe target population consists of adult patients with RAS wild-type unresectable mCRC who are undergoing first-line or second-line chemotherapy.\n\n## Intended Guideline Users\n\nThis guideline is targeted to clinicians involved in the management of patients with mCRC. Research Questions Are there survival and/or quality of life benefits related to the selective use of EGFR monoclonal antibodies (mAbs) and VEGF inhibitors based on PTL for the first and second-line treatment of RAS wild-type, unresectable mCRC?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/52446/download?token=mTOexMDz)", "external_id": "cco-53941", "metadata": {"authors": "R. Goodwin, C. Agbassi, E. Kennedy, J. Biagi, R. Wong, S. Welch, S. Berry, and the Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL END 2-31 Jul 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/52446/download?token=mTOexMDz", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "The Role of Primary Tumour Location in the Selection of Biologics for the Treatment of Unresectable Metastatic Colorectal Cancer: An Endorsement of a Canadian Consensus Statement", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53941"} +{"content": "## Guideline Objective\n\nThe Systemic Treatment Program would like to raise awareness of potential safety concerns and mitigation strategies shared by provinces who have adopted the subcutaneous rituximab formulation.\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/34341/download?token=Bvg8Lsvd)", "external_id": "cco-53981", "metadata": {"authors": "CCO Systemic Treatment", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/34341/download?token=Bvg8Lsvd", "type_of_content": "Drug Safety, Guidelines & Advice, Clinical", "version": "1"}, "section_count": 2, "source": "cco", "title": "Safety Considerations for the Implementation of Subcutaneous Rituximab Formulation", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/53981"} +{"content": "## Guideline Objective\n\nTo improve the quality and accuracy of hormone receptor (HR) testing and its utility as a prognostic and predictive marker for invasive and in situ breast cancer.\n\n## Patient Population\n\nTissue from adult female patients with primary or metastatic invasive or in situ breast cancer was the focus, since most of the literature includes tissue from female patients. However, the recommendations in this guideline would also apply to tissue from male breast cancer patients.\n\n## Intended Guideline Users\n\nPersonnel involved in HR testing and interpretation and any healthcare provider involved in the management of breast cancer patients.\n\n## Research Question(s)\n\nClinical Validity of Immunohistochemistry (IHC): Can IHC reliably determine the levels of expression of the HR pathway and potentially correlate with the clinical outcome compared to other assays (dextran-coated charcoal [DCC] or ligand-binding assay [LBA], enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], and flow cytometry)? Optimizing IHC: How should HR testing be performed optimally to assess true HR status? This includes evaluating the effect of the following: Preanalytic variables (i.e., variables of testing involving the collection, fixation, and storage of samples) Analytic variables (i.e., variables associated with the method of testing itself) Thresholds to define results Postanalytic variables (i.e., variables associated with handling of the results, such as reporting) Quality Assurance of IHC: What parameters should be used to assess the proficiency of an individual laboratory performing HR-status testing? Clinical Validity of the Oncotype DX Assay: Can Oncotype DX reliably determine the levels of expression of the HR pathway?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/17546/download?token=o1jTJZEu)", "external_id": "cco-541", "metadata": {"authors": "S. Nofech-Mozes, E. Vella, S. Dhesy-Thind, W. Hanna", "document_status": "Education and Information", "id": "22-1 May 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/17546/download?token=o1jTJZEu", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Guideline on Hormone Receptor Testing in Breast Cancer and Other Primary Care Providers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/541"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81836/download?token=69cZmTcf)", "external_id": "cco-54246", "metadata": {"authors": "S. Das, L. Durocher-Allen, C. Hawkins, M. MacDonald, J. Perry, A. Sahgal, and the Adult Gliomas Expert Panel", "document_status": "Current", "id": "GL END 9-10 Aug 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/81836/download?token=69cZmTcf", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "An Endorsement of the ASCO-SNO Guideline on Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/54246"} +{"content": "## Research Question(s)\n\nWhat is the optimum organization for the delivery of cancer-related hepatic, pancreatic, and biliary tract surgery in Ontario? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/84056/download?token=u8m4MW9Z)", "external_id": "cco-546", "metadata": {"authors": "Expert Panel on HPB Surgical Oncology", "document_status": "Current", "id": "17-2 Apr 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/84056/download?token=u8m4MW9Z", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 1, "source": "cco", "title": "Hepatic, Pancreatic and Biliary Tract Surgical Oncology Standards", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/546"} +{"content": "## Guideline Objective\n\nThe objectives of the guideline are to make recommendations regarding the addition of neoadjuvant/concurrent/adjuvant chemotherapy to chemoradiotherapy in the management of locally advanced squamous cell or undifferentiated nasopharyngeal cancer (NPC) and to identify the optimal chemotherapeutic regimen that improves overall survival. Our recommendations are based on the 2021 Guideline on Chemotherapy in Combination with Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline\n\n## Patient Population\n\nNewly diagnosed patients, eligible for chemotherapy, with locally advanced squamous cell or undifferentiated NPC (stage III or IV).\n\n## Intended Guideline Users\n\nHealthcare providers involved in the management of NPC patients.\n\n## Research Question(s)\n\nThe Chemotherapy and Radiotherapy for Nasopharyngeal Cancer Development Group (GDG) of Ontario Health (Cancer Care Ontario) endorses the Chinese Society of Clinical Oncology (CSCO)/American Society of Clinical Oncology (ASCO) recommendations of Chemotherapy in Combination with Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline modified by the endorsement process described in this document. They were reprinted with the permission of Wolters Kluwer Health, Inc. and Copyright Clearance Center. Sixteen of the 21 CSCO/ASCO recommendations were endorsed without changes. Four (R 1.1, R 3.3, R 4.1, R 5.1) recommendations were endorsed with modifications and/or clarifications and one recommendation (R 3.4) was not endorsed\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81891/download?token=dHo_D6C9)", "external_id": "cco-551", "metadata": {"authors": "E. Winquist, J. Brown, C. Ho, S. Kuruvilla, B. Purgina, K. Zaza, The Chemotherapy and Radiotherapy for Nasopharyngeal Cancer Guideline Development Group", "document_status": "In-Review", "id": "GL END 5-7 Nov 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/81891/download?token=dHo_D6C9", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "An Endorsement of the 2021 Guideline on Chemotherapy in Combination with Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/551"} +{"content": "## Guideline Objective\n\nThe objective of this document is to provide guidelines for surgical techniques for RP and concurrent PLND and for the handling of the surgical specimens in the operating room and laboratory, in order to achieve optimal benefit for the patient, with minimal risk of harm.\n\n## Patient Population\n\nAdult males with potentially curable prostate cancer for whom RP is the preferred treatment option. Risk Categories: Patients may be considered \u201clow\u201d, \u201cintermediate\u201d, or \u201chigh\u201d risk for treatment failure (e.g., local recurrence, biochemical failure with prostate-specific antigen [PSA] relapse, emergence of metastatic disease) based on disease characteristics using the definitions proposed by D\u2019Amico et al. Patient Risk: Low Risk: PSA <10, Gleason \u2264 6, and clinical stage T1 or T2 Intermediate Risk: PSA 10-20, and/or Gleason 7 High Risk: PSA >20, Gleason \u2265 8, or clinical stage \u2265T3\n\n## Research Question(s)\n\nSurgical Questions What are the recommended surgical procedures and outcomes for radical prostatectomy (RP), specifically: What is the recommended extent of resection, and what is an acceptable positive margin rate? What are the reported rates for surgical complications, specifically incontinence, erectile dysfunction, rectal injury, and blood transfusion, and does surgical technique (e.g., nerve sparing, bladder neck preservation) affect complication rates? Under what circumstances should nerve-sparing techniques be used? Which patients should receive pelvic lymph node dissection (PLND), and what is the recommended extent of PLND? Pathological Questions What are the recommended procedures for handling the RP specimen in the operating room and for handling and processing the RP specimen (with or without lymph nodes) in the pathology lab? What diagnostic and prognostic elements should be included in the pathology report, what format should be used, and what reporting elements should be included? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75756/download?token=YMi76p4G)", "external_id": "cco-556", "metadata": {"authors": "J. Chin, J. Srigley, L.A. Mayhew, R.B. Rumble, C. Crossley, A. Hunter, N. Fleshner, B. Bora, R. McLeod, S. McNair, B. Langer, A. Evans, Prostate Cancer Surgery and Pathology Expert Panel", "document_status": "Current", "id": "17-3 Oct 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/75756/download?token=YMi76p4G", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Guideline for Optimization of Surgical and Pathological Quality Performance for Radical Prostatectomy in Prostate Cancer Management", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/556"} +{"content": "## Guideline Objective\n\nDescribe recommended entry and transfer of care criteria for colorectal Diagnostic Assessment Programs (DAPs) in Ontario.\n\n## Intended Guideline Users\n\nColorectal surgeons, general surgeons, internists, gastroenterologists, radiation and medical oncologists, radiologists, family physicians, general practitioners, emergency department physicians,\u00a0and primary care providers (e.g. nurse practitioners, registered nurses, physician assistants, etc.)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/39321/download?token=TdyTrSZJ)", "external_id": "cco-56266", "metadata": {"authors": "Erin Kennedy, Melissa Kaan, Andrea Hatvani, Yasir Khan, Catherine Dube, Hugh Langley, Barbara-Anne Maier, Millie Litt, Nancy Baxter, Blair McDonald, Catherine Cotton, Jamie White, Tracey Corner, Anne Newman, Gary Roberts, Bharat Sharma, Chetty Runjan, Bronwen McCurdy", "document_status": "Education and Information", "pdf_url": "https://www.cancercareontario.ca/en/file/39321/download?token=TdyTrSZJ", "type_of_content": "Guidelines & Advice, Clinical", "version": "1"}, "section_count": 2, "source": "cco", "title": "Recommendation Report: Entry and Transfer of Care Criteria for Colorectal Diagnostic Assessment Programs (DAPs) in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/56266"} +{"content": "## Patient Population\n\nPatients with curable colon and rectal cancer in whom surgical management with radical excision is undertaken. This may include selected patients with M1 disease. This document does not apply to patients with primary cancers that are managed by polypectomy or full thickness transanal excision, patients treated for recurrent tumours, or patients undergoing surgery with palliative intent.\n\n## Research Question(s)\n\nWhat is the recommended technique and extent of surgical resection for curable colorectal cancer (CRC), including extent of bowel resection, extent of lymph node resection, and reporting requirements? What is the recommended approach to processing and reporting the resected specimen, including specimen marking in the operating room, as well as processing and reporting requirements in the pathology laboratory?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/71941/download?token=Bc9kJQQg)", "external_id": "cco-566", "metadata": {"authors": "A.J. Smith, D.K. Driman, K. Spithoff, R. McLeod, A. Hunter, R.B. Rumble, B. Langer , Colon and Rectal Cancer Surgery and Pathology Expert Panel", "document_status": "Archived", "id": "17-4 Nov 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/71941/download?token=Bc9kJQQg", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "Optimization of Surgical and Pathological Quality Performance in Radical Surgery for Colon and Rectal Cancer: Margins and Lymph Nodes", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/566"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence evaluation of metastasis. Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/39961/download?token=GrslJ2U9)", "external_id": "cco-56676", "metadata": {"authors": "R. Poon,, Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "pet 2018-1 Oct 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/39961/download?token=GrslJ2U9", "type_of_content": "Guidelines & Advice, Evidence Summary", "version": "n/a"}, "section_count": 3, "source": "cco", "title": "PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2018", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/56676"} +{"content": "## Patient Population\n\nMale and female patients with early-stage breast cancer.\n\n## Intended Guideline Users\n\nClinicians involved in breast surgery, including surgeons, pathologists, medical oncologists, radiation oncologists, nuclear medicine practitioners, radiologists, other allied health professionals (e.g., nurses, physiotherapists), administrators, and also breast cancer patients.\n\n## Research Question(s)\n\nClinical Practice Should SLNB be the recommended standard of care for women and men with proven breast cancer, whose clinical presentation is suggestive of early-stage disease? How should the results of SLNB be utilized in clinical practice? Can level I/II axillary lymph node dissection (ALND) be avoided in patients with negative findings on sentinel lymph node biopsy (SLNB)? Is level I/II ALND necessary for all patients with positive findings on SLNB? What is the role of SLNB in special circumstances in clinical practice? (special circumstances include large and locally advanced invasive tumours, multicentric tumours, inflammatory breast cancer, ductal carcinoma in situ (DCIS), older age (65 years or more), obesity, male breast cancer, pregnancy, evaluation of the internal mammary nodes, presence of suspicious palpable axillary nodes, prior breast or axillary surgery, and preoperative systemic therapy). What factors affect the success of SLNB (including low rates of complications and falsenegative results)? What are the potential benefits and harms associated with SLNB? Technical Aspects of SLNB What is the recommended mapping technique for SLNB? What operative technique is recommended? What is the recommended technique for pathological processing, handling, and reporting? Organization of Care How should the delivery of SLNB be organized in Ontario with respect to team membership, experience and training, and the institutional setting? What is the recommended experience and training for surgeons who perform SLNB? What are the recommended criteria and resources for institutions performing SLNB? Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Guidance to Implementing Breast Sentinel Lymph Node Biopsy (SLNB) within a Hospital: An Information Package - Toolkit\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/11291/download?token=qxUBbAIa)", "external_id": "cco-571", "metadata": {"authors": "R. George, M. L. Quan, D. McCready, R. McLeod, R.B. Rumble, SLNB in Breast Cancer Expert Panel", "document_status": "Archived", "id": "17-5 Jul 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/11291/download?token=qxUBbAIa", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/571"} +{"content": "## Guideline Objective\n\nTo assess the added clinical value of magnetic resonance (MR)-guided intracavitary (IC) or MR-guided intracavitary/interstitial (ICIS) brachytherapy (BT), compared with two-dimensional (2D) BT and computed tomography (CT)-guided BT.\n\n## Patient Population\n\nWomen with potentially curable, non-operable, locally advanced cervical cancer receiving external beam radiation (with or without chemotherapy) and BT.\n\n## Intended Guideline Users\n\nIntended users include radiation and gynecologic oncologists, physicists, dosimetrists and radiation therapists for the purpose of MR-guided IC and ICIS BT for patients with cervical cancer. Administrators and policy makers will also use the guideline for programmatic planning Research Questions Does MR-guided IC BT, with or without IS needles and including treatment plan adaptation and optimization, improve tumour control and/or survival and/or reduce harmful side effects compared with conventional 2D-guided BT or CT-guided BT in patients with cervical cancer? Which patients with cervical cancer benefit from the use of MR-guided ICIS BT compared with MR-guided IC BT alone? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81356/download?token=VS8RakKH)", "external_id": "cco-57316", "metadata": {"authors": "D. D\u2019Souza,, M. Milosevic,, J. Brown,, S.E. Ferguson,, E. Leung,, A. Ravi,, MR-Guided Intracavitary and interstitial Brachytherapy for Cervical Cancer Expert Panel", "document_status": "Current", "id": "GL 21-2 Nov 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/81356/download?token=VS8RakKH", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Three-Dimensional MR-Guided Intracavitary and Interstitial Brachytherapy for Cervical Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57316"} +{"content": "## Guideline Objective\n\nThe intent of these quality statements is to drive the development of strategies to implement self-management and self-management support in cancer care throughout the cancer continuum. It is also to encourage administrators and individual providers to begin to examine how self-management and self-management support can be implemented and measured in their individual organizations and practices. This document does not prescribe how organizations and individuals should achieve compliance with the statements, but it establishes a standard for how care should be optimally designed to support self-management in Ontario. The quality statements outline the level of service that any person (patient, family member or caregiver) using adult oncology services in Ontario should expect to receive with regard to self-management support. The quality statements address healthcare provider-to-patient collaboration and pertain primarily to activities within the Regional Cancer Programs.\n\n## Patient Population\n\nAll people affected by cancer.\n\n## Intended Guideline Users\n\nHealthcare administrators and individual healthcare providers. Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Self-Management in Cancer Toolkit\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/41086/download?token=KOsw_H62)", "external_id": "cco-57371", "metadata": {"authors": "Patient Education Program", "document_status": "Current", "id": "N/A Nov 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/41086/download?token=KOsw_H62", "type_of_content": "Guidelines & Advice, Health System", "version": "1"}, "section_count": 3, "source": "cco", "title": "Self-Management in Cancer: Quality Standards", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57371"} +{"content": "## Guideline Objective\n\nTo provide a summary of evidence surrounding the clinical utility of Gallium-68 (68Ga) positron emission tomography (PET) imaging in patients with neuroendocrine tumours (NETs) and recommendations for their use in Ontario.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed well-differentiated NETs\n\n## Intended Guideline Users\n\nThis recommendation report is intended to guide the Ontario PET Steering Committee with respect to the development of indications in the context of the patient management pathway. This recommendation report may also be useful to inform clinicians who are involved in the care of patients with NETs. Research Questions What benefit to clinical management does PET or PET/CT contribute to the initial diagnosis of NETs? What benefit to clinical management does PET or PET/CT contribute to the staging and restaging of NETs? What benefit to clinical management does PET or PET/CT contribute to the assessment of treatment response for NETs? What benefit to clinical management does PET or PET/CT contribute to the routine surveillance of NETs? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/41036/download?token=zHVBmnmi)", "external_id": "cco-57516", "metadata": {"authors": "S. Singh,, R. Poon,, R. Wong,, U. Metser, , PET Steering Committee", "document_status": "Current", "id": "PET 19 Nov 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/41036/download?token=zHVBmnmi", "type_of_content": "Guidelines & Advice, Clinical", "version": "n/a"}, "section_count": 3, "source": "cco", "title": "Gallium-68 PET Imaging in Neuroendocrine Tumours", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57516"} +{"content": "## Guideline Objective\n\nTo address the drug waste issue related to Beyond-Use-Dates (BUD) implementation as per the NAPRA Model Standards, a BUD Mitigation Strategy Working Group was created. The primary objective of the Working Group was to develop a Recommendations Report which complies with the NAPRA Model Standards for BUD and provides potential strategies to minimize wastage due to single-dose vials.\n\n## Patient Population\n\nN/A\n\n## Intended Guideline Users\n\nProviders (Pharmacists and other Health Professionals) Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/41066/download?token=lipZ-kBB)", "external_id": "cco-57521", "metadata": {"authors": "Beyond-Use Date Mitigation Strategy Working Group", "document_status": "Current", "id": "N/A Mar 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/41066/download?token=lipZ-kBB", "type_of_content": "Guidelines & Advice, Clinical", "version": "1"}, "section_count": 3, "source": "cco", "title": "Cancer Care Ontario Beyond-Use Date Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57521"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to provide recommendations on the most appropriate management of patients with malignant pleural mesothelioma. Our recommendations are based on the 2018 American Society of Clinical Oncology (ASCO) guideline on the treatment of malignant pleural mesothelioma.\n\n## Patient Population\n\nThis guideline targets adult patients with malignant pleural mesothelioma.\n\n## Intended Guideline Users\n\nThe intended users of this guideline are medical, surgical, and radiation oncologists; oncology nurses and physician assistants; pulmonologists; radiologists; pathologists; and general practitioners managing patients with malignant pleural mesothelioma. Research Question Which treatment strategy leads to the greatest benefit and least adverse effects for patients with malignant pleural mesothelioma?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/64766/download?token=Aq1sEH9X)", "external_id": "cco-57556", "metadata": {"authors": "M. de Perrot, E.T. Vella, P. Bradbury, J. Cho, C. Dennie, J. Goffin, R. MacRae, D. Maziak, M. Tsao, Y.C. Ung, P.M. Ellis, Lung Cancer Disease Site Group", "document_status": "In-Review", "id": "7-14 Dec 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/64766/download?token=Aq1sEH9X", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 3, "source": "cco", "title": "Endorsement of the 2018 American Society of Clinical Oncology Treatment of Malignant Pleural Mesothelioma Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57556"} +{"content": "## Guideline Objective\n\nThe current evidence summary was developed to assist the Patient Reported Outcomes and Symptom Management Program of CCO in revising the algorithm on dyspnea prepared in 2010.\n\n## Patient Population\n\nThe target population is adult patients with cancer experiencing dyspnea. Acute symptoms induced by the current cancer treatment (chemotherapy, radiotherapy) were considered outside the scope.\n\n## Intended Guideline Users\n\nThe intended users of this evidence summary are staff of the Patient Reported Outcomes and Symptom Management Program. This evidence summary may also be of interest to physicians and nurses dealing with cancer or palliative care symptom management. Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60561/download?token=ojUiX6gl)", "external_id": "cco-57721", "metadata": {"authors": "Glenn G. Fletcher", "document_status": "Current", "id": "ES SMG-3 Jan 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/60561/download?token=ojUiX6gl", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Guidelines on Management of Dyspnea (Breathlessness) in Patients with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57721"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to provide clinical practice recommendations for the use of biodegradable spacers for prostate cancer treatment.\n\n## Patient Population\n\nPatients undergoing radiation treatment for localized prostate cancer\n\n## Intended Guideline Users\n\nRadiation oncologists and genitourinary oncologists involved in the management of prostate cancer. Research Questions Does the use of biodegradable hydrogel spacers during RT for prostate cancer decrease rectal (and other) toxicities and maintain QOL following treatment?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70586/download?token=CHgW2cr7)", "external_id": "cco-57731", "metadata": {"authors": "P Chung, J Brown, D D\u2019Souza, W Koll, S Morgan, and the biodegradable spacer insertion during radiotherapy for prostate cancer recommendation report group (SPACER RRG).", "document_status": "In-Review", "id": "RR 21-5 Jan 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/70586/download?token=CHgW2cr7", "type_of_content": "Guidelines & Advice, Clinical", "version": "n/a"}, "section_count": 3, "source": "cco", "title": "Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/57731"} +{"content": "## Guideline Objective\n\nTo evaluate the appropriateness of, and make recommendations on, routine testing for human papillomavirus (HPV) status in adult patients with primary, or neck nodal metastatic, squamous cell carcinoma (SCC) of the head and neck.\n\n## Patient Population\n\nAdult patients with squamous cell carcinomas arising in oropharynx, larynx, hypopharynx, nasopharynx, sinonasal tract, or oral cavity subsites or an unknown primary head and neck site.\n\n## Intended Guideline Users\n\nClinicians involved in the delivery of care of adult patients with head and neck squamous cell carcinoma (HNSCC). Pathologists involved in the evaluation of HNSCCs.\n\n## Research Question(s)\n\nWhat is the relationship between HPV positivity and outcome in head and neck squamous cell carcinomas (HNSCC)? In which head and neck subsites is the prevalence of HPV-associated squamous cell carcinoma high enough to justify routine testing of HPV positivity? What is the diagnostic and prognostic value of routine testing of HPV status in patients with neck nodal metastatic squamous cell carcinoma from an unknown head and neck primary? What is the optimal testing method for the identification of HPV positivity in head and neck squamous cell carcinomas (HNSCC)? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81881/download?token=ttklKj4p)", "external_id": "cco-581", "metadata": {"authors": "C. Lacchetti, J. Waldron, B. Perez-Ordonez, S. Kamel-Reid, C. Cripps, R. Gilbert , Head and Neck Cancer Disease Site Group", "document_status": "Current", "id": "5-9 Jan 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/81881/download?token=ttklKj4p", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 4, "source": "cco", "title": "Routine Human Papilloma Virus (HPV) Testing in Squamous Cell Head and Neck Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/581"} +{"content": "## Guideline Objective\n\nTo enable the development of a standardized and comprehensive approach to toxicity management across the province, TMAC formulated eight recommendations for executive review by CCO. These consensus-based recommendations address focus areas such as implementing solutions for engaging patients and families, improving access to timely support, targeting high-risk patients for additional toxicity management support, and enabling effective & coordinated multidisciplinary teams.\n\n## Patient Population\n\nN/A\n\n## Intended Guideline Users\n\nThese recommendations will serve as a guiding framework for future toxicity management planning and implementation by CCO and the Regional Cancer Programs, which will tailor the operationalization of recommendations per regional/local contexts. Research Questions N/A Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/43601/download?token=BCD9_kip)", "external_id": "cco-58191", "metadata": {"authors": "Toxicity Management Advisory Committee (TMAC)", "document_status": "Current", "id": "N/A May 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/43601/download?token=BCD9_kip", "type_of_content": "Guidelines & Advice", "version": "Final"}, "section_count": 3, "source": "cco", "title": "Guidance for the Development of a Provincial Approach to Toxicity Management Summary of Recommendations from the Toxicity Management Advisory Committee", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/58191"} +{"content": "## Guideline Objective\n\nTo provide updated guidance regarding the therapy for multiple myeloma.\n\n## Patient Population\n\nPatients with multiple myeloma,including smouldering myeloma.\n\n## Intended Guideline Users\n\nClinicians and institutions providing care for patients with multiple myeloma. Research Questions This clinical practice guideline update addresses four topic areas with these questions: Should smoldering myeloma (asymptomatic) be treated? If smoldering myeloma is treated based on what criteria, and with what regimen(s)? For whom should autologous stem cell transplantation (ASCT) be offered and based on what criteria? What is the recommended initial therapy before ASCT? What post-ASCT therapy (consolidation and/or mainte- nance) is recommended and for what duration? Transplant-Ineligible Multiple Myeloma? What is the recommended regimen for initial therapy(ies) in transplant-ineligible patients? What are the outcome goals following initial therapy for transplant-ineligible patients? What are the recommended therapy(ies) at first relapse? What are the recommended therapy(ies) after subsequent relapses? How does previous treatment impact choice of therapy? What factors influence the choice of relapse therapy? Note that the questions have been reorganized and reworded from the 2019 guideline and that smoldering myeloma has been added as a topic area.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/82531/download?token=ylTtUsJm)", "external_id": "cco-58411", "metadata": {"authors": "Lisa K. Hicks MD MSc, Hans J. Messersmith MPH, Samer Al Hadidi MD, Rahul Banerjee MD, Benjamin A. Derman MD, Shaji Kumar MD, Tanya M. Wildes MD, Susan Bal MD, Sita Bhella MD, Cynthia Chmielewski, Caitlin Costello MD, Raetasha Dabney MD, Monique Hartley-Brown MD, Alan Langerak MD, Brea Lipe MD, Thomas Martin MD, Arleigh McCurdy MD, Hira Mian MD, Eloisa Riva MD, Rahul Seth DO, Latha Subramanian MD, Joseph Mikhael MD", "document_status": "Current", "id": "GL 6-A-2023-1 Jan 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/82531/download?token=ylTtUsJm", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Treatment of Multiple Myeloma: ASCO\u2013Ontario Health (Cancer Care Ontario) Living Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/58411"} +{"content": "## Patient Population\n\nAdult patients presenting in primary care settings comprise the target population. This guideline does not provide recommendations for patients who present with alarming emergency symptoms and signs of hemodynamic instability, acute gastrointestinal hemorrhaging, acute intestinal obstructions, or unremitting abdominal pain. These patients should be immediately referred to emergency for assessment and treatment. In addition, this guideline does not address CRC screening for asymptomatic patients.\n\n## Intended Guideline Users\n\nFPs, general practitioners, emergency room physicians, other PCPs (nurse practitioners, registered nurses, and physician assistants), surgeons and gastroenterologists. For the purposes of this document, we have referred to FPs, general practitioners, emergency room physicians, and other PCPs as \u2018FPs and other PCPs\u2019. Along the diagnostic assessment pathway, FPs and other PCPs should apply the College of Physicians and Surgeons of Ontario\u2019s policy on Test Results Management to ensure that an appropriate response to test results is met. This guideline is also intended for policymakers to help ensure that resources are in place so that target wait times can be achieved.\n\n## Research Question(s)\n\nOverall Question How should patients presenting to family physicians (FPs) and other primary care providers (PCPs) with signs and/or symptoms of colorectal cancer (CRC) be managed? The following questions are the factors considered in answering the overall question: What signs, symptoms, and other clinical features that present in primary care are predictive of CRC? What is the diagnostic accuracy of investigations commonly considered for patients presenting with signs and/or symptoms of CRC? What major, known risk factors increase the likelihood of CRC in patients presenting with signs and/or symptoms of CRC? Which factors are associated with delayed referral? Which delay factors can be attributed to patients, and which factors can be attributed to providers? Does a delay in the time to consultation affect patient outcome? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81366/download?token=pI8OuI1B)", "external_id": "cco-586", "metadata": {"authors": "L. Del Giudice, E. Vella, A. Hey, W. Harris, M. Simunovic, C. Levitt , Colorectal Cancer Referral Expert Panel", "document_status": "Current", "id": "24-1 Apr 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/81366/download?token=pI8OuI1B", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Referral of Patients with Suspected Colorectal Cancer by Family Physicians and Other Primary Care Providers", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/586"} +{"content": "## Guideline Objective\n\nThese Recommendations aim to provide guidance to healthcare providers and administrators on implementing optimal delivery of follow-up care for all cancer survivors by clarifying: The roles of primary care providers and specialist teams; Settings in which this care should be provided; and, Processes involved in organization of follow-up care.\n\n## Patient Population\n\nAll cancers\n\n## Intended Guideline Users\n\nHealth care providers, health system planners and administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/46716/download?token=9AJDzhvQ)", "external_id": "cco-58736", "metadata": {"authors": "Cancer Care Ontario", "document_status": "Current", "id": "N/A Mar 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/46716/download?token=9AJDzhvQ", "type_of_content": "Guidelines & Advice, Health System, Models of Care", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Follow-Up Model of Care for Cancer Survivors: Recommendations for the Delivery of Follow-up Care for Cancer Survivors in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/58736"} +{"content": "## Guideline Objective\n\nTake-home cancer drugs (THCD) are medications used for the active treatment of cancer and are usually dispensed for administration in the home (e.g., oral chemotherapy). These drugs have become a standard treatment for many cancers and present opportunities and challenges for patients, providers, and the health system. Robust guidelines with clear processes have been developed for intravenous cancer drugs (IVCD) and as a result, its delivery is viewed as more comprehensive, organized, safer and person-centred than THCD. Currently, dispensing models for THCD remain variable across Ontario. To date, there has been no formal examination of delivery models for THCD nor have specific standards and expectations been established in the province. As such, in April 2017, CCO convened the Oncology Pharmacy Task Force. The mandate of this Task Force was to advise Cancer Care Ontario (CCO) on how to enhance the current system for THCD delivery to optimize quality and safety; subsequently, to deliver a report to the Ministry of Health and Long-Term Care (MOHLTC) based on the findings of the Task Force. The objective of this report is to present consensus-based recommendations and alternate models of THCD delivery that optimize quality and safety. Our goal was not to create new knowledge but to make the best use of existing areas of evidence and lessons learned in other jurisdictions as well as to contribute to emerging practice to address the gaps.\n\n## Patient Population\n\nN/A\n\n## Intended Guideline Users\n\nProviders (Physicians, Pharmacists, Nurses) & Administrators Research Questions N/A Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/45516/download?token=CpuaFl_B)", "external_id": "cco-58926", "metadata": {"authors": "Aliya Pardhan,, Kathy Vu,, Daniela Gallo-Hershberg,, Leta Forbes,, Scott Gavura,, Vishal Kukreti", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/45516/download?token=CpuaFl_B", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Enhancing the Delivery of Take-Home Cancer Drugs in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/58926"} +{"content": "## Guideline Objective\n\nThe purpose of this guideline is to provide advice about the organization and delivery of healthcare services for adult patients with head and neck cancer (not including thyroid cancer).\n\n## Patient Population\n\nAdult patients who present with symptoms of, or have been diagnosed with, head and neck malignancies, including advanced salivary and skin, but not thyroid cancer.\n\n## Intended Guideline Users\n\nThis document is intended for administrators responsible for maintaining, developing, and implementing head and neck cancer programs, as well as oncology healthcare professionals who interact with head and neck cancer patients during the full continuum of care from diagnosis to post-treatment follow-up and rehabilitation. Research Questions What minimum requirements are necessary for the organization and delivery of multidisciplinary care to patients with head and neck malignancies, including advanced salivary and skin, but not thyroid cancers? Areas of interest include healthcare teams and unique infrastructure. What are the recommended staff requirements and expertise required by medical/surgical, nursing, and allied healthcare professionals to provide optimal care for these head and neck patients? Areas of interest include minimum volumes and training to optimize patient outcomes. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81861/download?token=V4Sd2h6r)", "external_id": "cco-58936", "metadata": {"authors": "J. Irish,, J. Kim,, J. Waldron,, J. Yoo,, M. Brouwers,, E. Meertens,, S. McNair,, C. Walker-Dilks", "document_status": "In-Review", "id": "GL 5-3ORG Apr 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/81861/download?token=V4Sd2h6r", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 3, "source": "cco", "title": "Organizational Guidance for the Care of Patients with Head and Neck Cancer in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/58936"} +{"content": "## Guideline Objective\n\nTo provide direction as to appropriate non-hematologic autoimmune indications for aHCT, focusing on three selected autoimmune diseases (MS, SSc, IBD), To potentially identify specialized resources, in addition to (or instead of) what is provided in the cancer system, to enable safe and effective aHCT for the three selected autoimmune diseases, To provide evidence to support programmatic decision making regarding indications for the three selected autoimmune disease.\n\n## Patient Population\n\nAll adult patients with MS, SSc, or IBD receiving aHCT were included.\n\n## Intended Guideline Users\n\nThe SSO and SCT Advisory Committee to inform planning of services for HCT delivery in Ontario. Research Questions In patients with MS, is aHCT more effective than alternative therapies in halting disease progression? In patients with SSc, is aHCT more effective than alternative therapies in halting disease progression? In patients with IBD, is aHCT more effective than alternative therapies in halting disease progression?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70521/download?token=b002u9lu)", "external_id": "cco-59296", "metadata": {"authors": "H. Atkins,, J. Brown,, C. Bredeson,, T. Kouroukis, and the Specialized Services Oversight and Stem Cell Transplant Advisory Committee", "document_status": "Current", "id": "ES SCT-10 May 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/70521/download?token=b002u9lu", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Autologous hematopoietic cell transplantation for autoimmune diseases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/59296"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to make recommendations regarding the non-surgical treatment of advanced hepatocellular carcinoma (HCC).\n\n## Patient Population\n\nThese recommendations apply to adults with locally advanced and advanced HCC, Barcelona Clinic Liver Cancer Stage B and higher, who are not suitable for transplant or surgery.\n\n## Intended Guideline Users\n\nIntended users of the guideline are clinicians involved in the care of patients who have HCC; specifically, medical oncologists, radiation oncologists, interventional radiologists, hepatologists, and surgical oncologists. Research Questions What are benefits of other local therapies (transarterial ethanol ablation [TEA], bland transarterial embolization [TAE], radiofrequency ablation [RFA], transarterial radioembolization [TARE], stereotactic body radiation therapy [SBRT] and drug eluting bead transarterial chemoembolization [DEB-TACE]) versus transarterial chemoembolization (TACE)? What is the benefit of the addition of sorafenib to local therapies (TEA, TAE, RFA, TARE, SBRT, TACE, DEB-TACE) What is the benefit of other systemic treatment regimens versus sorafenib? What is the benefit of the eradication of viral hepatitis (HCV and/or HBV) in patients with advanced HCC? What is the benefit of second-line systemic therapy following sorafenib? Is there a survival difference in HCV populations compared with HBV populations compared with non-viral populations when treated with sorafenib? Is there a survival difference in HCV populations compared with HBV populations compared with non-viral populations when treated with TACE, TAE, or TEA? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/46921/download?token=IzscZr53)", "external_id": "cco-59651", "metadata": {"authors": "B.M. Meyers, , J. Knox,, R. Cosby,, R. Beecroft,, K. Chan,, N. Coburn,, J. Feld,, D. Jonker,, A. Mahmud,, J. Ringash, and the Gastrointestinal Disease Site Group", "document_status": "In-Review", "id": "GL 2-24 May 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/46921/download?token=IzscZr53", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Non-Surgical Management of Advanced Hepatocellular Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/59651"} +{"content": "## Guideline Objective\n\nThis document presents a practical framework and standards to guide the delivery of systemic treatment Ontario-wide, that is, within cancer-centres, and in facilities beyond the confines of regional cancer centres. The primary goal is to provide safe, evidence-based systemic cancer treatment, maximizing the efficient use of resources and employing the principle of person-centered care with an emphasis on providing care as close to home as possible. Service provision, complexity of care, safety, accessibility, and quality care across all levels defined by the patient, organization, and system perspective, as well as appropriateness, transparency, and accountability have been considered. Both education and research are integral due to their important roles in safety and quality improvement.\n\n## Patient Population\n\nAll adult patients with cancer who are receiving systemic treatment.\n\n## Intended Guideline Users\n\nThe standards in this guideline apply to the organization and structure of systemic treatment programs in Ontario. They apply to all institutions and programs delivering ambulatory systemic treatment within the province of Ontario. Research Questions What is the best way to organize the delivery of ambulatory systemic treatment in Ontario? Specifically, what has been published or implemented in other jurisdictions that can inform the following aspects of delivery of systemic treatment: Safe delivery of systemic treatment Staff numbers to safely deliver systemic treatment (double checks, volumes of oncology patients per nurse, volumes of systemic treatment doses/patients prepared per pharmacy technician, volumes of systemic treatment doses/patients verified per oncology pharmacist) Validated teaching tools for oral systemic treatment Requirements of health care providers to be sufficiently skilled and maintain competency (volume of oncology patients per nurse, volume of systemic treatment doses/patients prepared per pharmacy technician, volume of systemic treatment doses/patients verified per pharmacist) Health care providers and their roles The role of oncologists/hematologists, general practitioners in oncology, and nurse practitioners in prescribing systemic treatment Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81231/download?token=8Ip57YmI)", "external_id": "cco-60086", "metadata": {"authors": "L.Forbes, , L.D. Durocher-Allen, , K. Vu, , D. Gallo-Hershberg, , A. Pardhan, , K. Kennedy, , J. Newton, , L. Pitre, , D. Root", "document_status": "Current", "id": "GL 12-10 Jul 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/81231/download?token=8Ip57YmI", "type_of_content": "Guidelines & Advice, Health System", "version": "2"}, "section_count": 3, "source": "cco", "title": "Regional Models of Care for Systemic Treatment: Standards for the Organization and Delivery of Systemic Treatment", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60086"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, or epilepsy is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, or epilepsy (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer sarcoidosis or epilepsy with respect to: Diagnosis and staging Assessment of treatment response. Detection and restaging of recurrence. Evaluation of metastasis. Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/47636/download?token=NZkZqtfc)", "external_id": "cco-60091", "metadata": {"authors": "R. Poon, , and the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2018-2 Jul 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/47636/download?token=NZkZqtfc", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2018", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60091"} +{"content": "## Guideline Objective\n\nCancer Care Ontario\u2019s Prevention and Cancer Control portfolio with the Program in Evidence-Based Care developed this report to evaluate the existing evidence so as to inform the development of screening recommendations and risk reduction strategies for persons affected or at risk for Lynch syndrome in Ontario\u2019s colorectal cancer (CRC) screening program (ColonCancerCheck). Lynch syndrome is an autosomal dominant genetic condition. These recommendations will inform program design and policy for screening in Ontario. The main objectives of this evidence review were to identify, among persons affected or at risk for Lynch syndrome: i. The risk for Lynch syndrome cancers; ii. Screening protocols that are effective for each Lynch syndrome cancer; iii. Risk reduction strategies that are effective for each Lynch syndrome cancer; iv. The most effective surveillance protocol for persons with a CRC who do not have a total proctocolectomy. A systematic review of the evidence was performed and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method was used to evaluate the quality of the evidence for each of the outcomes.\n\n## Patient Population\n\nPeople affected or at risk for Lynch syndrome or Lynch-like syndrome. People affected with Lynch syndrome are defined as: People with a Lynch syndrome cancer and a known Lynch syndrome germline mutation; People with a known Lynch syndrome germline mutation. People at risk for Lynch syndrome or Lynch-like syndrome, defined as: People with a Lynch syndrome cancer and a germline mutation of unknown significance (considered Lynch-like syndrome); People with a Lynch syndrome cancer and evidence of MMR protein loss but who do not have a germline mutation and where sporadic microsatellite instability (MSI) has reasonably been ruled out (considered Lynch-like syndrome); A relative of someone with confirmed Lynch syndrome; this relative has not undergone genetic testing. (Note: consider first-degree relative separately from second-degree relative if possible). Relatives of those at risk for Lynch syndrome or of those with Lynch-like syndrome: For example, (1) a relative of a person with a Lynch syndrome cancer and a germline mutation of unknown significance; this relative also has the germline mutation of unknown significance; or (2) a relative of a person with a Lynch syndrome cancer and evidence of MMR protein loss but who does not have a germline mutation and where sporadic MSI has reasonably been ruled out; this relative does not have a germline mutation.\n\n## Intended Guideline Users\n\nThe primary user is the Cancer Screening Program at Cancer Care Ontario. Other stakeholders include primary care physicians, colorectal surgeons, gastroenterologists, and pathologists. Research Questions What is the risk for Lynch syndrome cancers for people affected or at risk for Lynch syndrome? Are there differences in risk for various germline mutations? For each Lynch syndrome cancer, what cancer screening protocols are effective for people affected or at risk for Lynch syndrome? For those cancers, identify the following: Which cancer screening modalities have been found to be effective by cancer type? What is the evidence for ages of screening initiation and cessation? What is the evidence for intervals between screening tests? Are there differences in effectiveness for various germline mutations? For each Lynch syndrome cancer, what risk reduction strategies are effective for people affected or at risk for Lynch syndrome? What is the evidence for ages of initiation and cessation? What is the evidence for timing of the strategy? What is the evidence for each gene mutation? What is the most effective colonoscopy surveillance protocol for persons with a colorectal cancer and a known or suspected Lynch syndrome germline mutation who did not have a total proctocolectomy? Specifically: What is the evidence for frequency of colonoscopy surveillance? What is the evidence for age of cessation of surveillance? What is the evidence for each gene mutation?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/75301/download?token=lzW09vz_)", "external_id": "cco-60276", "metadata": {"authors": "J. Tinmouth, , C. Zwaal, , R. Gryfe, , J.C. Carroll, , N. Baxter, , B.R. McCurdy , and S.E. Ferguson", "document_status": "In-Review", "id": "ES 15-16 Oct 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/75301/download?token=lzW09vz_", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 3, "source": "cco", "title": "Cancer Screening for Persons at Risk for or Affected with Lynch Syndrome Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60276"} +{"content": "## Guideline Objective\n\nThe objective of the Position Statement is to provide recommendations to assist hospitals and cancer centers appropriately prepare for the implementation of oncology biosimilars.\n\n## Intended Guideline Users\n\nPrescribers, pharmacists, nurses, health administrators Feedback Prescribers, pharmacists, nurses, and health administrators are invited to submit feedback on these recommendations through their Clinical Operations Working Group representative, or by sending an email to the pan-Canadian Oncology Biosimilars Initiative . Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Position Statements for the Implementation of Oncology Biosimilars (French) Position Statements for the Implementation of Oncology Biosimilars FAQs\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49296/download?token=zrLH4xYw)", "external_id": "cco-60296", "metadata": {"authors": "Pan-Canadian Clinical Operations Working Group Core Writing Team, Jessica Arias, Dr. Vishal Kukreti, Sean Hopkins, Paul Lokko, Samantha Zaffino", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49296/download?token=zrLH4xYw", "type_of_content": "Guidelines & Advice, Position Statement", "version": "1"}, "section_count": 2, "source": "cco", "title": "Position Statements for the Implementation of Oncology Biosimilars from the pan-Canadian Clinical Operations Working Group", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60296"} +{"content": "## Guideline Objective\n\nThe standards aim to provide guidance to oncology nurses and administrators on the standard to achieve safe, high quality oncology nursing telepractice, irrespective of established systems within organizations to respond to patient telephone calls during business hours or after hours.\n\n## Patient Population\n\nFor the purposes of this guideline, men and women who were previously treated for a childhood cancer were not included.\n\n## Intended Guideline Users\n\nAdministrators, Nurses\n\n## Research Question(s)\n\nN/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49561/download?token=TqxFh2fY)", "external_id": "cco-60456", "metadata": {"authors": "Oncology Nursing Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49561/download?token=TqxFh2fY", "type_of_content": "Guidelines & Advice, Position Statement", "version": "N/A"}, "section_count": 4, "source": "cco", "title": "Oncology Nursing Telepractice Standards", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60456"} +{"content": "## Guideline Objective\n\nTo provide guidance on aspects of complex retroperitoneal surgical technique, including extent of resection and timing of surgery with respect to chemotherapy, and to investigate what other considerations are necessary to ensure safe surgery in this group of patients.\n\n## Patient Population\n\nThis guideline applies to people with metastatic testicular cancer, T3b or T4 or node positive and metastatic renal cell cancer and T3, T4 or node positive upper tract urothelial cancer[1].\n\n## Intended Guideline Users\n\nThis guideline is intended for genitourinary surgeons involved in retroperitoneal surgery, clinicians involved in the care of cancer patients who have received retroperitoneal surgery, and doctors referring patients for retroperitoneal surgery.\n\n## Research Question(s)\n\nWhat is the most appropriate role for surgical intervention in patients with T3b, T4 or node-positive mRCC, metastatic UTUC, and metastatic testicular cancer? Does neoadjuvant or adjuvant chemotherapy improve outcomes for patients receiving surgery for the treatment of T3b, T4 or node-positive metastatic renal cancer, metastatic UTUC, and metastatic testicular cancer? Do patients with T3b, T4 or node-positive mRCC, metastatic UTUC, and metastatic testicular cancer have better oncologic outcomes and/or lower complications at higher volume or academic centres (compared to lower volume and community centres)? Are there other considerations around implementation of surgery in patients with T3b, T4 or node-positive mRCC, metastatic UTUC and metastatic testicular cancer to ensure it is done safely? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81071/download?token=rTcJrPx0)", "external_id": "cco-60501", "metadata": {"authors": "A. Finelli, N. Coakley, J. Chin, T. Flood, A. Loblaw, C. Morash, R. Shayegan, R. Siemens, and the Genitourinary Cancer Guideline Development Group", "document_status": "Current", "id": "GL 3-20 Aug 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/81071/download?token=rTcJrPx0", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 4, "source": "cco", "title": "Complex surgery and perioperative systemic therapy for genitourinary cancer of the retroperitoneum", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60501"} +{"content": "## Guideline Objective\n\nTo make recommendations with respect to the use of T2-weighted magnetic resonance imaging (MRI) \u00b1 functional sequences in the pre-treatment local staging of patients with newly diagnosed prostate cancer.\n\n## Patient Population\n\nMen with newly diagnosed biopsy-confirmed prostate cancer who are under consideration for radical treatment.\n\n## Intended Guideline Users\n\nClinicians who are involved in the staging and treatment of prostate cancer patients.\n\n## Research Question(s)\n\nWhat is the performance and diagnostic accuracy of MRI \u00b1 DCE, DWI, MRS in men with newly diagnosed biopsy-confirmed prostate cancer who are under consideration for radical treatment? What is the impact of pre-treatment local staging by MRI \u00b1 DCE, DWI, MRS on patient outcomes, biochemical recurrence, changes in treatment planning (including nervesparing surgery), changes in stage classification, and surgical margin status in men with newly diagnosed biopsy-confirmed prostate cancer who are under consideration for radical treatment? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/70676/download?token=ykn_hRV0)", "external_id": "cco-606", "metadata": {"authors": "M. Haider, J. Salerno, A. Finelli, C. Morash, N. Power, N. Schieda, Magnetic Resonance Imaging in the Pre-Treatment Staging of Prostate Cancer Guideline Development Group", "document_status": "In-Review", "id": "27-3 Mar 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/70676/download?token=ykn_hRV0", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Magnetic Resonance Imaging for Pre-Treatment Local Staging of Prostate Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/606"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to facilitate a standardized approach to cancer medication-related infusion reactions in Ontario. The guideline is informed by best available evidence and expert consensus, and provides recommendations on assessment, prophylaxis, acute management, and re-challenge (including desensitization). Supporting resources for healthcare providers include an acute management algorithm, a drug table, and a desensitization protocol calculation tool. A patient-information sheet has been developed based on health literacy best practices and patient and caregiver input.\n\n## Patient Population\n\nAdult patients receiving systemic treatment.\n\n## Intended Guideline Users\n\nClinicians involved in the care of patients receiving systemic treatment (Physicians, Pharmacists, Nurses) Research Questions N/A Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Cancer Medication Infusion Reactions Drug Table Acute Management of Infusion Reactions Algorithm Cancer Medication Infusion Reactions Patient Sheet Cancer Medication Infusion Reactions Patient Sheet (French) Three-Bag 12-Step Protocol Calculation Tool\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49496/download?token=9-yhD6Sj)", "external_id": "cco-60646", "metadata": {"authors": "Andrea Crespo, Leta Forbes, Daniela Gallo-Hershberg, Katherine Enright, Vishal Kukreti, Lorraine Martelli, Carlo DeAngelis, Anna Granic, Leonard Kaizer, Melissa Lot, Charmaine Mothersill, Ferid Rashid, Lily Spasic, Leslie Young, Jason Yu", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49496/download?token=9-yhD6Sj", "type_of_content": "Guidelines & Advice", "version": "1"}, "section_count": 3, "source": "cco", "title": "Management of Cancer Medication-Related Infusion Reactions", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60646"} +{"content": "## Guideline Objective\n\nTo provide the optimal organizational guidelines for facilities performing stereotactic radiosurgery (SRS) on patients with brain metastasis in Ontario.\n\n## Patient Population\n\nAdult patients with brain metastasis eligible for SRS at centres in Ontario.\n\n## Intended Guideline Users\n\nClinicians involved in the organization and delivery of care for patients with brain metastases who are eligible to receive SRS in Ontario. Administrators involved in the organization and delivery of care for patients with brain metastases who are eligible to receive SRS in Ontario. Research Questions Who are the medical professionals who ideally should be part of the MCC evaluating patient eligibility and performing SRS? What are the training and/or certification requirements for members of the MCC performing SRS? What are the minimum applicable technologies required for the safe performance of SRS? What imaging is needed both pre (i.e., simulation) and post (i.e., follow-up) SRS to ensure safe practice and patient safety? What is the appropriate level of QA for: (a) treatment-delivery unit/machine quality control; (b) imaging; and (c) treatment planning What are the minimum requirements for patient follow-up after the SRS procedure (i.e., MRI timing and frequency)? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/75476/download?token=Vthzvgwx)", "external_id": "cco-60751", "metadata": {"authors": "A. Sahgal, S. Kellett, M. Ruschin, J. Greenspoon, M. Follwell, J. Sinclair, J. Perry, O. Islam, and the Stereotactic Radiosurgery for Brain Metastasis Guideline Development Group", "document_status": "Current", "id": "21-4 Aug 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/75476/download?token=Vthzvgwx", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60751"} +{"content": "## Guideline Objective\n\nTo inform primary care providers in the management of cardiovascular risk factors in patients following an autologous or allogeneic stem cell transplant.\n\n## Patient Population\n\nPatients undergoing an autologous or allogeneic stem cell transplant.\n\n## Intended Guideline Users\n\nPrimary care for patients undergoing autologous or allogeneic stem cell transplantation.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49356/download?token=1RSlQ4kz)", "external_id": "cco-60936", "metadata": {"authors": "Stem Cell Transplant Survivorship Community of Practice, Stem Cell Transplant Advisory Committee", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49356/download?token=1RSlQ4kz", "type_of_content": "Guidelines & Advice, Position Statement", "version": "1"}, "section_count": 3, "source": "cco", "title": "Management of Cardiovascular Risk Factors after Stem Cell Transplant", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60936"} +{"content": "## Guideline Objective\n\nTo inform primary care providers in the screening of secondary solid malignancies in patients following an autologous or allogeneic stem cell transplant.\n\n## Patient Population\n\nPatients undergoing an autologous or allogeneic stem cell transplant.\n\n## Intended Guideline Users\n\nPrimary care for patients undergoing autologous or allogeneic stem cell transplantation.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49396/download?token=CfdcTPuo)", "external_id": "cco-60961", "metadata": {"authors": "Stem Cell Transplant Survivorship Community of Practice, Stem Cell Transplant Advisory Committee", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49396/download?token=CfdcTPuo", "type_of_content": "Guidelines & Advice, Position Statement", "version": "2"}, "section_count": 3, "source": "cco", "title": "Screening for Secondary Solid Malignancies after Stem Cell Transplant", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60961"} +{"content": "## Guideline Objective\n\nTo inform primary care providers in the management of cardiovascular risk factors in patients following an autologous or allogeneic stem cell transplant.\n\n## Patient Population\n\nPatients undergoing an autologous or allogeneic stem cell transplant.\n\n## Intended Guideline Users\n\nPrimary care for patients undergoing autologous or allogeneic stem cell transplantation.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/49416/download?token=Mzmgwqp7)", "external_id": "cco-60981", "metadata": {"authors": "Stem Cell Transplant Survivorship Community of Practice, Stem Cell Transplant Advisory Committee", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/49416/download?token=Mzmgwqp7", "type_of_content": "Guidelines & Advice, Position Statement", "version": "2"}, "section_count": 3, "source": "cco", "title": "Summary of Recommendations for Primary Care Management after Stem Cell Transplant", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/60981"} +{"content": "## Guideline Objective\n\nTo develop a standardized approach for the generation of clear, concise somatic cancer panel testing reports To identify the recommended components to be included in any somatic caner panel report To identify items to be considered moving forward to improve/standardize caner panel reporting across the province Intended Users Physicians, geneticists, healthcare administrators, genetic counsellors", "external_id": "cco-61436", "metadata": {"authors": "Somatic Cancer Panel Reporting Working Group", "document_status": "Archived", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 1, "source": "cco", "title": "Somatic Cancer Panel Reporting in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/61436"} +{"content": "## Guideline Objective\n\nThis policy provides specific evidence-informed screening recommendations for trans and nonbinary people. Trans people have a gender identity that is different from the sex they were assigned at birth. Nonbinary people have a gender identity that does not fall into male or female categories. Cisgender people have a gender identity that matches the sex they were assigned at birth. Trans and nonbinary people are medically under-served [1] Open [1] Close [1] Reference 1 Close reference Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding [Internet]. Washington, DC: National Academies Press (US); 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64806 Opens in a new window Open [1] Close [1] and less likely to be up to date with breast and cervical screening than cisgender women. [2] Open [2] Close [2] Reference 2 Close reference Canadian Cancer Society [Internet]. Screening in LGBTQ communities: Why should you get screened? 2019. Available from: http://www.cancer.ca/en/prevention-and-screening/reduce-cancer-risk/find-cancer-early/screening-in-lgbtq-communities/why-should-you-get-screened/?region=on Opens in a new window Open [2] Close [2] [3] Open [3] Close [3] Reference 3 Close reference Peitzmeier S, Khullar K, Reisner S, Potter J. Pap test use is lower among female-to-male patients than non-transgender women. Am J Prev Med. 2014;47(6):808-12. Open [3] Close [3] [4] Open [4] Close [4] Reference 4 Close reference Bazzi, A.R., et al., Adherence to Mammography Screening Guidelines among Transgender Persons and Sexual Minority Women. Am J Public Health, 2015. 105(11): p. 2356-8. Open [4] Close [4] This is because of barriers to accessing those services such as healthcare providers who may not fully understand their needs [5] Open [5] Close [5] Reference 5 Close reference Bauer G, Zong X, Scheim A, Hammond R, Thind A. Factors Impacting Transgender Patients' Discomfort with Their Family Physicians: A Respondent-Driven Sampling Survey. PLoS ONE 10. 2015;12. Open [5] Close [5] and a lack of trans-specific cancer screening recommendations. These barriers also mean screen-eligible trans and nonbinary people may not be benefiting from all aspects of organized cancer screening. This policy helps make sure trans and nonbinary people are included in Ontario\u2019s breast cancer and cervical screening programs.\n\n## Patient Population\n\nTrans and nonbinary people\n\n## Intended Guideline Users\n\nHealthcare providers, cervical and breast screening experts and policy makers Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/66046/download?token=leCFt-7N)", "external_id": "cco-61546", "metadata": {"authors": "Inclusion of Trans People in Organized Cancer Screening Overarching Policy Steering Committee", "document_status": "Current", "id": "N/A Sep 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/66046/download?token=leCFt-7N", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "2.1"}, "section_count": 3, "source": "cco", "title": "Overarching Policy for the Screening of Trans People in the Ontario Breast Screening Program and the Ontario Cervical Screening Program", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/61546"} +{"content": "## Patient Population\n\nWomen without evidence of disease after primary potentially curative treatment for any stage of endometrial cancer comprise the target population. Of particular interest are outcomes from follow-up strategies reported for patients at a lower risk of recurrence (i.e., stage IA or IB, grade 1 or 2) and those at a higher risk of recurrence (i.e., stage IA or IB, grade 3, or stage IC or advanced stage).\n\n## Research Question(s)\n\nWhat is the most appropriate strategy for the follow-up of patients with endometrial cancer who are clinically disease free after receiving potentially curative primary treatment? Specifically, do differences in follow-up intervals, diagnostic interventions, clinical setting, or specialty influence patient outcomes related to local or distant recurrence, survival, or quality of life? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81686/download?token=PqdRiq0W)", "external_id": "cco-616", "metadata": {"authors": "M. Fung-Kee-Fung, J. Dodge, L. Elit, H. Lukka, A. Chambers, T. Oliver , Gynecology Cancer Disease Site Group", "document_status": "Current", "id": "4-9 Jun 2017", "pdf_url": "https://www.cancercareontario.ca/en/file/81686/download?token=PqdRiq0W", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "Follow-up After Primary Therapy for Endometrial Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/616"} +{"content": "## Guideline Objective\n\nThe framework is intended to support regional planning for caregiver support strategies by setting the foundation for oncology caregiver support in Ontario. The framework is intended as a best practice guide, which organizations can implement based on their unique circumstances, and develop strategies that best meet the needs of the populations they serve. The framework is also intended to foster more discussion between healthcare providers and caregivers around inclusion of caregivers as essential partners of cancer care. It is our hope that healthcare providers using this framework will champion a culture shift in oncology, leading to greater caregiver support that recognizes caregivers as valued partners in the cancer continuum.\n\n## Patient Population\n\nAll oncology patients\n\n## Intended Guideline Users\n\nRegional Cancer Programs, clinicians and administrators working in an oncology setting, other key stakeholders focused on caregivers Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/51071/download?token=9isPqBNb)", "external_id": "cco-61656", "metadata": {"authors": "The Psychosocial Oncology Program", "document_status": "Current", "id": "N/A Oct 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/51071/download?token=9isPqBNb", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Oncology Caregiver Support Framework", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/61656"} +{"content": "## Guideline Objective\n\nTo determine evidence-based indications for cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC).\n\n## Patient Population\n\nAdults (\u226518 years old) with a diagnosis of mesothelioma, appendiceal (including appendiceal mucinous neoplasm), colorectal, gastric, ovarian, or primary peritoneal carcinoma.\n\n## Intended Guideline Users\n\nThis guideline is intended for clinicians involved in the care of patients with mesothelioma, appendiceal (including appendiceal mucinous neoplasm), colorectal, gastric, ovarian, or primary peritoneal carcinoma. Research Questions Does the use of HIPEC with CRS provide better outcomes (i.e., improved survival and reduced adverse events) than current oncological management of patients with ovarian cancer? If so, which patients derive greater benefit? Does the use of HIPEC with CRS provide better outcomes (i.e., improved survival and reduced adverse events) than current oncological management of patients with peritoneal colorectal carcinomatosis? If so, which patients derive greater benefit? Does the use of HIPEC with CRS provide better outcomes (i.e., improved survival and reduced adverse events) than current oncological management of patients with gastric peritoneal carcinomatosis ? If so, which patients derive greater benefit? Does the use of HIPEC with CRS provide better outcomes (i.e., improved survival and reduced adverse events) than current oncological management of patients with peritoneal mesothelioma? If so, which patients derive greater benefit? Does the use of HIPEC with CRS provide better outcomes (i.e., improved survival and reduced adverse events) than current oncological management of patients with disseminated mucinous neoplasm of the appendix? If so, which patients derive greater benefit? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/70631/download?token=IzAA1Z35)", "external_id": "cco-61856", "metadata": {"authors": "R. Auer, D. Sivajohanathan, J. Biagi, J. Conner, E. Kennedy, T. May, the HIPEC Guideline Group", "document_status": "Current", "id": "GL 17-12 Sep 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/70631/download?token=IzAA1Z35", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Indications for Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/61856"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/51446/download?token=NIc1se_D)", "external_id": "cco-62066", "metadata": {"authors": "R. Poon, and the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "pet 2019-1 Nov 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/51446/download?token=NIc1se_D", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines: January to June 2019", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/62066"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69861/download?token=uFOu1We9)", "external_id": "cco-62586", "metadata": {"authors": "Population Health and Prevention, Population Health and Value-based Health Systems", "document_status": "Current", "id": "N/A Jan 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/69861/download?token=uFOu1We9", "type_of_content": "Guidelines & Advice", "version": "2"}, "section_count": 1, "source": "cco", "title": "Cannabis and cannabinoids: Cancer risk and use to manage cancer symptoms", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/62586"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69871/download?token=UuPo8K_7)", "external_id": "cco-62591", "metadata": {"authors": "Population Health and Prevention, Population Health and Value-based Health Systems", "document_status": "Current", "id": "N/A Jan 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/69871/download?token=UuPo8K_7", "type_of_content": "Guidelines & Advice, Evidence Summary", "version": "2"}, "section_count": 1, "source": "cco", "title": "Vaping products including e-cigarettes", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/62591"} +{"content": "## Research Question(s)\n\nWhat systemic therapy treatment options should be offered to patients with stage IV non\u2013small-cell lung cancer (NSCLC) without driver alterations, depending on the subtype of the patient\u2019s cancer?", "external_id": "cco-62681", "metadata": {"authors": "Nasser H. Hanna, MD, Bryan J. Schneider, MD, Sarah Temin, MSPH, Sherman Baker Jr., MD, Julie Brahmer, MD, Peter M. Ellis, MD, PhD, Laurie E. Gaspar, MD, MBA, Dharamvir Jain, MD, Rami Y. Haddad, MD, Paul J. Hesketh, MD, Ishmael Jaiyesimi, MD, David H. Johnson, MD, Natasha B. Leighl, MD, Tanyanika Phillips, MD, Gregory J. Riely, MD, PhD, Andrew G. Robinson, MD, Rafael Rosell, MD, Joan H. Schiller, MD, Navneet Singh, MD, DM, David R. Spigel, MD, Janis O. Stabler, MD, and Gregory Masters, MD, Joan Tashbar, MD", "document_status": "Current", "id": "7-A-2018-2 Jan 2020", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Therapy for Stage IV Non\u2013Small-Cell Lung Cancer Without Driver Alterations: ASCO and OH (CCO) Joint Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/62681"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/69771/download?token=7tWt0BE5)", "external_id": "cco-63026", "metadata": {"authors": "F.C. Wright, S. Kellett, A. Sun, T. Hanna, C. Nessim, N.J. Look Hong, C.A. Giacomantonio, C.F. Temple-Oberle, X. Song, T.M. Petrella, and the Melanoma Disease Site Group", "document_status": "Current", "id": "GL 8-10 Feb 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/69771/download?token=7tWt0BE5", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Locoregional Management of In-Transit Metastasis in Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/63026"} +{"content": "## Patient Population\n\nAdult patients with resectable, operable, and potentially curable thoracic (lower two thirds of esophagus) esophageal cancer for whom surgery is considered appropriate.\n\n## Research Question(s)\n\nShould patients with resectable esophageal cancer receive preoperative or postoperative therapy along with surgery? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/71706/download?token=yQUCOAOH)", "external_id": "cco-631", "metadata": {"authors": "R.A. Malthaner, R.K.S. Wong, K. Spithoff, R.B. Rumble, L. Zuraw , Gastrointestinal Cancer Disease Site Group", "document_status": "In-Review", "id": "2-11 Jun 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/71706/download?token=yQUCOAOH", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 2, "source": "cco", "title": "Preoperative or Postoperative Therapy for Resectable Esophageal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/631"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/53591/download?token=4MiKvBoT)", "external_id": "cco-63286", "metadata": {"authors": "P. Karanicolas, R. Beecroft, R. Cosby, E. David, M. Kalyvas, E. Kennedy, G. Sapisochin, R. Wong, K. Zbuk, and the Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL 2-30a Mar 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/53591/download?token=4MiKvBoT", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Regional Therapies for Colorectal Cancer Liver Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/63286"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74401/download?token=sjakR6lc)", "external_id": "cco-63341", "metadata": {"authors": "M. Sabloff, H. Feilotter, D. Sivajohanathan, C. Howlett, C. Ross, A. Schuh, A. Pollett, and the Minimal Residual Disease Testing Guideline Development Group", "document_status": "Current", "id": "MOTAC-6 Sep 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/74401/download?token=sjakR6lc", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Minimal Residual Disease Testing in Acute Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/63341"} +{"content": "## Patient Population\n\nWomen with newly diagnosed stage I ovarian cancer. Research Questions What is the role of adjuvant care in women with completely surgically staged stage I ovarian cancer? What is the role of adjuvant care in women who receive incomplete or no surgical staging of ovarian cancer? What is the optimal strategy for adjuvant care in women with ovarian cancer? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81696/download?token=ADNKbXhn)", "external_id": "cco-646", "metadata": {"authors": "Members of the Gynecology Cancer Disease Site Group, Gynecology Cancer Disease Site Group", "document_status": "Current", "id": "4-13 Mar 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/81696/download?token=ADNKbXhn", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 1, "source": "cco", "title": "Adjuvant Care for Stage I Ovarian Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/646"} +{"content": "## Guideline Objective\n\nTo provide recommendations for a systematic approach in determining priority for consultation and treatment of patients with cancer in Ontario during the time of a pandemic\n\n## Patient Population\n\nPatients with cancer who do not have a pandemic-related illness (e.g., infection) but require cancer treatment and/or services in regional cancer centres, hospitals and community ambulatory settings\n\n## Intended Guideline Users\n\nHealthcare providers and health system planners in Ontario\u2019s cancer system Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Supplemental clinical guidance for patients with breast cancer Supplemental clinical guidance for patients with cancer\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/54256/download?token=x2Vw_YMR)", "external_id": "cco-64736", "metadata": {"authors": "CCO Pandemic Plan Review Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/54256/download?token=x2Vw_YMR", "type_of_content": "Guidelines & Advice", "version": "2"}, "section_count": 3, "source": "cco", "title": "Pandemic Planning Clinical Guideline for Patients with Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/64736"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/64381/download?token=FL15tuMc)", "external_id": "cco-65431", "metadata": {"authors": "H. Lukka, J. Brown, C. Catton, B. Shayegan, the Hypofractionated Radiation Therapy for Prostate Cancer Guideline Development Group", "document_status": "In-Review", "id": "3-22 Apr 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/64381/download?token=FL15tuMc", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "An Endorsement of the 2018 Guideline on Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/65431"} +{"content": "ID: CED 17 Mar 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: T. Asmis, A.E. Haynes, C. Swallow, S. Verma", "external_id": "cco-656", "metadata": {"authors": "T. Asmis, A.E. Haynes, C. Swallow, S. Verma", "document_status": "Archived", "id": "CED 17 Mar 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Imatinib Mesylate in the Adjuvant Treatment of Gastrointestinal Stromal Tumours (GIST)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/656"} +{"content": "ID: CED 16 Jan 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. Clemons, E. Amir, A.E. Haynes, A. Eisen, M. Trudeau", "external_id": "cco-661", "metadata": {"authors": "M. Clemons, E. Amir, A.E. Haynes, A. Eisen, M. Trudeau", "document_status": "Archived", "id": "CED 16 Jan 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Zoledronic Acid as Adjuvant Therapy in Combination with Adjuvant Endocrine Therapy for Premenopausal Women with Early-Stage Hormone Receptor Positive Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/661"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/78456/download?token=4HyF_0a2)", "external_id": "cco-66326", "metadata": {"authors": "S. Bhella, N. Varela, A. Aw, C. Bredeson, M. Cheung, M. Crump, G. Fraser, S. Sajkowski, T. Kouroukis", "document_status": "In-Review", "id": "RR SCT-9 Jun 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/78456/download?token=4HyF_0a2", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "First-Line Therapy, Autologous Stem Cell Transplantation, and Post-Transplant Maintenance in the Management of Patients Newly Diagnosed with Mantle Cell Lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/66326"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/55466/download?token=4fKMauPt)", "external_id": "cco-66406", "metadata": {"authors": "R. Poon, The Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2019-2 Jun 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/55466/download?token=4fKMauPt", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2019", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/66406"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/55641/download?token=PoFUoS1Y)", "external_id": "cco-66536", "metadata": {"authors": "W.K. Evans, L.D. Durocher-Allen, P. Daeninck, D. Hammond, A. Lofters, P. Selby, M. Slaven", "document_status": "Current", "id": "ES 23-2 Jun 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/55641/download?token=PoFUoS1Y", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Cancer and the Health Effects of Cannabis and Cannabinoids: An update of the systematic review by the National Academies of Sciences, Engineering, and Medicine (2017) Consensus Study Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/66536"} +{"content": "ID: CED 15 Nov 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. Cheung, R. Tey, A. Haynes", "external_id": "cco-666", "metadata": {"authors": "M. Cheung, R. Tey, A. Haynes", "document_status": "Archived", "id": "CED 15 Nov 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Rituximab in Chronic Lymphocytic Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/666"} +{"content": "ID: CED 14-2 Oct 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Y. Madarnas, A. Eisen, R. Myers, A.E. Haynes", "external_id": "cco-671", "metadata": {"authors": "Y. Madarnas, A. Eisen, R. Myers, A.E. Haynes", "document_status": "Archived", "id": "CED 14-2 Oct 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Prophylactic Use of Filgrastim in Patients with Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/671"} +{"content": "## Guideline Objective\n\nTo provide guidance for consolidation or maintenance systemic therapy in patients with newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma (collectively, EOC).\n\n## Patient Population\n\nThese recommendations apply to patients with newly diagnosed stage II, III, or IV EOC after first-line therapy with cytoreductive surgery and adjuvant therapy (patients who require neoadjuvant therapy before cytoreductive surgery also qualify for this guideline).\n\n## Intended Guideline Users\n\nIntended users of this guideline are gynecologic oncologists, medical oncologists, and other clinicians who are involved in the treatment of the target patients in the province of Ontario. Research Questions Does maintenance systemic therapy improve OS, PFS, and patient-reported outcomes, with acceptable adverse effects in the target population? If so, what is the optimal regimen for maintenance therapy (dose/schedule/frequency)? In the target population, do patients with BRCA1/2 mutation (somatic or germline mutation) or HRD have different optimal regimens for maintenance therapy and outcomes compared with patients without BRCA mutation or HRD? Do patients with different histological subtypes (low-grade serous, endometrioid, clear cell, mucinous, undifferentiated/unclassifiable) or different stages have different optimal regimens for maintenance systemic therapy and outcomes? The outcomes of OS and PFS were rated as \"CRITICAL\", and adverse effects and patient-reported outcomes (i.e., QoL) were rated as \"IMPORTANT\" by the Working Group before the literature was searched. For adverse effects, the Working Group members decided to report Grade 3 or higher of the following seven adverse effects if available because they are relevant to the systemic therapy for patients with ovarian cancer: treatment-related death, anemia, neutropenia/leukopenia, thrombocytopenia, nausea, vomiting, and neuropathy. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81656/download?token=TPR4_p5g)", "external_id": "cco-67196", "metadata": {"authors": "H. Hirte, X. Yao, S.E. Ferguson, T. May, L. Elit, The Ovarian Cancer Guideline Development Group", "document_status": "Current", "id": "GL 4-18 Sep 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/81656/download?token=TPR4_p5g", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Consolidation or maintenance systemic therapy for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67196"} +{"content": "## Guideline Objective\n\nThe Recommendations for the Management of Actionable Incidental Findings in the Ontario Lung Screening Program provides additional support in determining \u2018actionability\u2019 of certain incidental findings. Reading radiologists were trained in the use of the reporting template scoring of nodules and follow-up recommendations. Incidental findings that require further action were reported and tracked. Definitions of \u201cactionability\u201d with respect to incidental findings were left to clinical discretion of the radiologist. The recommendations were created in response to several radiologists who requested additional support with respect to incidental findings.\n\n## Intended Guideline Users\n\nRadiologists, Other Physicians\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/56696/download?token=j62hItfo)", "external_id": "cco-67226", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/56696/download?token=j62hItfo", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Recommendations for the Management of Actionable Incidental Findings in the Lung Cancer Screening Pilot for People at High Risk", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67226"} +{"content": "## Guideline Objective\n\nTo define\u00a0a list of practice guidance\u00a0to aid in the standardization of Physics plan review across the province to ensure delivery of high-quality care for patients To provide Medical Physics training and education to achieve the main objective To advise the development of a new provincial funding model for radiation treatment (Radiation Treatment - Quality-Based Procedure initiative), specific to quality metrics, on the subject of radiation treatment plan physics review\n\n## Patient Population\n\nAll\n\n## Intended Guideline Users\n\nMedical physics and clinical staff supporting the provision of Radiation Treatment.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/56736/download?token=sFCSqoP-)", "external_id": "cco-67266", "metadata": {"authors": "Harald Keller, Alexandra Rink, Greg Salomons, Aaron Vandermeer, Leigh Conroy, Dal Granville, Josh Gaul, Theodore Mutanga, Moti Paudel, Runqing Renee Jiang, Jean-Pierre Bissonnette, Julie Kraus", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/56736/download?token=sFCSqoP-", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Best-Practice Guidance for Radiation Treatment Plan Physics Review", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67266"} +{"content": "## Guideline Objective\n\nTo improve quality and safety in treatment delivery by supporting coordination and standardization of patient-specific quality assurance practice across the province\n\n## Patient Population\n\nAll cancers\n\n## Intended Guideline Users\n\nMedical physics staff supporting the provision of radiation treatment\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/56741/download?token=N05uFsrL)", "external_id": "cco-67271", "metadata": {"authors": "Gordon Chan, Lee Chin, Ady Abdellatif, Jean-Pierre Bissonnette, Daria Comsa, Dal Granville, Jenna King, Patrick Rapley, Aaron Vandermeer, Julie Kraus", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/56741/download?token=N05uFsrL", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Best Practice Guidance for Patient-Specific Quality Assurance for IMRT and VMAT Plan Delivery Verification", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67271"} +{"content": "ID: CED 14-1 Sep 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: C.T. Kouroukis, A.E. Haynes", "external_id": "cco-676", "metadata": {"authors": "C.T. Kouroukis, A.E. Haynes", "document_status": "Archived", "id": "CED 14-1 Sep 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Prophylactic Use of Filgrastim in Patients with Hematological Malignancies", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/676"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/57401/download?token=pxiYdcfp)", "external_id": "cco-67756", "metadata": {"authors": "R. Poon, The Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2020-1 Nov 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/57401/download?token=pxiYdcfp", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2020", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67756"} +{"content": "## Guideline Objective\n\nTo enhance the current model of care for clinical cancer genetic services through increased efficiency of the healthcare workforce, integrated services, and increased patient access to high quality clinical cancer genetic services across Ontario.\n\n## Patient Population\n\nPeople with or without cancer who are identified as being at risk for a hereditary cancer syndrome and their families.\n\n## Intended Guideline Users\n\nClinical cancer genetic services providers, health system planners, administrators, and other individuals and organizations involved in the planning and delivery of cancer genetic services. Research Questions N/A\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/57556/download?token=bnAwupFv)", "external_id": "cco-67891", "metadata": {"authors": "Kathleen Bell, Dr. Aaron Pollett, Lindsey Thompson, Rachel Healey, Daniel Gillespie, Sharmilaa Kandasamy, Jennifer Hart", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/57556/download?token=bnAwupFv", "type_of_content": "Guidelines & Advice, Health System, Models of Care, Recommendation Report", "version": "1.0"}, "section_count": 3, "source": "cco", "title": "Enhancing Clinical Cancer Genetic Service Delivery in Ontario - Recommendations for a New Model of Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/67891"} +{"content": "## Research Question(s)\n\nThis clinical practice guideline addresses three overarching clinical questions: For patients with stage IV NSCLC with driver alterations: What is the most effective first-line therapy? What is the most effective second-line therapy? Is there a role for a third-line therapy or beyond? The guideline addresses patients with NSCLC in the following histologic or subgroups: EGFR, ALK, ROS1, BRAF, MET, RET, HER2, and NTRK.", "external_id": "cco-68336", "metadata": {"authors": "Nasser H. Hanna, MD, Andrew G. Robinson, MD, Sarah Temin, MSPH, Sherman Baker Jr, MD, Julie R. Brahmer, MD, Peter M. Ellis, MD, PhD, Laurie E. Gaspar, MD, MBA, Rami Y. Haddad, MD, Paul J. Hesketh, MD, Dharamvir Jain, MD, Ishmael Jaiyesimi, MD, David H. Johnson, MD, MACP, Natasha B. Leighl, MD, Pamela R. Moffitt, Tanyanika Phillips, MD, Gregory J. Riely, MD, PhD, Rafael Rosell, MD, Joan H. Schiller, MD, Bryan J. Schneider, MD, Navneet Singh, MD, DM, David R. Spigel, MD, Joan Tashbar, and Gregory Masters, MD", "document_status": "Current", "id": "7-A-2018-3 Feb 2021", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Therapy for Stage IV Non\u2013Small-Cell Lung Cancer With Driver Alterations: American Society of Clinical Oncology (ASCO) and Ontario Health (Cancer Care Ontario) Joint Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/68336"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81226/download?token=XlN4hZ93)", "external_id": "cco-68346", "metadata": {"authors": "A. Gupta, L.D., Durocher-Allen, S. Popovic, R. Tozer, X. Yao, and M. Ghert", "document_status": "Current", "id": "ES 11-13 Feb 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/81226/download?token=XlN4hZ93", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Systemic therapy of denosumab in altering surgical outcomes in patients with giant cell tumour of bone", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/68346"} +{"content": "ID: CED 13 Jun 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Y. Madarnas, A.E. Haynes, A. Eisen", "external_id": "cco-686", "metadata": {"authors": "Y. Madarnas, A.E. Haynes, A. Eisen", "document_status": "Archived", "id": "CED 13 Jun 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Continued Use of Trastuzumab Beyond Disease Progression in Patients with Metastatic Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/686"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59141/download?token=tplUodw_)", "external_id": "cco-68836", "metadata": {"authors": "Simron Singh, Glenn G. Fletcher, Xiaomei Yao, Jonathan Sussman", "document_status": "Current", "id": "ES 30-1 Mar 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/59141/download?token=tplUodw_", "type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "Virtual Care in Patients with Cancer: A Systematic Review", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/68836"} +{"content": "## Guideline Objective\n\nThis guideline aims to assist providers in selecting appropriate bowel preparation regimens for their adult colonoscopy patients.\n\n## Intended Guideline Users\n\nEndoscopists Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Fiche d'information - Pr\u00e9parer votre coloscopie - picosulfate de sodium, acide citrique et oxyde de magn\u00e9sium (PSMC) Fiche d'information - Pr\u00e9parer votre coloscopie - 4 litres poly\u00e9thyl\u00e8neglycol Fiche d'information - Pr\u00e9parer votre coloscopie - 2 litres poly\u00e9thyl\u00e8neglycol Bowel Preparation Information Sheet - Sodium picosulphate, citric acid and magnesium oxide (PSCM) Bowel Preparation Information Sheet - 4 litre polyethylene glycol Bowel Preparation Information Sheet - 2 litre polyethylene glycol\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59686/download?token=xq5utyFZ)", "external_id": "cco-69256", "metadata": {"authors": "Quality Management Partnership", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/59686/download?token=xq5utyFZ", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Bowel Preparation Selection Best Practice Guidelines", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69256"} +{"content": "## Guideline Objective\n\nThis document aims to: ensure that all important activities are completed before and after a colonoscopy improve communication within the care team, and between the care team and the patient standardize pre- and post-procedural activities across Ontario facilities\n\n## Intended Guideline Users\n\nEndoscopists\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59691/download?token=vzCRul6y)", "external_id": "cco-69261", "metadata": {"authors": "Quality Management Partnership", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/59691/download?token=vzCRul6y", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Pre- and Post-Procedure Guidelines and Checklists - Endoscopy/Colonoscopy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69261"} +{"content": "## Guideline Objective\n\nThis document aims to: improve the continuum of care for patients reduce the frequency of repeat examinations due to lack of information about the quality of examination, including bowel preparation quality and specific cecal landmarks reduce inappropriate decisions for the timing of surveillance colonoscopy because the key polyp descriptors (size and/or morphology) were absent. This information may allow increased adherence to published guidelines for surveillance of polyps reduce uncertainty about the follow-up arrangements and responsibility for follow-up ensure that referring physicians receive consistent and predictable information about the procedure findings, management plan and follow-up\n\n## Intended Guideline Users\n\nEndoscopists Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Background and Resource Summary - Endoscopy/Colonoscopy\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59696/download?token=uWn_E74y)", "external_id": "cco-69266", "metadata": {"authors": "Quality Management Partnership", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/59696/download?token=uWn_E74y", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Standardized Endoscopy Reporting Guidelines", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69266"} +{"content": "## Guideline Objective\n\nThis document aims to: improve patient recall of endoscopy findings and the management plan Improve patient compliance with the management plan decrease patient anxiety Increase patient knowledge about how to obtain final endoscopy results improve patient understanding of what to do if complications arise after a colonoscopy contribute to the provision of consistent discharge information to all patients, ensuring that key messages are available to all patients upon discharge\n\n## Intended Guideline Users\n\nEndoscopists Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Patient Discharge Template Document type d\u2019information relative \u00e0 la sortie du patient\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59701/download?token=ReyKtS2a)", "external_id": "cco-69271", "metadata": {"authors": "Quality Management Partnership", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/59701/download?token=ReyKtS2a", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Standardized Patient Discharge Guidelines - Endoscopy/Colonoscopy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69271"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59761/download?token=K8uALqdn)", "external_id": "cco-69326", "metadata": {"authors": "R. Poon, Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2020-2 May 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/59761/download?token=K8uALqdn", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 4, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2020", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69326"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the use of hepatic arterial infusion (HAI) in the treatment of patients with colorectal cancer (CRC) liver metastases with respect to overall survival, disease-free survival, progression-free survival (PFS), and hepatic PFS.\n\n## Patient Population\n\nThese recommendations apply to adults with liver metastases from CRC.\n\n## Intended Guideline Users\n\nThe intended users of this guideline are healthcare providers involved in the delivery of care of adults with liver metastases from CRC.\n\n## Research Question(s)\n\nThis guidance document examined the evidence to answer the following questions: What is the benefit of the addition of HAI to ST in patients with resectable or resected CRC liver metastases with respect to OS, DFS, PFS, and hepatic PFS? What is the benefit of the addition of HAI to ST in first-line treatment in patients with unresectable CRC liver metastases with respect to OS, DFS, PFS, and hepatic PFS? What is the benefit of the addition of HAI with or without ST in second-line (or later) treatment of unresectable CRC liver metastases with respect to OS, DFS, PFS, and hepatic PFS? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/80991/download?token=eQLzKLbH)", "external_id": "cco-69331", "metadata": {"authors": "J. Biagi, R. Cosby, S. Jayaraman, R. Wong, Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL 2-30B May 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/80991/download?token=eQLzKLbH", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Hepatic Arterial Infusion for Colorectal Liver Metastases", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69331"} +{"content": "## Guideline Objective\n\nThe recommendations report provides organizational requirements and recommendations for the delivery of acute leukemia services in Ontario, including infrastructure, expertise, policies and procedures. It will: reduce between-centre variability in the delivery of acute leukemia services provide guidance to centres interested in becoming acute leukemia service providers\n\n## Patient Population\n\nAcute Leukemia\n\n## Intended Guideline Users\n\nPhysicians and Healthcare Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60031/download?token=g3t-9tSC)", "external_id": "cco-69431", "metadata": {"authors": "Acute Leukemia Specifications Working Group, Acute Leukemia Advisory Committee, Acute Leukemia Less Intensive Chemotherapy Working Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/60031/download?token=g3t-9tSC", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "2"}, "section_count": 3, "source": "cco", "title": "Organizational Requirements for Acute Leukemia Service Providers in Ontario: Recommendations Report 2024", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69431"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/60476/download?token=JSjglrVX)", "external_id": "cco-69581", "metadata": {"authors": "Matthew C. Cheung, Bryan B. Franco, Nicholas Meti, Alia Thawer, Adithya Shankar, Andrew Loblaw, Frances C Wright, Colleen Fox, Naomi Peek, Vivian Sim, Simron Singh, Ontario Health (Cancer Care Ontario) Virtual Cancer Care Consensus Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/60476/download?token=JSjglrVX", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Person-Centred Virtual Cancer Care Clinical Guidance", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69581"} +{"content": "## Guideline Objective\n\nThis clinical practice guideline was produced jointly by Ontario Health (CCO) and the American Society of Clinical Oncology. The aim of this work is to provide recommendations on the best strategies for the management, and on the best timing and treatment (surgical and radio-therapeutic) of the axilla in early-stage breast cancer. Specific objectives are: 1) To determine which patients with early-stage breast cancer require axillary staging; 2) To determine whether any further axillary treatment is indicated for women with early-stage breast cancer who did not receive neoadjuvant chemotherapy (NAC) and are sentinel lymph node negative at diagnosis; 3) to determine which axillary strategy is indicated for women with early-stage breast cancer who did not receive NAC and are pathologically sentinel lymph node-positive at diagnosis (after a clinically node-negative presentation); 4) to determine what axillary treatment is indicated and what is the best timing of treatment for women with early-stage breast cancer treated with NAC; and 5) to determine which are the best methods for identifying sentinel nodes.\n\n## Patient Population\n\nPatients with early-stage breast cancer (i.e., stages I, IIA, IIB; and prognostic groups T1, T2, N0, N1mi, N1, M0; and primary tumour size \u22645 cm).\n\n## Intended Guideline Users\n\nGeneral surgeons, radiation oncologists, medical oncologists, and other clinicians involved in the management of women with early-stage breast cancer (e.g., pathologists, radiologists, oncology nurses, genetic counselors). Research Questions Which patients with early-stage breast cancer require axillary staging (i.e., SLNB, ALND, or US)? For women with early-stage breast cancer who did not receive NAC, and are sentinel lymph node negative at diagnosis: Is further axillary treatment (i.e., radiation, or surgery) indicated? What sentinel node-negative patient subgroups are most likely to benefit from further axillary treatment with radiation therapy? For women with early-stage breast cancer who did not receive NAC and are pathologically sentinel lymph node positive at diagnosis: Which axillary strategy is indicated? What sentinel node-positive patient subgroups are most likely to benefit from further axillary treatment either with radiation or with surgery or both? For women who were treated with NAC: If the lymph node is negative at diagnosis, what axillary treatment (i.e., radiation or surgery) is indicated after chemotherapy? If the lymph node is positive at diagnosis, what axillary treatment (i.e., radiation or surgery) indicated after chemotherapy? When is the best timing for performing sentinel node excision: prior or following NAC? Among patients with early breast cancer appropriate for axillary staging: Is there a better identification rate with single or dual tracer? Is there a better identification rate with US-guided SLNB or traditional SLNB? Is there a better identification rate with US or SLNB? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81806/download?token=rTFBvKNl)", "external_id": "cco-69736", "metadata": {"authors": "Muriel Brackstone MD, PhD, Fulvia Baldassarre MSc, Francisco Perera MD, Tulin Cil MD, Ian Dayes MD, Jay Engel MD, Anat Kornecki MD, Ralph George MD, Sandip SenGupta MD, Andrea Eisen MD", "document_status": "Current", "id": "GL 1-23-A Jul 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/81806/download?token=rTFBvKNl", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Management of the Axilla in Early-Stage Breast Cancer: Ontario Health (Cancer Care Ontario) and the American Society of Clinical Oncology Joint Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/69736"} +{"content": "ID: CED 12 Apr 2009\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: R. Dent, A.E. Haynes, K. Enright, C. Hamm, M. Trudeau, A. Eisen", "external_id": "cco-701", "metadata": {"authors": "R. Dent, A.E. Haynes, K. Enright, C. Hamm, M. Trudeau, A. Eisen", "document_status": "Archived", "id": "CED 12 Apr 2009", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Use of Bevacizumab in Metastatic Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/701"} +{"content": "## Guideline Objective\n\nTo facilitate clinically appropriate access to hereditary cancer testing for individuals based on their personal and/or family history of cancer, with considerations for tumour pathology and decision support for treatment.\n\n## Patient Population\n\nIndividuals with, or at risk for, a hereditary cancer syndrome\n\n## Intended Guideline Users\n\nGenetics Professionals\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/85611/download?token=1TyhpBzJ)", "external_id": "cco-70161", "metadata": {"authors": "Hereditary Cancer Testing Eligibility Working Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/85611/download?token=1TyhpBzJ", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 3, "source": "cco", "title": "Hereditary Cancer Testing Eligibility Criteria", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/70161"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to assess the optimal initial treatments for men with noncastrate advanced, recurrent, or metastatic prostate cancer. Our recommendations are based on the 2021 guideline on the Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update [1].\n\n## Patient Population\n\nMen with noncastrate advanced, recurrent, or metastatic prostate cancer.\n\n## Intended Guideline Users\n\nThe guideline document will support providers in recommending the most optimal initial treatments for men with noncastrate advanced, recurrent, or metastatic prostate cancer. Research Questions CLINICAL QUESTION 1: What are the standard initial treatment options for metastatic noncastrate prostate cancer? CLINICAL QUESTION 2: Are combination therapies such as combined androgen blockade (castration plus a nonsteroidal antiandrogen) better than castration alone for men with noncastrate locally advanced nonmetastatic prostate cancer? CLINICAL QUESTION 3: Does early (immediate) androgen deprivation therapy improve outcomes over deferred therapy for men with noncastrate locally advanced nonmetastatic disease? CLINICAL QUESTION 4: Is intermittent androgen deprivation therapy better than continuous androgen deprivation therapy for men with biochemically recurrent nonmetastatic disease?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/63276/download?token=8Y9hOa-l)", "external_id": "cco-70561", "metadata": {"authors": "G. Kulkarni, J. Brown, R. Breau, C. Morash, The initial Management of Prostate Cancer Guideline Development Group", "document_status": "In-Review", "id": "GL END 3-23 Oct 2021", "pdf_url": "https://www.cancercareontario.ca/en/file/63276/download?token=8Y9hOa-l", "type_of_content": "Guidelines & Advice", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2021 Guideline on the Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/70561"} +{"content": "ID: CED 10 Sep 2008\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: I. Walker, C.T. Kouroukis, A.E. Haynes, K. Imrie", "external_id": "cco-706", "metadata": {"authors": "I. Walker, C.T. Kouroukis, A.E. Haynes, K. Imrie", "document_status": "Archived", "id": "CED 10 Sep 2008", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Use of Imatinib Mesylate (GleevecTM) in Patients with Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/706"} +{"content": "## Guideline Objective\n\nThese recommendations look at interventional oncology procedures microwave (MWA) and cryoablation (CA) to determine where these treatment procedures are a suitable alternative to the currently recommended use of radiofrequency ablation (RFA). These recommendations were made by the Interventional Oncology Emerging Technologies Working Group and were endorsed by the Interventional Oncology Steering Committee. These were based on the systematic review of the available evidence, current practice in Ontario, and guidance from other jurisdictions and experts in the field.\n\n## Intended Guideline Users\n\nPhysicians and Health Care Administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/63631/download?token=6m7vuIzE)", "external_id": "cco-70676", "metadata": {"authors": "Interventional Oncology Emerging Technologies Working Group, Interventional Oncology Steering Committee", "pdf_url": "https://www.cancercareontario.ca/en/file/63631/download?token=6m7vuIzE", "type_of_content": "Guidelines & Advice"}, "section_count": 2, "source": "cco", "title": "Recommendations Report Microwave Ablation and Cryoablation", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/70676"} +{"content": "Full report: [evidence summary ES 1-25](https://www.cancercareontario.ca/sites/ccocancercare/files/assets/pebcES1-25f.pdf)", "external_id": "cco-70786", "metadata": {"authors": "Derek Muradali, Glenn G Fletcher, Erin Cordeiro, Samantha Fienberg, Ralph George, Supriya Kulkarni, Jean Seely, Rola Shaheen, Andrea Eisen, Preoperative Breast MRI Expert Panel", "document_status": "Current", "id": "GL 1-25 Mar 2023", "pdf_url": "https://www.cancercareontario.ca/sites/ccocancercare/files/assets/pebcES1-25f.pdf", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 1, "source": "cco", "title": "Preoperative Breast Magnetic Resonance Imaging", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/70786"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/64186/download?token=wkbOfsUu)", "external_id": "cco-70871", "metadata": {"authors": "R. Poon, The Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2021-1 Jan 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/64186/download?token=wkbOfsUu", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2021", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/70871"} +{"content": "## Guideline Objective\n\nThe objective of this report is to present evidence-based recommendations that optimize quality and safety and promote consistency in Systemic Treatment delivery in the Home and Community sector. Existing areas of evidence and lessons learned from other jurisdictions were leveraged to develop these recommendation statements which achieved consensus through a modified Delphi process. Home and Community Care Support Services (HCCSS), in collaboration with health system partners, will be leading the implementation phase of this initiative.\n\n## Patient Population\n\nPatients currently receiving systemic treatment in the home and community.\n\n## Intended Guideline Users\n\nHealth system partners currently providing or intending to provide systemic treatment in the home and community. Research Questions N/A Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools How to Safely Handle Cancer Medications and Body Fluids at Home\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/64376/download?token=Xj2Wg84b)", "external_id": "cco-71031", "metadata": {"authors": "Leta Forbes, Daniela Gallo-Hershberg, Lorraine Martelli, Jessica Ng, Sivanuja Paras, Aliya Pardhan, Anita Rombough, Samantha Zaffino", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/64376/download?token=Xj2Wg84b", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "1"}, "section_count": 3, "source": "cco", "title": "Enhancing the Delivery of Oncology Systemic Treatment in the Home and Community in Ontario Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/71031"} +{"content": "ID: CED 9 Aug 2008\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. Trudeau, J. Franek", "external_id": "cco-711", "metadata": {"authors": "M. Trudeau, J. Franek", "document_status": "Archived", "id": "CED 9 Aug 2008", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Docetaxel plus Cyclophosphamide as Adjuvant Therapy for Early, Operable Breast Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/711"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/66221/download?token=3Z66OIMN)", "external_id": "cco-71571", "metadata": {"authors": "A. Singnurkar, R. Poon, J. Detsky", "document_status": "Current", "id": "ES PET 20 Apr 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/66221/download?token=3Z66OIMN", "type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "18F-FET PET Imaging in Brain Tumours", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/71571"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/66621/download?token=T0vpNlTf)", "external_id": "cco-71756", "metadata": {"authors": "R. Poon and the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2021-2 Jun 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/66621/download?token=T0vpNlTf", "type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2021", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/71756"} +{"content": "Full report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/79921/download?token=5G8F0fiF)", "external_id": "cco-71976", "metadata": {"authors": "Members of the Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL 2-33 Jun 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/79921/download?token=5G8F0fiF", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 1, "source": "cco", "title": "Role of Adjuvant Treatment in Resected Pancreatic Ductal Adenocarcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/71976"} +{"content": "## Guideline Objective\n\nTo provide an updated guideline on the use of rituximab in lymphoma and chronic lymphocytic leukemia (CLL).\n\n## Patient Population\n\nAdult patients with lymphoma of any type, at any stage, and with any histology. Chronic Lymphocytic Leukemia Adult patients with CLL at any stage.\n\n## Intended Guideline Users\n\nHematologists and oncologists treating patients with lymphoma or CLL.\n\n## Research Question(s)\n\nLymphoma In patients with lymphoma of any type or stage, is rituximab used alone or in combination with chemotherapy more effective than non\u2013rituximab-containing regimens for improving overall survival (OS), disease control (as assessed by measures such as progression-free survival [PFS], event-free survival [EFS], time-to-treatment failure [TTF] , or response duration [RD]), response rate, or quality of life (QOL)? What are the adverse events associated with the use of rituximab used alone or in combination with chemotherapy compared with non\u2013rituximab-containing regimens? Which patients with lymphoma are more or less likely to benefit from treatment with rituximab compared with those treated with non\u2013rituximab-containing regimens? Chronic Lymphocytic Leukemia What beneficial outcomes are associated with the use of rituximab for the treatment of patients with CLL? Outcomes of interest are OS, disease control (as assessed by measures such as PFS, EFS, TTF, or RD), and response rate. What is the toxicity associated with the use of rituximab? Which patients are more or less likely to benefit from treatment with rituximab? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/64786/download?token=NeIucoT3)", "external_id": "cco-721", "metadata": {"authors": "A. Prica, F. Baldassarre, L.K. Hicks, K. Imrie, T. C. Kouroukis, M. Cheung , Hematology Disease Site Group", "document_status": "Archived", "id": "6-8 Mar 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/64786/download?token=NeIucoT3", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "Rituximab in Lymphoma and Chronic Lymphocytic Leukemia: A Clinical Practice Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/721"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/67526/download?token=yRinrhFz)", "external_id": "cco-72401", "metadata": {"authors": "S. Hotte, J. Brown, C. Canil, A. Lalani, S. Sridhar, the Systemic Therapy for Metastatic Urothelial Cancer Guideline Development Group", "document_status": "In-Review", "id": "GL END 3-24 Aug 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/67526/download?token=yRinrhFz", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Systemic Therapy for Metastatic Urothelial Cancer: An Endorsement of a Portion of the European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/72401"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/67821/download?token=PWFFyY6C)", "external_id": "cco-72931", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/67821/download?token=PWFFyY6C", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 1, "source": "cco", "title": "Hepatitis B Virus Screening and Management for Patients Receiving Systemic Treatment", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/72931"} +{"content": "Full report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/68686/download?token=G0dlTHwl)", "external_id": "cco-73481", "metadata": {"authors": "R. Poon and the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2022-1 Jan 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/68686/download?token=G0dlTHwl", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 1, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2022", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/73481"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to determine the most effective therapy for patients with thymic epithelial tumours.\n\n## Patient Population\n\nThe target population are adult patients with thymic epithelial tumours, including thymoma, thymic carcinoma, and thymic neuroendocrine tumours (NETs).\n\n## Intended Guideline Users\n\nThe intended users of this guideline are all healthcare professionals managing patients with thymic epithelial tumours.\n\n## Research Question(s)\n\nWhat are the benefits and harms of the treatment options for patients with thymic epithelial tumours? The interventions under consideration were systemic therapy (chemotherapy, imatinib, cixutumumab, sunitinib, saracatinib, everolimus, octreotide, pembrolizumab, nivolumab, atezolizumab), radiotherapy, surgery, or any combination of these treatments. The comparator was another treatment (systemic therapy, radiotherapy, surgery, or any combination) or no treatment. The Working Group considered overall survival, toxicity rates (grade 3 or above toxicities), and progression- or recurrence-free survival to be critical outcomes and response rates, and quality of life to be important outcomes for systemic therapy. The Working Group considered overall survival, toxicity rates (pneumonia, esophagitis, dermatitis), progression- or recurrence-free survival to be critical outcomes and response rates, and quality of life to be important outcomes for radiotherapy. The Working Group also considered overall survival, and positive/negative margin rate to be critical outcomes and progression- or recurrence-free survival, short-term (30-day) mortality, response rates, local recurrence, nodal (regional) disease, metastatic disease, quality of life, length of hospital stay, chest-in-tube days, conversion to open sternotomy, intraoperative complications and postoperative complications, toxicity rates (pain), postoperative bleeding, and reoperation to be important outcomes for surgery. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/82631/download?token=vkg8UC9X)", "external_id": "cco-736", "metadata": {"authors": "C. Falkson, E.T. Vella, P.M. Ellis, D.E. Maziak, Y.C. Ung, E. Yu, The Lung Cancer Disease Site Group", "document_status": "Current", "id": "7-11 Mar 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/82631/download?token=vkg8UC9X", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 4, "source": "cco", "title": "Surgical, Radiation, and Systemic Treatments of Patients with Thymic Epithelial Tumours", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/736"} +{"content": "## Guideline Objective\n\nTo provide guidance around the classification and diagnostic workup of mesenchymal tumours of soft tissue and bone.\n\n## Patient Population\n\nPatients diagnosed with soft tissue or bone tumours.\n\n## Intended Guideline Users\n\nClinicians, Pathologists, Geneticists and healthcare providers involved in the diagnosis of soft tissue and bone tumours.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70866/download?token=LmUvlJzh)", "external_id": "cco-73926", "metadata": {"authors": "Pathology and Laboratory Medicine Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/70866/download?token=LmUvlJzh", "type_of_content": "Guidelines & Advice", "version": "1.0"}, "section_count": 3, "source": "cco", "title": "Consensus Pathology Recommendations for Mesenchymal Tumours of Soft Tissue and Bone", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/73926"} +{"content": "## Guideline Objective\n\nTo provide clinicians with guidance on implementation and interpretation of routine, pre-treatment DPYD testing and genotype-guided dosing for cancer patients with planned fluoropyrimidine treatment in Ontario.\n\n## Patient Population\n\nCancer patients who are candidates for systemic treatment with fluoropyrimidines (5-fluorouracil or capecitabine)\n\n## Intended Guideline Users\n\nHealth care providers involved in the care of cancer patients who have planned systemic treatment with fluoropyrimidines (medical oncologists, nurses, pharmacists etc.) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Summary of Pre-treatment Dosing Recommendations (for providers) Testing for people taking capecitabine or 5-fluorouracil (5-FU) (for patients) D\u00e9pistage chez les personnes prenant de la cap\u00e9citabine ou du 5-fluorouracile (5-FU)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70151/download?token=CsLAJRD7)", "external_id": "cco-73951", "metadata": {"authors": "Sarah Salama, Leta Forbes, Daniela Gallo-Hershberg, The DPYD Expert Panel", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/70151/download?token=CsLAJRD7", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Fluoropyrimidine Treatment in Patients with Dihydropyrimidine Dehydrogenase (DPD) Deficiency: Guidance for Clinicians", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/73951"} +{"content": "## Guideline Objective\n\nThe objective of this organizational guideline is to ensure that cancer centres across Ontario have guidance as to how spine stereotactic body radiotherapy (SBRT) should be administered with the intent to minimize side effects and maximize patient safety. The administration of spine SBRT also includes the surveillance of SBRT patients post-SBRT, with both clinical and imaging follow-up practices as an essential practice for patient safety.\n\n## Patient Population\n\nAll cancer adult patients (>18) with spinal metastasis who are eligible to receive treatment with SBRT.\n\n## Intended Guideline Users\n\nStakeholders include all Ontario Regional Cancer Programs that currently deliver, or planning spine SBRT. Specifically, in these Cancer Programs this guideline is intended for: Clinicians involved in the organization and delivery of spine SBRT in Ontario. Administrators involved in the organization and delivery of care of patients with spinal metastasis who are eligible for spine SBRT in Ontario. Research Questions What are the optimal organizational standards for the safe delivery of spine SBRT to adult cancer patients with spinal metastases in Ontario with respect to: Multidisciplinary teams responsible for the delivery of spine SBRT Equipment/imaging requirements for simulation and delivery of spine SBRT QA of the treatment and treatment unit Post-spine SBRT imaging follow-up. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/82371/download?token=QS-r4wno)", "external_id": "cco-74056", "metadata": {"authors": "A. Sahgal, S. Kellett, T. Nguyen, P. Maralani, J. Greenspoon, K. Linden, A. Pearce, F. Siddiqi, M. Ruschin, SBRT for Spine Expert Panel", "document_status": "Current", "id": "GL 21-6 Apr 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/82371/download?token=QS-r4wno", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Consensus-based organizational guideline for the planning and delivery of spine stereotactic body radiotherapy treatment in Ontario", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74056"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to provide clinical practice recommendations for the management of thyroid nodules and differentiated thyroid cancers. Our recommendations are based on the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer [1] (the 2015 ATA Guidelines).\n\n## Patient Population\n\nAdults with thyroid nodules and differentiated thyroid cancers\n\n## Intended Guideline Users\n\nHealthcare providers involved in the management of thyroid diseases. Research Questions What is the role of thyroid cancer screening in people with familial follicular cell-derived differentiated thyroid cancer? What is the appropriate laboratory and imaging evaluation for patients with clinically or incidentally discovered thyroid nodules? What is the role of FNA, cytology interpretation, and molecular testing in patients with thyroid nodules? What are the principles of the molecular testing of FNA samples? What is the utility of 18FDG-PET scanning to predict malignant or benign disease when FNA cytology is indeterminate (AUS/FLUS, FN, SUSP)? What is the appropriate operation for cytologically indeterminate thyroid nodules? How should multinodular thyroid glands (i.e., two or more clinically relevant nodules) be evaluated for malignancy? What are the best methods for long-term follow-up of patients with thyroid nodules? What is the role of medical or surgical therapy for benign thyroid nodules? How should thyroid nodules in pregnant women be managed? What is the role of preoperative staging with diagnostic imaging and laboratory tests? What is the appropriate perioperative approach to voice and parathyroid issues? What are the basic principles of histopathologic evaluation of thyroidectomy samples? What initial stratification system should be used to estimate the risk of persistent/recurrent disease? How should initial risk estimates be modified over time? Should post-operative disease status be considered in decision-making for RAI therapy for patients with DTC? What is the role of molecular marker status in therapeutic RAI decision-making? How long does thyroid hormone need to be withdrawn in preparation for RAI remnant ablation/treatment or diagnostic scanning? Can recombinant human (rh) TSH (Thyrogen\u2122) be used as an alternative to thyroxine withdrawal for remnant ablation or adjuvant therapy in patients who have undergone near-total or total thyroidectomy? What activity of 131I should be used for remnant ablation or adjuvant therapy? Is a low-iodine diet necessary before remnant ablation? Should a post-therapy scan be performed following remnant ablation or adjuvant therapy? What is the appropriate degree of initial TSH suppression? Is there a role for adjunctive external beam irradiation or chemotherapy? What are the appropriate features of long-term management? What are the criteria for absence of persistent tumour (excellent response)? What are the appropriate methods for following patients after initial therapy? What is the role of serum Tg measurement in patients who have not undergone radioiodine remnant ablation? What is the role of US and other imaging techniques (RAI SPECT-CT, CT, MRI, PET-CT) during follow-up? What is the role of TSH suppression during thyroid hormone therapy in the long-term follow-up of DTC? What is the most appropriate management of DTC patients with metastatic disease? What is the optimal directed approach to patients with suspected structural neck recurrence? What is the surgical management of aerodigestive invasion? How should RAI therapy be considered for loco-regional or distant metastatic disease? How should distant metastatic disease to various organs be treated? When should empiric RAI therapy be considered for Tg-positive, RAI diagnostic scan\u2013negative patients? What is the management of complications of RAI therapy? How should patients who have received radioiodine therapy be monitored for risk of secondary malignancies? What other testing should patients receiving RAI therapy undergo? How should patients be counselled about radioiodine therapy and pregnancy, nursing, and gonadal function? How is RAI-refractory DTC classified? Which patients with metastatic thyroid cancer can be followed without additional therapy? What is the role for directed therapy in advanced thyroid cancer? Who should be considered for clinical trials? What is the role of systemic therapy (kinase inhibitors, other selective therapies, conventional chemotherapy, b-isphosphonates, denosumab) in treating metastatic DTC?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81866/download?token=FgXq7eLu)", "external_id": "cco-74246", "metadata": {"authors": "J. Yoo, C. Agbassi, H. Lochnan, D. Morrison, A. M. Sawka, J. Brierley, Head and Neck Disease Site Group Thyroid Cancer Subcommittee", "document_status": "In-Review", "id": "GL END 5-13 Jun 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/81866/download?token=FgXq7eLu", "type_of_content": "Guidelines & Advice, Clinical", "version": "N/A"}, "section_count": 3, "source": "cco", "title": "Cancer Care Ontario Thyroid Cancer Guideline: An Endorsement of the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74246"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nOntario PET Steering Committee What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/71306/download?token=cNUOrmEx)", "external_id": "cco-74266", "metadata": {"authors": "R. Poon, Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2022-2 Jun 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/71306/download?token=cNUOrmEx", "type_of_content": "Guidelines & Advice, Advice Report"}, "section_count": 4, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2022", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74266"} +{"content": "## Guideline Objective\n\nThe objective of this initiative was to formulate recommendations for ambulatory systemic treatment models of care, considering perspectives from patients, providers, cancer programs, and organizations. The aims of these recommendations are to: Optimize the utilization of health care resources, settings, and processes throughout the oncology clinic, oncology pharmacy, and systemic therapy suite. Enhance the experience of patients undergoing ambulatory systemic treatment. Improve the well-being of multidisciplinary team members involved in the delivery of this care.\n\n## Patient Population\n\nPatients receiving systemic treatment for all cancers\n\n## Intended Guideline Users\n\nOncology physicians, oncology nursing, oncology pharmacists, psychosocial oncology and allied health professionals, primary care providers supporting cancer patients, healthcare administrators and organizations involved in the planning and delivery of cancer services Research Questions What are the current challenges and gaps in the systemic treatment for cancer patients in Ontario, especially for underserved groups like First Nations, Inuit, M\u00e9tis, Urban Indigenous (FNIMUI) communities, Francophone populations, and other equity-deserving groups? What recommendations can be made to optimize service delivery models for oncology providers and patients in Ontario, considering a variety of settings including oncology clinics, pharmacies, and systemic therapy suites? How can the system better address the unique access barriers faced by underserved groups in the context of systemic treatment for cancer? What are the roles and responsibilities of different stakeholders (e.g., systemic treatment facilities, Regional Cancer Programs, Ontario Health) in achieving the proposed recommendations for improved systemic treatment delivery? How can the system ensure provider health and well-being while dealing with complex care requirements and provider burnout? What are the key enablers for success and considerations for implementing the proposed recommendations? Summary (PDF) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Optimisation Des Mod\u00e8les De Soins Pour Le Traitement Syst\u00e9mique En Milieu Ambulatoire R\u00e9sum\u00e9\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/72021/download?token=PN9-T_Tt)", "external_id": "cco-74406", "metadata": {"authors": "Ontario Health (Cancer Care Ontario) Models of Care, Person Centred Care, Systemic Treatment Programs", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/72021/download?token=PN9-T_Tt", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "1"}, "section_count": 3, "source": "cco", "title": "Optimizing Ambulatory Systemic Treatment Models of Care", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74406"} +{"content": "## Patient Population\n\nWomen with cervical cancer for whom primary treatment with radiotherapy is being considered: Those with locally advanced cervical cancer Those with bulky clinical stage IB (>4 cm) cervical cancer, who are treated with radiotherapy Those with high-risk early-stage cervical cancer (node-positive or margin-positive), who will be treated with radiotherapy following hysterectomy\n\n## Research Question(s)\n\nFor women with cervical cancer in whom radiotherapy is considered appropriate, does the addition of concurrent platinum-based chemotherapy improve survival and quality of life with acceptable toxicity? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/71766/download?token=J_2rfTiU)", "external_id": "cco-746", "metadata": {"authors": "H. Lukka, H. Hirte, A. Fyles, G. Thomas, M. Fung Kee Fung, M. Johnston , Gynecology Cancer Disease Site Group", "document_status": "In-Review", "id": "4-5 Jun 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/71766/download?token=J_2rfTiU", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Primary Treatment for Locally Advanced Cervical Cancer: Concurrent Platinum-Based Chemotherapy and Radiation", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/746"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to provide recommendations on diagnosing and treating Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). The recommendations are based on the National Comprehensive Cancer Network (NCCN) Version 2.2022 T-Cell Lymphomas Guideline on BIA-ALCL.\n\n## Patient Population\n\nPatients with suspected or confirmed BIA-ALCL.\n\n## Intended Guideline Users\n\nThe guideline document will support providers in diagnosing and treating patients with BIA-ALCL.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/72521/download?token=wqf0i7gC)", "external_id": "cco-74686", "metadata": {"authors": "F.C. Wright, J. Lipa, T. Zhong, E. Piliotis, Z. Ghorab, P. Stotland, M. Lee , Diagnosis and Treatment of BIA-ALCL Guideline Development Group", "document_status": "Current", "id": "GL-END-C50-35 Aug 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/72521/download?token=wqf0i7gC", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2022 NCCN Guideline on Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74686"} +{"content": "## Patient Population\n\nPatients with prostate cancer who are eligible for treatment with 177Lutetium-prostate-specific membrane antigen-617 (177Lutetium-PSMA-617).\n\n## Intended Guideline Users\n\nThis guideline is targeted for clinicians involved in the care of patients with prostate cancer who are eligible for treatment with 177Lutetium-PSMA-617.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/72781/download?token=B9DaoPhr)", "external_id": "cco-74856", "metadata": {"authors": "K. Zukotynski, C. Arinze, G. Kulkarni, S. Hotte, A. Loblaw, Genitourinary Disease Site Group", "document_status": "Current", "id": "GL-END 3-25 Nov 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/72781/download?token=B9DaoPhr", "type_of_content": "Guidelines & Advice, Advice Report"}, "section_count": 2, "source": "cco", "title": "Ontario Health (Cancer Care Ontario) Endorsement of ASCO Rapid Recommendation on 177Lutetium-Prostate-Specific Membrane Antigen-617 (PSMA-617) for Metastatic Castration-Resistant Prostate Cancer (mCRPC)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/74856"} +{"content": "## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee\n\n## Research Question(s)\n\nWhat is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/73051/download?token=tKlvid19)", "external_id": "cco-75036", "metadata": {"authors": "R. Poon, Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2023-1 Nov 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/73051/download?token=tKlvid19", "type_of_content": "Guidelines & Advice, Advice Report"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2023", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/75036"} +{"content": "## Intended Guideline Users\n\nHealth care providers and administrators\n\n## Research Question(s)\n\nWhat are the required and recommended diagnostic and prognostic tests for patients with MDS that are needed for clinical decision-making? What are the required and recommended diagnostic and prognostic tests for patients with MPN that are needed for clinical decision-making? What are the required and recommended diagnostic and prognostic tests for patients with MDS/MPN that are needed for clinical decision-making?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/73481/download?token=qcvUjj0N)", "external_id": "cco-75246", "metadata": {"authors": "MDS Working Group, MPN Working Group", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/73481/download?token=qcvUjj0N", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "1.0"}, "section_count": 2, "source": "cco", "title": "Consensus Diagnostic and Prognostic Testing for Myelodysplastic Syndromes, Myeloproliferative Neoplasms, and Myelodysplastic/Myeloproliferative Neoplasms: Recommendations Report - 2024", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/75246"} +{"content": "## Patient Population\n\nAdults living with cancer and care partners/family members (\u226518 years) Includes adult survivors of childhood cancer, Includes people currently in treatment and post treatment for cancer, Care partners include family members and other support people (i.e., friends) who provide unpaid care to cancer survivors.\n\n## Intended Guideline Users\n\nThe intended users of this guideline include oncology professionals, primary care providers, healthcare professionals working with cancer patients, psychosocial oncology professionals, and decision and policy makers in hospitals, clinics, and health systems in the province of Ontario. Research Questions Research Question 1: For patients who are living with cancer, are screening tools for FCR more effective for identifying patients and care partners who suffer from FCR than not screening? For such a screening tool, is there improved capacity to identify patients who experience FCR compared to the current standard of care (i.e., ESAS, psychosocial support)? Does the use of a screening tool increase referral to appropriate psychosocial resources? Research Question 2: For patients who are living with cancer, are assessment tools for FCR more effective for identifying the extent and nature of FCR in patients and care partners than usual care (e.g., ESAS)? Does the use of an assessment tool lead to better management of FCR (e.g., referral to appropriate psychosocial resources)? Research Question 3: What are the most effective strategies/components for managing or reducing FCR?\" Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/73766/download?token=G2-c5dEp)", "external_id": "cco-75576", "metadata": {"authors": "S. Lebel, C. Zwaal, L. Craig, R. Conrod, L. Freeman, J. Galica, C. Maheu, R. Nissim, J. Savard, Fear of Cancer Recurrence Guideline Group", "document_status": "Current", "id": "GL 19-7 Mar 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/73766/download?token=G2-c5dEp", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Fear of Cancer Recurrence Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/75576"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to provide recommendations on the diagnosis and management of uveal melanoma. The recommendations are based on version 2 of the Cancer Care Alberta Clinical Practice Guideline on Uveal Melanoma.\n\n## Patient Population\n\nPatients with suspected or confirmed uveal melanoma diagnosis.\n\n## Intended Guideline Users\n\nThe guideline document will support providers in the diagnosis and management of patients with uveal melanoma.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/74091/download?token=jAM0xAu7)", "external_id": "cco-75736", "metadata": {"authors": "F.C. Wright, M. Butler, R. Beecroft, A. Cyr, I. King, H. Krema, N. Laperriere, G. Matel, M. Ong, S. Courtney, and the Uveal Melanoma Guideline Endorsement Working Group", "document_status": "Current", "id": "C50-CIDAP-1 Mar 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/74091/download?token=jAM0xAu7", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2021 Cancer Care Alberta Clinical Practice Guideline on Uveal Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/75736"} +{"content": "ID: CED 8 Jul 2008\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: D. Jonker, J. Biagi, A.E. Haynes", "external_id": "cco-761", "metadata": {"authors": "D. Jonker, J. Biagi, A.E. Haynes", "document_status": "Archived", "id": "CED 8 Jul 2008", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Use of Epidermal Growth Factor Receptor Inhibitors in Advanced Colorectal Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/761"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/75886/download?token=wnmYFzfU)", "external_id": "cco-76381", "metadata": {"authors": "R. Poon, the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/75886/download?token=wnmYFzfU", "type_of_content": "Guidelines & Advice", "version": "PET 2023-2"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2023", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/76381"} +{"content": "## Guideline Objective\n\nTo provide guidance for the organization and delivery of healthcare services for adult patients with primary central nervous system (CNS) tumours in Ontario. The goal is to ensure that all patients in Ontario have access to comprehensive CNS tumour services, regardless of their place of residence. Specifically, to ensure appropriate coordination of concurrent services (surgery, chemotherapy, radiotherapy, and supportive care) within a province-wide CNS tumour program, including: Appropriate clinician/health professional skill set, experience, and qualifications Case review at multidisciplinary case conferences (MCCs) Access to expert multidisciplinary resources (including allied health/psychosocial oncology) Care as close to home as possible Access to clinical trials\n\n## Patient Population\n\nThis guideline focuses on adult patients with primary CNS tumours (glioma and other primary parenchymal neoplasms, sellar lesions, and skull-base lesions and meningioma) and their caregivers. This guideline does not apply to patients with brain or spinal metastases, sarcomatous tumours of the CNS, or pediatric patients with CNS tumour, as care considerations for these patients have been addressed by previous or parallel guideline efforts. For organizational guidance on brain metastases, please see the related Ontario Health (Cancer Care Ontario) (OH (CCO)) organizational care guideline for stereotactic radiosurgery treatment of brain metastasis.\n\n## Intended Guideline Users\n\nStakeholders include all Ontario Regional Cancer Programs and affiliated centres that deliver CNS tumour care (primary brain tumours), as well as programs that plan to provide CNS tumour care in the future. Specifically, this document is intended for administrators responsible for developing, implementing, and maintaining CNS tumour programs and for the oncology health care professionals who interact with and care for patients with CNS tumours. Research Questions What are the centre requirements for the organization and delivery of care for adult patients with CNS primary tumours? What are the recommended staff requirements and expertise required by medical/surgical, nursing, and allied healthcare professionals to provide optimal care for patients with CNS primary tumours? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/76601/download?token=DyfgEJi4)", "external_id": "cco-76866", "metadata": {"authors": "S. Das, C. Walker-Dilks, G. Nicholas, A. Sahgal, The Organizational Guidance for the Care of Patients with CNS Tumours Guideline Development Group", "document_status": "Current", "id": "GL 9-11 Oct 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/76601/download?token=DyfgEJi4", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Organizational Guidance for the Care of Patients with Central Nervous System Tumours in Ontario: Consensus Recommendations", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/76866"} +{"content": "## Guideline Objective\n\nTo determine the preferred first-line treatment strategy for patients with advanced-stage Hodgkin lymphoma (HL) among the following regimens: doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD); brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A-AVD); escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP); and other treatments with or without positron emission tomography (PET) response-adapted strategies? To determine the role of radiation as part of the first-line treatment strategy for these patients.\n\n## Patient Population\n\nAdult patients (\u226518 years of age) with advanced-stage HL who require upfront (first-line) treatment. Advanced stage refers to stage III/IV; however, patients with stage IIB with adverse features (large mediastinal mass or extranodal disease) are also included as their prognoses are similar to those with advanced disease.\n\n## Intended Guideline Users\n\nClinicians treating patients with advanced-stage HL, including hematologists, radiation oncologists, radiologists, medical oncologists, nurse practitioners, and hematology pharmacists. Research Questions In patients with advanced-stage HL: For patients younger than 60 years of age, what is the ideal treatment strategy, among A-AVD, ABVD, ABVD-PET response-adapted, eBEACOPP, and eBEACOPP\u2013PET response-adapted, and other treatments with or without PET response-adapted strategies, as part of the first-line therapy, to improve patient outcomes, and how does it affect adverse events? For patients 60 years of age and older, what is the ideal treatment strategy, among ABVD; B-AVD; brentuximab alone or in combination; prednisone, vinblastine, doxorubicin, and gemcitabine (PVAG); cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), Chlorambucil-VinBLAStine-Procarbazine-Prednisone (CHLVPP); or other agents, as part of the first-line therapy to improve patient outcomes, and how does it affect adverse events? Does consolidation radiotherapy after first-line chemotherapy improve outcomes such as OS, PFS, recurrence, and adverse events in adult patients with advanced-stage HL? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/84366/download?token=cVw3LuO7)", "external_id": "cco-76936", "metadata": {"authors": "L. Mozessohn, R. Poon, F.G. Baldassarre, M.C. Cheung, C. Faught, D. Rodin, A. Singnurkar, A. Suleman, A. Prica, L.K. Hicks", "document_status": "Current", "id": "GL 6-25 Mar 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/84366/download?token=cVw3LuO7", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "First-line treatment of advanced-stage Hodgkin lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/76936"} +{"content": "## Guideline Objective\n\nTo provide recommendations and identify considerations around cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in patients receiving T-cell engaging antibody treatment.\n\n## Patient Population\n\nAdults receiving treatment with a T-cell engaging antibody.\n\n## Intended Guideline Users\n\nClinicians treating patients receiving a T-cell engaging antibody and/or managing possible toxicities, including CRS and/or ICANS. Research Questions What prophylactic measures are needed to help prevent CRS and ICANS? Is there a role for prophylactic tocilizumab? Can the premedications be standardized across T-cell engaging antibodies? Are there specific patient groups who are at a higher risk of experiencing CRS and ICANS? What is the appropriate management of CRS based on grade? What is the appropriate management of ICANS based on grade? What factors should be taken into consideration for the outpatient administration of ramp-up doses? Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Des anticorps engageant les lymphocytes T: Carte portefeuille d'alerte m\u00e9dicale T-cell Engaging Antibody Treatment: Wallet Card Organizational Readiness Recommendations for Delivering T-cell Engaging Antibodies Recommandations de pr\u00e9paration organisationnelle pour l\u2019administration d\u2019anticorps engageant les lymphocytes T Treating cancer with T-cell engaging antibodies: What you need to know (Patient Information Sheet) Traitement du cancer par des anticorps engageant les lymphocytes T : Ce que vous devez savoir (fiche d\u2019information)\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77826/download?token=I_JpcHHr)", "external_id": "cco-76976", "metadata": {"document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/77826/download?token=I_JpcHHr", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "T-Cell Engaging Antibodies: Management of Cytokine Release Syndrome (CRS) and Immune Effector-Associated Neurotoxicity Syndrome (ICANS)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/76976"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to determine the most effective therapies for patients with oligometastatic or oligoprogressive non-small cell lung cancer (NSCLC)\n\n## Patient Population\n\nThe target population includes adult patients with oligometastatic or oligoprogressive NSCLC.\n\n## Intended Guideline Users\n\nThe intended users include oncologists and thoracic surgeons involved in the treatment of patients with oligometastatic or oligoprogressive NSCLC. Research Questions What are the optimal patient/disease characteristics to select patients with oligometastatic NSCLC for de\ufb01nitive treatment combining systemic and local therapies? What are the selection criteria for choice of local treatment modality in the management of patients with oligometastatic NSCLC? What are the appropriate sequencing and timing of systemic therapy and de\ufb01nitive local therapies for patients with oligometastatic NSCLC? What are the optimal dose-fractionation regimens, planning, and delivery technique of RT for patients with oligometastatic NSCLC? After a de\ufb01nitive local therapy approach for oligometastatic NSCLC, what are the indications for additional local therapy upon disease progression? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/76821/download?token=lwldOhQe)", "external_id": "cco-77026", "metadata": {"authors": "Y. Ung, E.T. Vella, A. Chan, D. Maziak, R. Nayak, K. Ramchandar, A. Robinson, the Lung Cancer Disease Site Group", "document_status": "Current", "id": "GL END 7-24 Nov 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/76821/download?token=lwldOhQe", "type_of_content": "Guidelines & Advice, Advice Report"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the ASTRO/ESTRO 2023 Guideline for the Treatment of Patients with Oligometastatic or Oligoprogressive Non-Small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77026"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are to provide recommendations on the diagnosis and treatment of penile cancer. The recommendations are based on the 2023 European Association of Urology (EAU) -American Society of Clinical Oncology (ASCO) Guidelines on Penile Cancer.\n\n## Patient Population\n\nPatients with a suspected or confirmed penile cancer diagnosis.\n\n## Intended Guideline Users\n\nThe guideline document will support providers in the diagnosis and treatment of patients with penile cancer. Research Questions Endorsement, no research questions\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/76941/download?token=3L0d7Gbc)", "external_id": "cco-77096", "metadata": {"authors": "G. Kulkarni, D. Jiang, L. Lavallee, G. Morton, S. Prendeville, and the Penile Cancer Guidelines Endorsement Expert Panel", "document_status": "Current", "id": "Guideline Endorsement C50-CIDAP-2 Nov 2024", "pdf_url": "https://www.cancercareontario.ca/en/file/76941/download?token=3L0d7Gbc", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2023 European Association of Urology (EAU) -American Society of Clinical Oncology (ASCO) Guidelines on Penile Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77096"} +{"content": "## Guideline Objective\n\nThe Use of Molecular Tools for Identifying and Guiding Treatment of Cancers of Unknown Primary.\n\n## Patient Population\n\nAll adult patients with a diagnosis of CUP.\n\n## Intended Guideline Users\n\nClinicians, laboratory physicians, and scientists involved in the care and testing of patients with cancers of unknown primary Policy makers, health care administrators, and the OMH Research Questions Can clinical outcomes, such as OS and PFS, and/or diagnostic outcomes (such as sensitivity and specificity) be improved through molecular profiling in patients with a diagnosis of cancer of unknown primary.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77561/download?token=tRin6ng8)", "external_id": "cco-77641", "metadata": {"authors": "S. Saibil, X. Yao, D. Sivajohanathan, M. Deodat, M Vickers, P. Wheatley-Price, J. Yoon, H. Feilotter", "document_status": "Current", "id": "MOTAC-7 Jan 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/77561/download?token=tRin6ng8", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "The Use of Molecular Tools for Identifying and Guiding Treatment of Cancers of Unknown Primary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77641"} +{"content": "## Guideline Objective\n\nThe objectives of this guideline are: To ensure the approach to molecular testing for endometrial cancer is consistent across the province, and; Help physicians appropriately triage and facilitate the treatment of patients with endometrial cancer.\n\n## Intended Guideline Users\n\nHospital and community-based pathologists with a special interest in gynecologic cancers, gynecologists, gynecologic oncologists, and other healthcare professionals who care for patients with endometrial cancer, including radiation oncologists and medical oncologists.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77606/download?token=_nbNvaEN)", "external_id": "cco-77686", "metadata": {"authors": "Endometrial Cancer Molecular Testing Working Group Members", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/77606/download?token=_nbNvaEN", "type_of_content": "Guidelines & Advice", "version": "1"}, "section_count": 2, "source": "cco", "title": "Endometrial Cancer Molecular Testing Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77686"} +{"content": "## Guideline Objective\n\nThis document provides interim guidance on cervical screening and colposcopy for people ages 21 to 24 who started screening before the formal change in age of initiation in the Ontario Cervical Screening Program (OCSP). When human papillomavirus (HPV) testing is launched in the OCSP, the age of initiation for cervical screening will change from age 21 to age 25. After this change, there will be a transitional period when cervical screening and colposcopy decisions will need to be made for people under age 25 who started screening before the implementation of HPV testing.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/77796/download?token=EM0KFk_e)", "external_id": "cco-77691", "metadata": {"authors": "Ontario Cervical Screening Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/77796/download?token=EM0KFk_e", "type_of_content": "Guidelines & Advice"}, "section_count": 1, "source": "cco", "title": "Ontario Cervical Screening Program: Interim guidance to support the transition years following the launch of human papillomavirus testing in Ontario: Cervical screening and colposcopy recommendations for people ages 21 to 24", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77691"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to provide recommendations on the management of symptomatic brain radiation necrosis after stereotactic radiosurgery. The recommendations are based on the 2023 International Stereotactic Radiosurgery Society\u2019s Guideline: A Systematic Review Informing the Management of Symptomatic Brain Radiation Necrosis After Stereotactic Radiosurgery and International Stereotactic Radiosurgery Society Recommendations.\n\n## Patient Population\n\nPatients receiving stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT) for brain metastases and presenting with symptomatic brain radiation necrosis after stereotactic radiosurgery.\n\n## Intended Guideline Users\n\nThe guideline document will support providers, including neuro-oncologists, neurosurgeons, radiation oncologists, medical oncologists, pathologists, radiologists etc., in the management of patients presenting with symptomatic brain radiation necrosis after stereotactic radiosurgery. Research Questions Endorsement, no research questions.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/78206/download?token=vfdDPVFL)", "external_id": "cco-77996", "metadata": {"authors": "S. Das, J. Greenspoon, K.J. Jerzak, T. Nguyen, T.L. Ng, R. Ramos, F. Ynoe de Moraes, D. Bhatti, the Brain Radiation Necrosis Guideline Endorsement Expert Panel", "document_status": "Current", "id": "Guideline Endorsement C50-CIDAP-3 Mar 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/78206/download?token=vfdDPVFL", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2023 International Stereotactic Radiosurgery Society\u2019s (ISRS) Guideline: A Systematic Review Informing the Management of Symptomatic Brain Radiation Necrosis After Stereotactic Radiosurgery and ISRS Recommendations", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/77996"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/78501/download?token=w4VmKsBu)", "external_id": "cco-78226", "metadata": {"authors": "F. G. Baldassarre, The Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2024-1 Mar 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/78501/download?token=w4VmKsBu", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2024", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/78226"} +{"content": "## Guideline Objective\n\nTo provide guidance to inform systemic treatment clinicians and administrators as they prepare for and respond to future emergency scenarios at systemic treatment facilities in Ontario.\n\n## Patient Population\n\nPatients receiving systemic treatment at hospitals in Ontario.\n\n## Intended Guideline Users\n\nHealth care providers, administrators and organizations involved in the planning and delivery of systemic treatment (medical oncologists, nurses, pharmacists, patient care managers and directors) Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools Pr\u00e9paration aux urgences en traitement syst\u00e9mique - Document d\u2019orientation\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/80786/download?token=3swAtt0g)", "external_id": "cco-79076", "metadata": {"authors": "Grant Fuller, Daniela Gallo-Hershberg, Leta Forbes", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/80786/download?token=3swAtt0g", "type_of_content": "Guidelines & Advice"}, "section_count": 3, "source": "cco", "title": "Systemic Treatment Emergency Preparedness Guidance Document", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/79076"} +{"content": "## Patient Population\n\nAdult patients with symptomatic endobronchial disease in non-small cell lung cancer.\n\n## Research Question(s)\n\nIs there a role for high dose rate endobronchial brachytherapy (HDREB) in the palliation of respiratory symptoms in patients with non-small cell lung cancer? If so, what is the optimal dose of HDREB in this setting? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74316/download?token=NfiAppHt)", "external_id": "cco-791", "metadata": {"authors": "Lung Cancer Disease Site Group", "document_status": "Current", "id": "7-16 Dec 2022", "pdf_url": "https://www.cancercareontario.ca/en/file/74316/download?token=NfiAppHt", "type_of_content": "Guidelines & Advice, Clinical", "version": "4"}, "section_count": 2, "source": "cco", "title": "The Role of High Dose Rate Brachytherapy in the Palliation of Symptom in Patients with Non-Small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/791"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the diagnosis, treatment and follow-up of patients with pre-malignant and malignant gestational trophoblastic disease (GTD).\n\n## Patient Population\n\nIndividuals with a confirmed or suspected diagnosis of GTD.\n\n## Intended Guideline Users\n\nAll healthcare providers involved in the care of patients with GTD.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/81631/download?token=RPAyZGJG)", "external_id": "cco-79681", "metadata": {"authors": "G. Bouchard-Fortier, D. Sivajohanathan, N. Coakley, M. Cesari, L. Eiriksson, A. Lohman, S. Ferguson, The Ontario Gynecologic Cancers Advisory Committee", "document_status": "Current", "id": "GL END 4-19 Nov 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/81631/download?token=RPAyZGJG", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "An Endorsement of the 2025 Practical Guidelines for the Treatment of Gestational Trophoblastic Disease: Collaboration of the EOTTD, ESGO, GCIG, ISSTD", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/79681"} +{"content": "## Patient Population\n\nPatients presenting with high-risk benign breast lesions, including atypical ductal hyperplasia, mucocele-like lesions, papillary lesions, radial scars/complex sclerosing lesions, atypical lobular hyperplasia, lobular carcinoma in situ, columnar cell change, flat epithelial atypia, fibroepithelial lesions with increased stromal cellularity, spindle cell lesions/mesenchymal lesions, and microglandular adenosis.\n\n## Intended Guideline Users\n\nSurgeons, oncologists, primary care providers, radiologists, and pathologists with a special interest in breast cancer.\n\n## Research Question(s)\n\nDescribe the risk of upstaging at excision of high-risk lesions diagnosed by needle biopsy. What are the factors that predict upstaging? Which high-risk benign breast lesions need to be excised versus followed? a) For lesions that are not excised and are concordant, what is the appropriate interval and length of follow-up? Full Report (PDF) Guideline-Based Clinical Tools Close Guideline-Based Clinical Tools L\u00e9sions mammaires b\u00e9nignes \u00e0 risque \u00e9lev\u00e9 Rapport de recommandations : Guide de r\u00e9f\u00e9rence rapide High-Risk Benign Breast Lesions Recommendations Report: Quick Reference\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/82151/download?token=wUndXSZn)", "external_id": "cco-79886", "metadata": {"authors": "High-Risk Benign Breast Lesions Working Group Members", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/82151/download?token=wUndXSZn", "type_of_content": "Guidelines & Advice", "version": "1"}, "section_count": 3, "source": "cco", "title": "High-Risk Benign Breast Lesions Recommendations Report", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/79886"} +{"content": "## Guideline Objective\n\nThe objective of this guideline is to provide guidance on the use of systemic therapy in patients with unresectable, metastatic cutaneous melanomas.\n\n## Patient Population\n\nThese recommendations apply to adult patients (18+) with unresectable lymph node metastasis (American Joint Committee on Cancer [AJCC] TNM stage IIIC/D) and distant metastatic (AJCC TNM stage IV) cutaneous melanoma for whom systemic therapy is indicated. Pathological staging is according to the 8th edition AJCC staging system.\n\n## Intended Guideline Users\n\nThe intended users of the guideline are medical oncologists, dermatologists, family doctors and other clinicians who are involved in the treatment and follow-up care of patients with melanoma in the province of Ontario. Research Questions Research Question 1 For adult patients (18+) with unresectable lymph node metastasis (AJCC TNM stage IIIC/D) and distant metastatic (AJCC TNM stage IV) cutaneous melanoma: What systemic treatment options (immunotherapies and targeted therapies) with what optimal timing and sequencing, alone or in combination, have demonstrated clinical benefit, compared with traditionally used treatments (chemotherapies, alternative immunotherapies and targeted therapies)? Are there groups of patients with molecular (e.g., BRAF-mutated, NRAS-mutated, KIT-mutated) and/or clinical disease subtypes (e.g., lymph node metastasis, brain metastases) who benefit from certain systemic treatments alone or in combination? Research Question 2 What is the optimal systemic therapy management of disease progression following treatment breaks in the target population? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/82476/download?token=3GmtZb02)", "external_id": "cco-79966", "metadata": {"authors": "T. Petrella, S. Kellett, T. Baetz, G. Knight, E. McWhirter, A. Sun, X. Song, F. Wright, The Melanoma Disease Site Group", "document_status": "Current", "id": "GL 8-12 Jan 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/82476/download?token=3GmtZb02", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Systemic Treatments for Unresectable and Metastatic Cutaneous Melanoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/79966"} +{"content": "## Guideline Objective\n\nAs part of a regular monitoring program recommended by the PEBC, a systematic review of recent evidence on the use of PET in patients with cancer, sarcoidosis, epilepsy or dementia or fever of unknown origin or inflammation is conducted every six months. This report is intended to be a high-level, brief summary of the identified evidence, and not a detailed evaluation of its quality and relevance.\n\n## Patient Population\n\nAdult and pediatric patients with suspected or diagnosed cancer(s), sarcoidosis, epilepsy or dementia or fever of unknown origin or inflammation. (The cancer is not limited to those cancers with approved or Ontario Health Insurance (OHIP) insured services).\n\n## Intended Guideline Users\n\nOntario PET Steering Committee Research Questions What is the role of positron emission tomography (PET) in the clinical management of patients with cancer, sarcoidosis, epilepsy or dementia with respect to: Diagnosis and staging Assessment of treatment response Detection and restaging of recurrence and Evaluation of metastasis Outcomes of interest are: survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/82516/download?token=WMOnJINZ)", "external_id": "cco-79971", "metadata": {"authors": "F. G. Baldassarre and P. L.Santaguida from the Program in Evidence-Based Care Disease Site Group Reviewers", "document_status": "Current", "id": "PET 2024-2 Jan 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/82516/download?token=WMOnJINZ", "type_of_content": "Guidelines & Advice, Advice Report"}, "section_count": 3, "source": "cco", "title": "Evidence from Primary Studies and Systematic Reviews for June to December 2024", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/79971"} +{"content": "## Patient Population\n\nPatients with small-cell lung cancer.\n\n## Intended Guideline Users\n\nMedical oncologists, radiation oncologists, thoracic surgeons, pulmonologists, pathologists, radiologists, primary\u00a0care physicians, nurse practitioners, physician assistants, pharmacists, nurses, and other providers. Research Question What is the optimal systemic therapy for patients with small-cell lung cancer (SCLC)?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/72631/download?token=wPZYhBjf)", "external_id": "cco-801", "metadata": {"authors": "Humera Khurshid, Nofisat Ismaila, Jessica Bian, Raetasha Dabney, Millie Das, Peter Ellis, Jill Feldman, Christine Hann, Swati Kulkarni, Janessa Laskin, Rami Manochakian, Deebya Raj Mishra, Isabel Preeshagul, Pavan Reddy, Ashish Saxena, Frank Weinberg, Gregory P. Kalemkerian", "document_status": "Current", "id": "7-A-2022-1-17v3 Oct 2023", "pdf_url": "https://www.cancercareontario.ca/en/file/72631/download?token=wPZYhBjf", "type_of_content": "Guidelines & Advice, Clinical", "version": "3"}, "section_count": 2, "source": "cco", "title": "Systemic Therapy for Small-Cell Lung Cancer: ASCO-Ontario Health (Cancer Care Ontario) Guideline", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/801"} +{"content": "## Guideline Objective\n\nRecommendations to standardize the reporting of somatic genetic testing results.\n\n## Patient Population\n\nAdult, Pediatric\n\n## Intended Guideline Users\n\nClinicians, laboratory experts and system administrators.\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/84231/download?token=mOixTZAV)", "external_id": "cco-80286", "metadata": {"authors": "Standardized Somatic Genetics Reporting Working Group (SSGRWG)", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/84231/download?token=mOixTZAV", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "1"}, "section_count": 3, "source": "cco", "title": "Recommendations for the Standardization of Somatic Genetic Testing Reports", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/80286"} +{"content": "## Guideline Objective\n\nTo provide direction on laboratory testing best practices for diagnostic, prognostic, and measurable residual disease (MRD) testing in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). These recommendations encompass the adult, adolescent and young adult (AYA), and pediatric patient populations.\n\n## Patient Population\n\nAdult, adolescent and young adult (AYA), and pediatric patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL)\n\n## Intended Guideline Users\n\nHealth care professionals, Health system administrators\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/84316/download?token=9x8PMYY3)", "external_id": "cco-80331", "metadata": {"authors": "Acute Leukemia Working Group, Pathology and Laboratory Medicine Program", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/en/file/84316/download?token=9x8PMYY3", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 3, "source": "cco", "title": "Acute Leukemia: Consensus Pathology Recommendations for Diagnosis and Monitoring", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/80331"} +{"content": "## Guideline Objective\n\nTo provide guidance with respect to the management of resectable, stage 1-3 rectal adenocarcinoma.\n\n## Patient Population\n\nThe target population for the guideline is adults with non-metastatic, resectable stage 1-3 rectal cancer as defined in TNM Classification of Malignant Tumours version 8\n\n## Intended Guideline Users\n\nThe intended users of this guideline are clinicians (medical oncologists, radiation oncologists, surgeons, and radiologists) involved in the care of patients with non-metastatic, resectable rectal cancer. Research Questions This guidance document examines the evidence to answer the following questions: Total Neoadjuvant Therapy (TNT) What is the role of total neoadjuvant therapy (TNT) in adults with resectable stage 1-3 rectal cancer when the ultimate goal is: operative management non-operative management? What is the preferred protocol and sequencing for TNT when the ultimate goal is: operative management non-operative management? Non-Operative Management (NOM) What is the rate of local regrowth and distant metastases in those who have had a complete response (CR) or near CR after any neoadjuvant therapy followed by non-operative management (NOM)? What is the best timing for assessment and what modalities should be used (DRE, endoscopy, MRI, etc.) to determine response following neoadjuvant therapy? How is clinical complete response (cCR) or near cCR defined following neoadjuvant therapy? What is the optimal schedule for surveillance of patients undergoing NOM providing the largest benefit? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/84406/download?token=ZdzEzPy0)", "external_id": "cco-80341", "metadata": {"authors": "C. Cho, S. R. Goodwin, S. Chadi, R. Cosby, K. Dennis, D. Jonker, C. Walsh, A. Mahmud, S. Berry, V. Francescutti, K. Jhaveri , The Gastrointestinal Disease Site Group", "document_status": "Current", "id": "GL 2-34 May 2026", "pdf_url": "https://www.cancercareontario.ca/en/file/84406/download?token=ZdzEzPy0", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Management of Resectable, Stage 1-3 Rectal Adenocarcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/80341"} +{"content": "## Guideline Objective\n\nThe recommendations were developed by Ontario Health (Cancer Care Ontario) and a panel of experts in endoscopy, primary care, epidemiology, health care administration, and the public to provide endoscopists and primary care providers with evidence-based recommendations for screening people with a family history of nonhereditary colorectal neoplasia. The recommendations are designed to ensure that the benefits of colorectal cancer screening outweigh the potential harms for screening participants.\n\n## Patient Population\n\nAsymptomatic people with a family history of nonhereditary colorectal neoplasia.\n\n## Intended Guideline Users\n\nEndoscopists, primary care providers. Research Questions What are the recommended colorectal cancer screening strategies in Ontario for people with a family history of colorectal neoplasia? These recommendations are also available in French: Recommandations de Contr\u00f4leCancerColorectal pour le d\u00e9pistage des personnes ayant des ant\u00e9c\u00e9dents familiaux de n\u00e9oplasie colorectale non h\u00e9r\u00e9ditaire (PDF). Full Report (PDF)\n\nFull report: [Recommandations de Contr\u00f4leCancerColorectal pour le d\u00e9pistage des personnes ayant des ant\u00e9c\u00e9dents familiaux de n\u00e9oplasie colorectale non h\u00e9r\u00e9ditaire](https://www.cancercareontario.ca/sites/ccocancercare/files/assets/coloncancercheck-recommendations-family-history-fr.pdf)", "external_id": "cco-80466", "metadata": {"authors": "Jill Tinmouth, Aarani Paramalingam, Bronwen R McCurdy, Christine Stogios, Victoria Tewkesbury, Meghan Walker, Catherine Dub\u00e9", "document_status": "Current", "pdf_url": "https://www.cancercareontario.ca/sites/ccocancercare/files/assets/coloncancercheck-recommendations-family-history-fr.pdf", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 3, "source": "cco", "title": "ColonCancerCheck Recommendations for Screening People with a Family History of Nonhereditary Colorectal Neoplasia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/80466"} +{"content": "## Patient Population\n\nAdult patients with truncal or extremity cutaneous melanoma with nodal metastases.\n\n## Intended Guideline Users\n\nClinicians and healthcare providers involved in the management or referral of patients with nodal metastases from truncal or extremity cutaneous melanoma.\n\n## Research Question(s)\n\nWhat is the optimal surgical management of patients with positive sentinel lymph nodes (SLNs) from cutaneous melanoma of the trunk or extremities with respect to: Factors for predicting non-sentinel lymph node (NSLN) positivity Completion lymph node dissection (CLND) at the time of SLN positivity versus observation Extent of nodal dissection What is the optimal surgical management of patients with biopsy-proven clinically palpable or biopsy-proven radiologically detected lymph nodes from cutaneous melanoma of the trunk or extremities with respect to extent of nodal dissection Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/74416/download?token=hGn2aMxZ)", "external_id": "cco-806", "metadata": {"authors": "A.M. Easson, R. Cosby, D.R. McCready, C. Temple, T. Petrella, F. Wright , Melanoma Disease Site Group", "document_status": "Current", "id": "8-6 Aug 2018", "pdf_url": "https://www.cancercareontario.ca/en/file/74416/download?token=hGn2aMxZ", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 3, "source": "cco", "title": "Surgical Management of Patients with Lymph Node Metastases from Cutaneous Melanoma of the Trunk or Extremities", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/806"} +{"content": "## Patient Population\n\nPatients with lung cancer for whom thoracic RT is indicated.\n\n## Intended Guideline Users\n\nRadiation oncologists involved in RT planning\n\n## Research Question(s)\n\nWhat role should positron emission tomography (PET) play in radiation treatment planning for non-small cell lung cancer (NSCLC)? Specifically, does the combination of PET and computed axial tomography (CT) imaging provide data that is superior to CT imaging data alone for the purposes of radiation treatment (RT) planning? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/1191/download?token=3rn7QvXa)", "external_id": "cco-811", "metadata": {"authors": "Y.C. Ung, A. Bezjak, N. Coakley, W.K. Evans, Lung Cancer Disease Site Group", "document_status": "Current", "id": "7-18 Nov 2010", "pdf_url": "https://www.cancercareontario.ca/en/file/1191/download?token=3rn7QvXa", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 3, "source": "cco", "title": "Positron Emission Tomography in Radiation Treatment Planning for Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/811"} +{"content": "## Patient Population\n\nAdult patients with lung cancer.\n\n## Research Question(s)\n\nWhat is the role of 18-Fluorodeoxyglucose (18FDG) Positron Emission Tomography (PET) in: The diagnosis of solitary pulmonary nodules (SPN)? The staging of primary non-small cell lung cancer (NSCLC) at initial diagnosis? The staging of primary small cell lung cancer (SCLC)? Outcomes of interest include accuracy measures of imaging and the impact of PET on patient management and patient outcomes. Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/35301/download?token=axA1_Bwy)", "external_id": "cco-821", "metadata": {"authors": "Y.C. Ung, D.E. Maziak, J.A. Vanderveen, C.A. Smith, K. Gulenchyn, W.K. Evans, Lung Cancer Disease Site Group", "document_status": "Current", "id": "7-20 Version 2 Oct 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/35301/download?token=axA1_Bwy", "type_of_content": "Guidelines & Advice, Clinical", "version": "2"}, "section_count": 2, "source": "cco", "title": "18-Fluorodeoxyglucose Positron Emission Tomography in the Diagnosis and Staging of Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/821"} +{"content": "## Guideline Objective\n\nTo make recommendations in the maintenance setting regarding the use of systemic treatment in the care of patients with non-small cell lung cancer (NSCLC).\n\n## Patient Population\n\nAdvanced, stage IIIB/IV patients who have NSCLC who have not progressed (i.e., complete response, partial response or stable disease) following four to six cycles of platinum-based chemotherapy and maintained an Eastern Cooperative Oncology Group performance status of 0 to 2.\n\n## Intended Guideline Users\n\nOncologists involved in the care of patients with NSCLC who require maintenance systemic treatment.\n\n## Research Question(s)\n\nIn patients with advanced NSCLC who have received initial first-line platinum-based chemotherapy for a minimum of four cycles, does maintenance systemic therapy improve overall survival (OS), progression-free survival (PFS), or quality of life in comparison with either placebo or second line therapy at the time of progression? In patients with advanced NSCLC who have received initial first-line platinum-based chemotherapy for a minimum of four cycles, does any systemic therapy agent improve OS, PFS or quality of life in comparison with other systemic therapies? In patients with advanced NSCLC, are there any clinical or molecular characteristics that identify subgroups of patients who derive greater benefit from maintenance systemic therapy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/44766/download?token=ifLP9P3g)", "external_id": "cco-831", "metadata": {"authors": "S. Kulkarni, E. Vella, N. Coakley, S. Cheng, R. Gregg, Y.C. Ung, P.M. Ellis, Lung Cancer Disease Site Group", "document_status": "In-Review", "id": "7-22 Aug 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/44766/download?token=ifLP9P3g", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "The Use of Systemic Treatment in the Maintenance of Patients with Non-Small Cell Lung Cancer", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/831"} +{"content": "ID: 13-7 Feb 2005\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: Program in Evidence-Based Care", "external_id": "cco-846", "metadata": {"authors": "Program in Evidence-Based Care", "document_status": "Archived", "id": "13-7 Feb 2005", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "The Prevention and Management of Acute Skin Reactions Related to Radiation Therapy", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/846"} +{"content": "## Guideline Objective\n\nThe guideline objective is to make recommendations on the most effective teaching strategies and methods of delivery for patient education in the cancer system.\n\n## Patient Population\n\nIndividuals living with or at risk of developing cancer and their care partners who seek services from the cancer system covering the entire continuum of care (prevention, screening, diagnosis, treatment, survivorship, and palliative care).\n\n## Intended Guideline Users\n\nIntended users of this guideline are members of the healthcare team involved in patient education. This may include patient education specialists and other leaders in healthcare. Intended users may also include physicians, nurse practitioners, nurses, and other allied healthcare professionals with an interest in patient education.\n\n## Research Question(s)\n\nWhat are the most effective teaching strategies and methods of delivery for patient education to support the individual living with or at risk of developing cancer and their care partner in knowledge, physical and psychological well-being, satisfaction, experience, and self-efficacy? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/78741/download?token=mRv7zLvh)", "external_id": "cco-851", "metadata": {"authors": "J. Papadakos, L.D. Durocher-Allen, D. Devitt, L. Krames, K. Lawrie, N. Pocrnic, A. Premji, A. Sultana, S. Wong, The Effective Teaching Strategies and Methods for Patient Education Expert Panel", "document_status": "Current", "id": "GL 20-2 Apr 2025", "pdf_url": "https://www.cancercareontario.ca/en/file/78741/download?token=mRv7zLvh", "type_of_content": "Guidelines & Advice, Health System, Models of Care", "version": "2"}, "section_count": 4, "source": "cco", "title": "Effective Teaching Strategies and Methods for Cancer Patient Education", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/851"} +{"content": "ID: CED 18 Jun 2010\nType of Content: Guidelines & Advice, Clinical\nDocument Status: Archived\nAuthors: M. MacKenzie, C. Quinton-Gladstone, A.E. Haynes, S. Hotte", "external_id": "cco-886", "metadata": {"authors": "M. MacKenzie, C. Quinton-Gladstone, A.E. Haynes, S. Hotte", "document_status": "Archived", "id": "CED 18 Jun 2010", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 1, "source": "cco", "title": "Zoledronic Acid for Metastatic Renal Cell Carcinoma (MRCC)", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/886"} +{"content": "## Guideline Objective\n\nTo provide a systematic literature review that will be one of the six components of the Recommendation Report (i.e., demand forecasting, costing analysis, jurisdictional review, literature review, system capacity, and current state) of the Focal Ablation Advisory Committee.\n\n## Patient Population\n\nPatients with HCC.\n\n## Intended Guideline Users\n\nInterventional radiologists, radiation oncologists, hepatobiliary surgeons, medical oncologists, healthcare professionals caring for patients with HCC or colorectal liver metastases.\n\n## Research Question(s)\n\nWhat is the effectiveness of transarterial chemoembolization (TACE) for the treatment of patients with hepatocellular carcinoma (HCC)? What is the side effect profile and treatment outcome of conventional TACE versus drug-eluting bead TACE (DEB-TACE)? What patient populations are most likely to benefit from TACE? Is there a difference in any important outcomes when performing TACE as an inpatient or an outpatient procedure?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70431/download?token=UlaT3OP5)", "external_id": "cco-901", "metadata": {"authors": "A. M\u00e9nard, F.G. Baldassarre, G. Martel, J. Kachura, Focal Ablation Advisory Committee", "document_status": "Archived", "id": "FA 2 Mar 2015", "pdf_url": "https://www.cancercareontario.ca/en/file/70431/download?token=UlaT3OP5", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Focal Tumour Ablation: Transarterial Chemoembolization for Hepatocellular Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/901"} +{"content": "## Guideline Objective\n\nTo make recommendations regarding the care of women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2.\n\n## Patient Population\n\nThese recommendations apply to women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2.\n\n## Intended Guideline Users\n\nThis guideline is targeted for: clinicians involved in the care of women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2. Research Questions In women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2 and are at increased risk for epithelial ovarian, fallopian tube, or primary peritoneal cancer, does screening with either serial U/S, CA125 or ROCA, decrease their risk of ovarian cancer? In women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2 and are at increased risk for epithelial ovarian, fallopian tube, or primary peritoneal cancer, what is the optimal strategy to prevent these cancers? What is the optimal post-surgical management protocol to address the sequelae of RRSO in women who harbour a pathogenic or likely pathogenic variant in BRCA1 and BRCA2? Summary (PDF) Full Report (PDF)\n\nFull report: [Summary (PDF)](https://www.cancercareontario.ca/en/file/81676/download?token=MLQWHg_A)", "external_id": "cco-931", "metadata": {"authors": "M. Jacobson, N. Coakley , M. Bernardini , L. Elit, S.E. Ferguson, R. Kim, The Gynecologic Guideline Development Group", "document_status": "Current", "id": "GL #4-4v2 Sep 2020", "pdf_url": "https://www.cancercareontario.ca/en/file/81676/download?token=MLQWHg_A", "type_of_content": "Guidelines & Advice", "version": "2"}, "section_count": 3, "source": "cco", "title": "Risk Reduction Strategies for BRCA1/2 Hereditary Ovarian Cancer Syndromes", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/931"} +{"content": "## Guideline Objective\n\nTo provide a systematic literature review on the use of radiofrequency ablation and microwave ablation in the treatment of hepatocellular carcinoma and colo-recctal cancer liver metastases that will be one of the component of the Recommendation Report of the Focal Ablation Advisory Committee. The additional components to their report are demand forecasting, costing analysis, jurisdictional review, system capacity, and current state.\n\n## Patient Population\n\nPatients with HCC or colorectal liver metastases.\n\n## Intended Guideline Users\n\nInterventional radiologists, radiation oncologists, hepatobiliary surgeons, medical oncologists, healthcare professionals caring for patients with HCC or CLM.\n\n## Research Question(s)\n\nWhat is the effectiveness of liver lesion thermal ablation using radiofrequency ablation or microwave ablation, alone or in combination with other strategies for the treatment of patients with hepatocellular carcinoma (HCC) or liver metastases (e.g., from colorectal cancer)? What are the subgroups of patients most likely to benefit from thermal ablation interventions? What are the potential adverse events associated with thermal ablation techniques?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/70426/download?token=XSrEOgIM)", "external_id": "cco-941", "metadata": {"authors": "F.G. Baldassarre, M. Baerlocher, R. Beecroft, L.A. Dawson, Focal Ablation Advisory Committee", "document_status": "Archived", "id": "FA 1 Jul 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/70426/download?token=XSrEOgIM", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "Focal Tumor Ablation: Thermal Ablation of Hepatocellular Carcinoma and Metastases from Colorectal Carcinoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/941"} +{"content": "## Guideline Objective\n\nTo determine if testing for DNMT3A mutation in this patient population determines prognosis with standard indication and consolidation therapy, as a guide to choosing alternative treatment if appropriate.\n\n## Patient Population\n\nAML patients with a normal cytogenetic profile.\n\n## Intended Guideline Users\n\nClinicians, patients and funding bodies.\n\n## Research Question(s)\n\nWhat is the prognostic value of DNMT3A mutation screening in cytogenetically normal patients with acute myeloid leukemia (AML)?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/32851/download?token=4aEEfXF8)", "external_id": "cco-946", "metadata": {"authors": "B. Leber, N. Ismaila, S. Kamel-Reid, M. Rutherford, Molecular Oncology Advisory Committee", "document_status": "Archived", "id": "MOAC 1 Nov 2013", "pdf_url": "https://www.cancercareontario.ca/en/file/32851/download?token=4aEEfXF8", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "The Prognostic Value of the DNMT3A Biomarker in Cytogenetically Normal Patients with Acute Myeloid Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/946"} +{"content": "## Patient Population\n\nAdult cancer patients being considered for treatment that includes either bone marrow or stem cell transplantation.\n\n## Research Question(s)\n\nWhat are the accepted indications for stem cell transplantation? What measures are commonly reported to assess transplant outcomes? Are there published standards guiding performance of transplantation?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/32746/download?token=LALKYLsh)", "external_id": "cco-951", "metadata": {"authors": "K. Imrie, R.B. Rumble, M. Crump, Advisory Panel on Bone Marrow and Stem Cell Transplantation, Hematology Disease Site Group", "document_status": "Archived", "id": "SCT Jan 2009", "pdf_url": "https://www.cancercareontario.ca/en/file/32746/download?token=LALKYLsh", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Stem Cell Transplantation in Adults", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/951"} +{"content": "## Guideline Objective\n\nTo establish the indications for allogeneic stem cell transplantation (allo-SCT) in the management of acute lymphoblastic leukemia (ALL) in adults To identify the role of reduced-intensity conditioning (RIC) regimens for SCT in the management of ALL of adult patients To identify the role of tyrosine-kinase inhibitors (TKIs) for patients undergoing allo-SCT for Philadelphia chromosome-positive ALL (Ph+ ALL) To identify the role of alternative donor transplantation (haploidentical, cord blood) in the management of adult patients with ALL who lack a suitable related or unrelated donor.\n\n## Patient Population\n\nAdult ALL patients considered for treatment that involves SCT.\n\n## Intended Guideline Users\n\nPhysicians performing SCT in Ontario, healthcare institutions and system leaders responsible for providing resources for SCT.\n\n## Research Question(s)\n\nDoes allo-SCT improve the outcome of adult patients with ALL in CR1 or beyond when compared with conventional chemotherapy (CT)? Does a RIC or non-myeloablative conditioning allo-SCT improve the outcome of adult patients with ALL who are not suitable for ablative regimens when compared with standard non-transplant therapies? Does the use of BCR-ABL TKIs following allogeneic transplantation improve the outcome of adult patients with Philadelphia chromosome-positive ALL when compared with allogeneic transplantation without TKI? Does alternative donor transplant (haploidentical, cord blood) improve the outcome of adult patients with ALL who lack a suitable related or unrelated donor compared with standard, non-transplant chemotherapy?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/82926/download?token=PRpMsX_y)", "external_id": "cco-961", "metadata": {"authors": "C. Bredeson, N.P. Varela, I. Walker, J. Kuruvilla, C.T. Kouroukis, Stem Cell Transplant Steering Committee", "document_status": "Archived", "id": "SCT 6 Feb 2016", "pdf_url": "https://www.cancercareontario.ca/en/file/82926/download?token=PRpMsX_y", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 4, "source": "cco", "title": "Stem Cell Transplantation in the Treatment of Acute Lymphoblastic Leukemia: Recommendations", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/961"} +{"content": "## Patient Population\n\nAdult and paediatric patients who have received an allogeneic transplant and are experiencing graft-versus-host disease.\n\n## Research Question(s)\n\nIs there a benefit associated with the use of extra-corporeal photopheresis (ECP) compared with other treatment options for patients who have received an allogeneic transplant and are experiencing graft-versus-host disease (GVHD) if response rate, survival, or improvement in symptoms are the outcomes of interest?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/75816/download?token=6FlLdPrp)", "external_id": "cco-966", "metadata": {"authors": "C. Bredeson, R.B. Rumble, N.P. Varela, J. Kuruvilla, C.T. Kouroukis, Stem Cell Transplant Steering Committee", "document_status": "Archived", "id": "SCT 5 Aug 2013", "pdf_url": "https://www.cancercareontario.ca/en/file/75816/download?token=6FlLdPrp", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Extra-corporeal Photopheresis in the Management of Graft-Versus-Host Disease in Patients who Have Received Allogeneic Blood or Bone Marrow Transplants: Recommendations", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/966"} +{"content": "## Patient Population\n\nAdult patients with lymphoma who are being considered for treatment that includes either bone marrow or stem cell transplantation.\n\n## Research Question(s)\n\nWhat is the role of stem cell transplantation in the treatment of the various lymphomas?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/59006/download?token=OZlM1IyO)", "external_id": "cco-971", "metadata": {"authors": "C.T. Kouroukis, R.B. Rumble, J. Kuruvilla, M. Crump, J. Herst, C. Hamm", "document_status": "Archived", "id": "SCT 4 Dec 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/59006/download?token=OZlM1IyO", "type_of_content": "Guidelines & Advice, Recommendation Report"}, "section_count": 2, "source": "cco", "title": "Stem Cell Transplantation in Lymphoma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/971"} +{"content": "## Patient Population\n\nAdult patients with MDS or AML being considered for treatment that includes either blood or bone marrow transplantation.\n\n## Research Question(s)\n\nWhat is the role of stem cell transplantation (SCT) in the treatment of MDS? What is the role of SCT in the treatment of AML?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/84261/download?token=9ZyHhcB-)", "external_id": "cco-976", "metadata": {"authors": "C.T. Kouroukis, R.B. Rumble, I. Walker, C. Bredeson, A. Schuh", "document_status": "Archived", "id": "SCT 3 Mar 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/84261/download?token=9ZyHhcB-", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Stem Cell Transplantation in Myelodysplastic Syndromes and Acute Myeloid Leukemia", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/976"} +{"content": "## Patient Population\n\nAdult patients with primary (AL) amyloidosis who are being considered for treatment that includes either bone marrow or SCT.\n\n## Research Question(s)\n\nWhat is the role of stem cell transplantation (SCT) in the treatment of primary systemic (AL, amyloid light-chain) amyloidosis?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/84256/download?token=zJUwPt_J)", "external_id": "cco-981", "metadata": {"authors": "C.T. Kouroukis, R.B. Rumble", "document_status": "Archived", "id": "SCT-2 Nov 2019", "pdf_url": "https://www.cancercareontario.ca/en/file/84256/download?token=zJUwPt_J", "type_of_content": "Guidelines & Advice, Recommendation Report", "version": "2"}, "section_count": 2, "source": "cco", "title": "Stem Cell Transplantation in Primary Systemic Amyloidosis", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/981"} +{"content": "## Patient Population\n\nAdult MM patients considered for treatment that includes blood or marrow transplantation.\n\n## Research Question(s)\n\nWhat is the role of stem cell transplantation (SCT) in the treatment of multiple myeloma (MM)?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/84251/download?token=xEfFS7kh)", "external_id": "cco-986", "metadata": {"authors": "C.T. Kouroukis, R.B. Rumble", "document_status": "Archived", "id": "SCT 1 Mar 2012", "pdf_url": "https://www.cancercareontario.ca/en/file/84251/download?token=xEfFS7kh", "type_of_content": "Guidelines & Advice, Clinical"}, "section_count": 2, "source": "cco", "title": "Stem Cell Transplantation in Multiple Myeloma", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/986"} +{"content": "## Guideline Objective\n\nAt the request of the Ontario PET Steering Committee, literature pertaining to the utility of PET/CT in the clinical management of patients with extrahepatic colorectal cancer metastasis was summarized.\n\n## Patient Population\n\nPatients with new or recurrent colorectal cancer who are potentially eligible for surgical resection of extrahepatic metastasis.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This evidence summary may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nIn patients with colorectal cancer, what is the role of fluorodeoxyglucose (FDG) PET/CT in determining suitability for surgical removal for isolated lung and abdominal (nodal) metastasis?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/18681/download?token=RbU6ymq6)", "external_id": "cco-991", "metadata": {"authors": "A. Swaminath, S. Kellett, K. Chan, Ontario PET Steering Committee", "document_status": "Current", "id": "PET ES-15 Jan 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/18681/download?token=RbU6ymq6", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "The Utility of PET/CT in Colorectal Cancer Metastasis: An Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/991"} +{"content": "## Guideline Objective\n\nAt the request of the Ontario PET Steering Committee, literature pertaining to the utility of PET/CT in the clinical management of patients with breast cancer (stages II-IV) including inflammatory breast cancer was summarized.\n\n## Patient Population\n\nPatients with breast cancer (stages II-IV) including inflammatory breast cancer.\n\n## Intended Guideline Users\n\nTo guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This evidence summary may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.\n\n## Research Question(s)\n\nIn patients with breast cancer (stages II-IV), does the addition of positron emission tomography/computed tomography (PET/CT) impact clinical management at initial staging when compared to conventional practices?\n\nFull report: [Full Report (PDF)](https://www.cancercareontario.ca/en/file/11041/download?token=40kW7e2l)", "external_id": "cco-996", "metadata": {"authors": "S. Kellett, U. Metser, D. Langer, Ontario PET Steering Committee", "document_status": "Current", "id": "PET ES-14 Jan 2014", "pdf_url": "https://www.cancercareontario.ca/en/file/11041/download?token=40kW7e2l", "type_of_content": "Guidelines & Advice, Evidence Summary"}, "section_count": 4, "source": "cco", "title": "The Utility of PET/CT in Breast Cancer (Stages II-IV): An Evidence Summary", "url": "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/996"} diff --git a/datasets/amfv_datasets/__init__.py b/datasets/amfv_datasets/__init__.py index ea5d65c3..f7f7cb6d 100644 --- a/datasets/amfv_datasets/__init__.py +++ b/datasets/amfv_datasets/__init__.py @@ -1 +1,74 @@ -"""Dataset processing utilities for AMFV.""" +"""Web scraping helpers and source-specific scrapers.""" + +from amfv_datasets.scraping.base import ( + USER_AGENT, + ScrapedDocument, + ScrapeError, + ScrapeRun, + default_client, + scrape_listing_documents, +) +from amfv_datasets.scraping.cco import ( + CcoFetchError, + GuidelineRef, + PageFetch, + guideline_ref_from_url, + list_cco_guidelines, + playwright_client, + playwright_fetch, + scrape_cco, + scrape_cco_guideline, +) +from amfv_datasets.scraping.cli import OutputFormat, ScraperSource +from amfv_datasets.scraping.html import ( + LinkMode, + absolute_unique_urls, + clean_text, + document_title, + first_matching_urls, + html_to_markdown, +) +from amfv_datasets.scraping.nice import ( + GuidanceListingPage, + GuidanceRef, + NiceFetchError, + build_guideline_text, + guidance_ref_from_url, + list_published_guidance, + scrape_guideline, + scrape_nice, +) + +__all__ = [ + "CcoFetchError", + "GuidanceRef", + "GuidanceListingPage", + "GuidelineRef", + "LinkMode", + "NiceFetchError", + "OutputFormat", + "PageFetch", + "ScrapeError", + "ScrapeRun", + "ScrapedDocument", + "ScraperSource", + "USER_AGENT", + "absolute_unique_urls", + "build_guideline_text", + "clean_text", + "document_title", + "default_client", + "first_matching_urls", + "guidance_ref_from_url", + "guideline_ref_from_url", + "html_to_markdown", + "list_cco_guidelines", + "list_published_guidance", + "playwright_client", + "playwright_fetch", + "scrape_cco", + "scrape_cco_guideline", + "scrape_guideline", + "scrape_listing_documents", + "scrape_nice", +] \ No newline at end of file diff --git a/datasets/amfv_datasets/scraping/base.py b/datasets/amfv_datasets/scraping/base.py index 0708ee87..08e33711 100644 --- a/datasets/amfv_datasets/scraping/base.py +++ b/datasets/amfv_datasets/scraping/base.py @@ -69,12 +69,12 @@ def default_client( return httpx.Client(headers=client_headers, timeout=timeout, follow_redirects=follow_redirects) -def scrape_listing_documents[ListingItemT]( +def scrape_listing_documents[ClientT, ListingItemT]( *, documents: int | None, - client_factory: Callable[[], AbstractContextManager[httpx.Client]], - list_page: Callable[[httpx.Client, int], Iterable[ListingItemT]], - scrape_item: Callable[[httpx.Client, ListingItemT], ScrapedDocument], + client_factory: Callable[[], AbstractContextManager[ClientT]], + list_page: Callable[[ClientT, int], Iterable[ListingItemT]], + scrape_item: Callable[[ClientT, ListingItemT], ScrapedDocument], document_delay_seconds: float = 5.0, first_page_items: Iterable[ListingItemT] | None = None, ) -> Iterable[ScrapedDocument]: @@ -83,7 +83,8 @@ def scrape_listing_documents[ListingItemT]( Args: documents: Number of documents to scrape. When unset, listing pages are fetched until a page returns no items (default: None). - client_factory: Factory returning a context-managed HTTP client. + client_factory: Factory returning a context-managed client, passed through + to `list_page` and `scrape_item` unchanged. list_page: Function that lists source-specific items for a page. scrape_item: Function that scrapes one listed item into a document. document_delay_seconds: Delay before scraping each document after the @@ -125,4 +126,4 @@ def scrape_listing_documents[ListingItemT]( "USER_AGENT", "default_client", "scrape_listing_documents", -] +] \ No newline at end of file diff --git a/datasets/amfv_datasets/scraping/cco.py b/datasets/amfv_datasets/scraping/cco.py new file mode 100644 index 00000000..57a036ea --- /dev/null +++ b/datasets/amfv_datasets/scraping/cco.py @@ -0,0 +1,442 @@ +"""Scrape Cancer Care Ontario guidance into normalized ScrapedDocument records. + +Each document's `content` is markdown-formatted text; the actual output +format (markdown files, JSONL, or a HuggingFace dataset) is chosen by the +CLI's `--format` flag and has nothing to do with this module. + +CCO (Cancer Care Ontario, now part of Ontario Health) publishes guidance pages +under `/en/guidelines-advice/types-of-cancer/`. The `types-of-cancer` +index page is itself the full master listing of every guideline (the +category buttons on it are just filtered subsets of the same list), paged +through a Drupal "Load more" pager rather than a plain "next" link, so we +follow that pager directly instead of separately crawling each category. + +Each guideline page carries a short metadata block (version, document status, +authors) and a few short narrative sections (objective, patient population, +intended users), with the full clinical recommendations distributed as a +linked PDF. + +As with NICE, we scrape the HTML page rather than the linked PDF: PDF text +extraction loses reading order, and this repo has no PDF pipeline yet. This +means the scraped content here is limited to the page's short summary +sections; the PDF is recorded as a link (or URL) in the content and as +`pdf_url` in the document metadata for a later PDF-aware pass to pick up. + +CCO sits behind an Azure WAF JS challenge, so plain HTTP requests get a 403 +regardless of headers. We fetch pages through a real headless browser +(Playwright) instead, which resolves the challenge the same way a normal +visitor's browser would. Every function below that touches the network takes +a plain `fetch(url) -> html` callable rather than a browser handle directly, +so the discovery and parsing logic stays unit-testable without a browser. +""" + +from __future__ import annotations + +from collections.abc import Callable, Iterable, Iterator +from contextlib import contextmanager +from dataclasses import dataclass +from urllib.parse import urljoin, urlparse + +from lxml import html as lxml_html +from playwright.sync_api import Error as PlaywrightError +from playwright.sync_api import sync_playwright + +from amfv_datasets.scraping.base import USER_AGENT, ScrapedDocument, ScrapeError, ScrapeRun, scrape_listing_documents +from amfv_datasets.scraping.html import LinkMode, absolute_unique_urls, document_title + +BASE_URL = "https://www.cancercareontario.ca" +CCO_DATASET_NAME = "cco-webscrape" +CCO_DATASET_DISPLAY_NAME = "CCO Webscrape" +DOCUMENT_DELAY_SECONDS = 5.0 + +_LISTING_PREFIX = "/en/guidelines-advice/types-of-cancer/" +_CATEGORY_INDEX_URL = f"{BASE_URL}{_LISTING_PREFIX.rstrip('/')}" + +_FIELD_LABELS = ("Version", "ID", "Type of Content", "Document Status", "Authors") +_SECTION_HEADERS = ( + "Guideline Objective", + "Patient Population", + "Intended Guideline Users", + "Research Question(s)", + "Recommendations", + "Key Evidence", + "Qualifying Statements", + "Related Guidelines", +) + +_MAIN_CONTENT_XPATH = "//*[@role='main'] | //div[@id='content']" + +_CHALLENGE_TITLE_MARKERS = ("azure waf", "just a moment", "checking your browser", "attention required") +_CHALLENGE_WAIT_SECONDS = 4.0 +_CHALLENGE_MAX_ATTEMPTS = 4 + +PageFetch = Callable[[str], str] + + +class CcoFetchError(ScrapeError): + """Raised when a guideline cannot be sourced from CCO.""" + + +@dataclass(frozen=True) +class GuidelineRef: + """A published CCO guideline reference.""" + + id: str + page_url: str + + +def guideline_ref_from_url(url: str) -> GuidelineRef: + """Parse a CCO guideline URL into a canonical guideline reference. + + Args: + url: CCO guideline URL to parse. + """ + parsed = urlparse(url.strip()) + if parsed.scheme not in {"http", "https"} or parsed.netloc.lower() not in { + "www.cancercareontario.ca", + "cancercareontario.ca", + }: + raise CcoFetchError(f"Enter a CCO guideline URL from cancercareontario.ca; got {url!r}") + + path = parsed.path.rstrip("/") + guideline_id = path.rsplit("/", 1)[-1] + if not path.startswith(_LISTING_PREFIX) or not guideline_id.isdigit(): + raise CcoFetchError(f"Enter a URL like https://www.cancercareontario.ca{_LISTING_PREFIX}64736; got {url!r}") + return GuidelineRef(id=guideline_id, page_url=f"{BASE_URL}{path}") + + +def _looks_like_challenge(title: str) -> bool: + lowered = title.lower() + return any(marker in lowered for marker in _CHALLENGE_TITLE_MARKERS) + + +def _content_with_retries(page, attempts: int = 5, delay_ms: int = 500) -> str: # noqa: ANN001 + last_error: PlaywrightError | None = None + for _ in range(attempts): + try: + return page.content() + except PlaywrightError as error: + last_error = error + page.wait_for_timeout(delay_ms) + raise last_error # type: ignore[misc] + + +def playwright_fetch(page, url: str) -> str: # noqa: ANN001 + """Fetch a URL's rendered HTML through a Playwright page, riding out CCO's WAF challenge. + + Args: + page: An open Playwright `Page` to navigate. + url: URL to fetch. + """ + status = None + last_error: PlaywrightError | None = None + for _ in range(_CHALLENGE_MAX_ATTEMPTS): + try: + response = page.goto(url, wait_until="domcontentloaded", timeout=30_000) + status = response.status if response else status + try: + page.wait_for_load_state("load", timeout=15_000) + except PlaywrightError: + pass + page.wait_for_timeout(int(_CHALLENGE_WAIT_SECONDS * 1000)) + if not _looks_like_challenge(page.title()): + return _content_with_retries(page) + except PlaywrightError as error: + last_error = error + page.wait_for_timeout(int(_CHALLENGE_WAIT_SECONDS * 1000)) + if last_error is not None: + raise CcoFetchError(f"Could not fetch {url!r} after {_CHALLENGE_MAX_ATTEMPTS} attempts: {last_error}") + raise CcoFetchError(f"Bot challenge did not clear for {url!r} (last HTTP status {status})") + + +@contextmanager +def playwright_client(*, headless: bool = True) -> Iterator[PageFetch]: + """Open a headless-browser-backed page fetcher for CCO. + + Args: + headless: Whether to run the browser headless. Set False to watch the + challenge resolve while debugging (default: True). + """ + with sync_playwright() as playwright: + browser = playwright.chromium.launch(headless=headless) + context = browser.new_context(user_agent=USER_AGENT, locale="en-US") + page = context.new_page() + try: + yield lambda url: playwright_fetch(page, url) + finally: + context.close() + browser.close() + + +def list_cco_guidelines(fetch: PageFetch) -> list[GuidelineRef]: + """Discover CCO guideline references from the master listing page. + + The `types-of-cancer` index page is the full listing of every guideline; + we page through it with its "Load more" pager, collecting guideline detail + links along the way. + + Args: + fetch: Callable returning the rendered HTML for a listing or pagination URL. + """ + detail_urls: set[str] = set() + seen_pages: set[str] = set() + queue = [_CATEGORY_INDEX_URL] + while queue: + page_url = queue.pop(0) + if page_url in seen_pages: + continue + seen_pages.add(page_url) + doc = lxml_html.fromstring(fetch(page_url)) + hrefs = absolute_unique_urls(doc.xpath("//a[@href]/@href"), base_url=BASE_URL) + for href in hrefs: + path = urlparse(href).path + if path.startswith(_LISTING_PREFIX) and path.rsplit("/", 1)[-1].isdigit(): + detail_urls.add(href) + for next_url in _next_page_urls(doc): + if next_url not in seen_pages: + queue.append(next_url) + return [GuidelineRef(id=url.rsplit("/", 1)[-1], page_url=url) for url in sorted(detail_urls)] + + +def _next_page_urls(doc: lxml_html.HtmlElement) -> list[str]: + hrefs = doc.xpath("//a[@rel='next']/@href") + if not hrefs: + hrefs = doc.xpath("//li[contains(concat(' ', normalize-space(@class), ' '), ' pager-next ')]/a/@href") + if not hrefs: + hrefs = doc.xpath("//a[translate(normalize-space(text()), 'NEXT', 'next')='next']/@href") + return [urljoin(BASE_URL, href) for href in hrefs] + + +def _main_content(doc: lxml_html.HtmlElement) -> lxml_html.HtmlElement: + matches = doc.xpath(_MAIN_CONTENT_XPATH) + return matches[0] if matches else doc + + +def _text_tokens(doc: lxml_html.HtmlElement) -> list[str]: + return [text.strip() for text in doc.xpath(".//text()") if text.strip()] + + +_STOP_TOKENS = frozenset({f"{label}:" for label in _FIELD_LABELS} | set(_SECTION_HEADERS)) + + +def _field_values(tokens: list[str]) -> dict[str, str]: + fields: dict[str, str] = {} + for index, token in enumerate(tokens): + for label in _FIELD_LABELS: + prefix = f"{label}:" + if token.startswith(prefix): + value = token[len(prefix) :].strip() + if not value: + continuation_limit = 2 if label == "ID" else 1 + extra: list[str] = [] + cursor = index + 1 + while ( + cursor < len(tokens) and len(extra) < continuation_limit and tokens[cursor] not in _STOP_TOKENS + ): + extra.append(tokens[cursor]) + cursor += 1 + value = " ".join(extra).strip() + fields[label] = value + break + else: + bare = token.rstrip(":") + if bare in _FIELD_LABELS and index + 1 < len(tokens): + fields[bare] = tokens[index + 1].strip() + return fields + + +def _section_text(tokens: list[str], *, trim_suffix: str | None) -> dict[str, str]: + marks = [(index, token) for index, token in enumerate(tokens) if token in _SECTION_HEADERS] + sections: dict[str, str] = {} + for position, (index, header) in enumerate(marks): + end = marks[position + 1][0] if position + 1 < len(marks) else len(tokens) + value = " ".join(tokens[index + 1 : end]).strip() + if trim_suffix and value.endswith(trim_suffix): + value = value[: -len(trim_suffix)].strip() + sections[header] = value + return sections + + +def _pdf_link(doc: lxml_html.HtmlElement) -> tuple[str, str] | None: + for anchor in doc.xpath(".//a[@href]"): + href = anchor.get("href") + if "/en/file/" in href or href.lower().endswith(".pdf"): + label = " ".join(anchor.text_content().split()) or "Full Report (PDF)" + return urljoin(BASE_URL, href), label + return None + + +def _document_content( + sections: dict[str, str], + *, + fields: dict[str, str], + pdf_link: tuple[str, str] | None, + link_mode: LinkMode, +) -> str: + parts = [f"## {header}\n\n{text}" for header, text in sections.items() if text] + if pdf_link: + pdf_url, pdf_label = pdf_link + parts.append(f"Full report: [{pdf_label}]({pdf_url})" if link_mode is LinkMode.KEEP else pdf_label) + if not parts and fields: + parts.append("\n".join(f"{label}: {value}" for label, value in fields.items() if value)) + return "\n\n".join(parts).strip() + + +def _best_title(html_text: str, doc: lxml_html.HtmlElement, fallback: str) -> str: + candidate = document_title(html_text, fallback="", suffixes=(" | Cancer Care Ontario",)) + candidate = candidate.strip().lstrip("|").strip() + if candidate: + return candidate + for heading in doc.xpath(".//h1"): + text = " ".join(heading.text_content().split()) + if text: + return text + return fallback + + +def scrape_cco_guideline( + fetch: PageFetch, + ref: GuidelineRef, + *, + link_mode: LinkMode = LinkMode.KEEP, +) -> ScrapedDocument: + """Scrape a CCO guideline page into a normalized document. + + Args: + fetch: Callable returning the rendered HTML for the guideline page. + ref: CCO guideline reference to scrape. + link_mode: Whether links are kept as markdown links or stripped to their + visible text (default: LinkMode.KEEP). + """ + html_text = fetch(ref.page_url) + doc = lxml_html.fromstring(html_text) + title = _best_title(html_text, doc, ref.id) + + full_tokens = _text_tokens(doc) + fields = _field_values(full_tokens) + pdf_link = _pdf_link(doc) + + content_root = _main_content(doc) + scoped_tokens = _text_tokens(content_root) if content_root is not doc else full_tokens + sections = _section_text(scoped_tokens, trim_suffix=pdf_link[1] if pdf_link else None) + if not sections and content_root is not doc: + sections = _section_text(full_tokens, trim_suffix=pdf_link[1] if pdf_link else None) + + content = _document_content(sections, fields=fields, pdf_link=pdf_link, link_mode=link_mode) + if not content: + raise CcoFetchError(f"No readable content for guideline '{ref.id}'") + + metadata: dict[str, str] = {key.lower().replace(" ", "_"): value for key, value in fields.items()} + if pdf_link: + metadata["pdf_url"] = pdf_link[0] + + return ScrapedDocument( + source="cco", + external_id=f"cco-{ref.id}", + title=title, + url=ref.page_url, + content=content, + section_count=len(sections) or 1, + metadata=metadata, + ) + + +def _scrape_guideline_or_placeholder( + fetch: PageFetch, + ref: GuidelineRef, + *, + link_mode: LinkMode, +) -> ScrapedDocument: + try: + return scrape_cco_guideline(fetch, ref, link_mode=link_mode) + except Exception as error: # noqa: BLE001 + return ScrapedDocument( + source="cco", + external_id=f"cco-{ref.id}", + title=ref.id, + url=ref.page_url, + content="", + section_count=0, + metadata={"scrape_error": str(error)}, + ) + + +_MIN_EXPECTED_GUIDELINES = 50 +_DISCOVERY_ATTEMPTS = 3 + + +def _discover_guidelines_with_retries(fetch: PageFetch) -> list[GuidelineRef]: + refs: list[GuidelineRef] = [] + for _ in range(_DISCOVERY_ATTEMPTS): + refs = list_cco_guidelines(fetch) + if len(refs) >= _MIN_EXPECTED_GUIDELINES: + return refs + raise CcoFetchError( + f"Discovery only found {len(refs)} guideline(s) after {_DISCOVERY_ATTEMPTS} attempts " + "(expected several hundred); the listing page likely didn't load correctly" + ) + + +def scrape_cco( + *, + documents: int | None, + link_mode: LinkMode = LinkMode.KEEP, + url: str | None = None, + headless: bool = True, +) -> ScrapeRun: + """Scrape CCO documents from a URL or category listing pages. + + Guidelines that fail to parse (an unrecognized page template, a fetch + error, and so on) don't abort the run: they're yielded as a placeholder + document with `metadata["scrape_error"]` set instead, since across ~400 + guidelines spanning two decades of page templates some parse failures + are expected. + + Args: + documents: Number of documents to scrape. Ignored when `url` is set. + When unset, every guideline discovered by crawling the category + index and its listing pages is scraped (default: None). + link_mode: Whether links are kept as markdown links or stripped to their + visible text (default: LinkMode.KEEP). + url: CCO source URL to scrape as a single document (default: None). + headless: Whether to run the underlying browser headless (default: True). + """ + if url is not None: + + def scrape_url() -> Iterable[ScrapedDocument]: + with playwright_client(headless=headless) as fetch: + yield scrape_cco_guideline(fetch, guideline_ref_from_url(url), link_mode=link_mode) + + return ScrapeRun(documents=scrape_url(), total=1) + + with playwright_client(headless=headless) as fetch: + refs = _discover_guidelines_with_retries(fetch) + total = len(refs) if documents is None else min(documents, len(refs)) + return ScrapeRun( + total=total, + documents=scrape_listing_documents( + documents=documents, + client_factory=lambda: playwright_client(headless=headless), + first_page_items=refs, + list_page=lambda fetch, page: [], + scrape_item=lambda fetch, ref: _scrape_guideline_or_placeholder(fetch, ref, link_mode=link_mode), + document_delay_seconds=DOCUMENT_DELAY_SECONDS, + ), + ) + + +__all__ = [ + "BASE_URL", + "CCO_DATASET_DISPLAY_NAME", + "CCO_DATASET_NAME", + "DOCUMENT_DELAY_SECONDS", + "CcoFetchError", + "GuidelineRef", + "PageFetch", + "guideline_ref_from_url", + "list_cco_guidelines", + "playwright_client", + "playwright_fetch", + "scrape_cco", + "scrape_cco_guideline", +] \ No newline at end of file diff --git a/datasets/amfv_datasets/scraping/cli.py b/datasets/amfv_datasets/scraping/cli.py index e8aece34..1e260084 100644 --- a/datasets/amfv_datasets/scraping/cli.py +++ b/datasets/amfv_datasets/scraping/cli.py @@ -25,6 +25,7 @@ ) from amfv_datasets.scraping.base import ScrapedDocument, ScrapeRun +from amfv_datasets.scraping.cco import scrape_cco from amfv_datasets.scraping.html import LinkMode from amfv_datasets.scraping.nice import scrape_nice @@ -33,6 +34,7 @@ class ScraperSource(StrEnum): """Supported scraper sources.""" ALL = "all" + CCO = "cco" NICE = "nice" @@ -70,6 +72,8 @@ def scrape_documents( for selected_source in _expand_source(source): match selected_source: + case ScraperSource.CCO: + return scrape_cco(documents=documents, link_mode=link_mode, url=url) case ScraperSource.NICE: return scrape_nice(documents=documents, link_mode=link_mode, url=url) case ScraperSource.ALL: @@ -125,7 +129,7 @@ def write_markdown_files(documents: Iterable[ScrapedDocument], output_path: Path def _expand_source(source: ScraperSource) -> tuple[ScraperSource, ...]: if source is ScraperSource.ALL: - return (ScraperSource.NICE,) + return (ScraperSource.CCO, ScraperSource.NICE) return (source,) @@ -230,16 +234,19 @@ def _markdown_filename(document: ScrapedDocument) -> str: def _markdown_document(document: ScrapedDocument) -> str: - metadata = [ + lines = [ f"# {document.title}", "", f"Source: <{document.url}>", f"External ID: `{document.external_id}`", - "", - document.content.strip(), - "", ] - return "\n".join(metadata) + for key, value in document.metadata.items(): + if value and key != "pdf_url": + lines.append(f"{key.replace('_', ' ').title()}: {value}") + lines.append("") + lines.append(document.content.strip()) + lines.append("") + return "\n".join(lines) def main() -> None: @@ -258,4 +265,4 @@ def main() -> None: "write_huggingface_dataset", "write_jsonl", "write_markdown_files", -] +] \ No newline at end of file diff --git a/datasets/test/test_scraping_cco.py b/datasets/test/test_scraping_cco.py new file mode 100644 index 00000000..1de685c5 --- /dev/null +++ b/datasets/test/test_scraping_cco.py @@ -0,0 +1,325 @@ +"""Tests for CCO scraping helpers.""" + +from types import SimpleNamespace + +import pytest +from amfv_datasets.scraping.cco import ( + BASE_URL, + CcoFetchError, + GuidelineRef, + _discover_guidelines_with_retries, + _scrape_guideline_or_placeholder, + guideline_ref_from_url, + list_cco_guidelines, + playwright_fetch, + scrape_cco_guideline, +) +from amfv_datasets.scraping.html import LinkMode +from playwright.sync_api import Error as PlaywrightError + +_GUIDELINE_HTML = """ + +

Pandemic Planning Clinical Guideline for Patients with Cancer

+

Version: 2 Dec 2021

+

Type of Content: Guidelines & Advice

+

Document Status: Current

+

Authors: CCO Pandemic Plan Review Group

+

Guideline Objective

+

To provide recommendations for a systematic approach to cancer care during a pandemic.

+

Patient Population

+

Patients with cancer who require treatment in regional cancer centres.

+

Intended Guideline Users

+

Healthcare providers and health system planners in Ontario's cancer system.

+ Full Report (PDF) (376.82 KB) + +""" + + +def _fake_fetch(pages: dict[str, str]): + calls: list[str] = [] + + def fetch(url: str) -> str: + calls.append(url) + return pages[url] + + fetch.calls = calls + return fetch + + +def test_guideline_ref_from_url_accepts_detail_url() -> None: + """CCO guideline URLs are normalized to a canonical reference.""" + ref = guideline_ref_from_url("https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/64736/") + assert ref == GuidelineRef(id="64736", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/64736") + + +@pytest.mark.parametrize( + "url", + [ + "https://example.com/en/guidelines-advice/types-of-cancer/64736", + "https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/breast", + ], + ids=["wrong-domain", "category-not-detail-page"], +) +def test_guideline_ref_from_url_rejects_invalid_url(url: str) -> None: + """Non-CCO domains and category (non-numeric) URLs are rejected.""" + with pytest.raises(CcoFetchError): + guideline_ref_from_url(url) + + +def test_scrape_cco_guideline_parses_fields_and_sections() -> None: + """Guideline metadata fields and narrative sections are extracted from the page.""" + ref = GuidelineRef(id="64736", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/64736") + fetch = _fake_fetch({ref.page_url: _GUIDELINE_HTML}) + + document = scrape_cco_guideline(fetch, ref) + + assert document.source == "cco" + assert document.external_id == "cco-64736" + assert document.title == "Pandemic Planning Clinical Guideline for Patients with Cancer" + assert document.metadata["version"] == "2 Dec 2021" + assert document.metadata["type_of_content"] == "Guidelines & Advice" + assert document.metadata["document_status"] == "Current" + assert document.metadata["authors"] == "CCO Pandemic Plan Review Group" + assert document.metadata["pdf_url"] == f"{BASE_URL}/en/file/64736/download?token=abc" + assert document.content == ( + "## Guideline Objective\n\n" + "To provide recommendations for a systematic approach to cancer care during a pandemic.\n\n" + "## Patient Population\n\n" + "Patients with cancer who require treatment in regional cancer centres.\n\n" + "## Intended Guideline Users\n\n" + "Healthcare providers and health system planners in Ontario's cancer system.\n\n" + f"Full report: [Full Report (PDF) (376.82 KB)]({BASE_URL}/en/file/64736/download?token=abc)" + ) + + +def test_scrape_cco_guideline_strips_pdf_link_text_in_strip_mode() -> None: + """Strip link mode keeps the PDF label without a markdown link.""" + ref = GuidelineRef(id="64736", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/64736") + fetch = _fake_fetch({ref.page_url: _GUIDELINE_HTML}) + + document = scrape_cco_guideline(fetch, ref, link_mode=LinkMode.STRIP) + + assert "[Full Report" not in document.content + assert document.content.endswith("Full Report (PDF) (376.82 KB)") + + +def test_scrape_cco_guideline_falls_back_to_metadata_for_thin_pages() -> None: + """Pages with only bibliographic metadata (no narrative sections, no PDF link) still scrape.""" + thin_html = """ + +

Fecal Immunochemical Tests Compared With Guaiac Fecal Occult Blood Tests

+

ID:

+

15-8

+

Nov 2011

+

Type of Content: Guidelines & Advice, Clinical

+

Document Status: Archived

+

Authors: FIT Guidelines Expert Panel

+ + """ + ref = GuidelineRef(id="2116", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/2116") + fetch = _fake_fetch({ref.page_url: thin_html}) + + document = scrape_cco_guideline(fetch, ref) + + assert document.metadata["id"] == "15-8 Nov 2011" + assert document.metadata["document_status"] == "Archived" + assert "pdf_url" not in document.metadata + assert "ID: 15-8 Nov 2011" in document.content + assert "Document Status: Archived" in document.content + + +def test_scrape_cco_guideline_handles_archived_pages_with_bibliography_outside_main() -> None: + """Archived pages: broken , metadata outside role=main, commented-out body.""" + html = """ + <html> + <head><title>| Cancer Care Ontario + +
+

Diagnostic Imaging in Breast Cancer

+
ID: DIBrCa Apr 2012
+
Type of Content: Guidelines & Advice, Clinical
+
Document Status: Archived
+
Authors: Diagnostic Imaging Guidelines Panel
+
+
+ +
+
Feedback CCO tips Understanding CCO Disclaimer: informational purposes only.
+ + + """ + ref = GuidelineRef(id="2561", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/2561") + fetch = _fake_fetch({ref.page_url: html}) + + document = scrape_cco_guideline(fetch, ref) + + assert document.title == "Diagnostic Imaging in Breast Cancer" + assert document.metadata["id"] == "DIBrCa Apr 2012" + assert document.metadata["document_status"] == "Archived" + assert document.metadata["authors"] == "Diagnostic Imaging Guidelines Panel" + assert "pdf_url" not in document.metadata + assert "Feedback" not in document.content + assert "Document Status: Archived" in document.content + + +def test_scrape_cco_guideline_falls_back_to_full_page_when_scoping_misses_content() -> None: + """If role=main matches an empty/irrelevant element, parsing falls back to the whole page.""" + html_with_misleading_main = """ + +

Unrelated widget with no guideline content.

+
+

A Real Guideline

+

Version: 1

+

Guideline Objective

+

Do the thing.

+
+ + """ + ref = GuidelineRef(id="301", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/301") + fetch = _fake_fetch({ref.page_url: html_with_misleading_main}) + + document = scrape_cco_guideline(fetch, ref) + + assert document.metadata["version"] == "1" + assert "## Guideline Objective\n\nDo the thing." in document.content + + +def test_scrape_cco_guideline_excludes_footer_boilerplate_from_last_section() -> None: + """Nav/footer text outside the main content region doesn't bleed into the last section.""" + html_with_chrome = """ + + +
+

Exercise for People with Cancer

+

Version: 3

+

Intended Guideline Users

+

Oncologists and exercise consultants.

+

Research Question(s)

+

Does exercise improve quality of life?

+
+
+ Feedback CCO tips Understanding CCO Disclaimer: informational purposes only. +
+ + """ + ref = GuidelineRef(id="201", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/201") + fetch = _fake_fetch({ref.page_url: html_with_chrome}) + + document = scrape_cco_guideline(fetch, ref) + + assert "Feedback" not in document.content + assert "Disclaimer" not in document.content + assert "## Intended Guideline Users\n\nOncologists and exercise consultants." in document.content + assert "## Research Question(s)\n\nDoes exercise improve quality of life?" in document.content + + +class _FakePage: + def __init__(self, html: str, *, fail_times: int = 0) -> None: + self._html = html + self._fail_times = fail_times + self._content_calls = 0 + + def goto(self, url: str, wait_until: str | None = None, timeout: int | None = None) -> SimpleNamespace: + return SimpleNamespace(status=200) + + def wait_for_timeout(self, milliseconds: int) -> None: + pass + + def wait_for_load_state(self, state: str | None = None, timeout: int | None = None) -> None: + pass + + def title(self) -> str: + return "A Guideline | Cancer Care Ontario" + + def content(self) -> str: + self._content_calls += 1 + if self._content_calls <= self._fail_times: + raise PlaywrightError("Page.content: Unable to retrieve content because the page is navigating.") + return self._html + + +def test_playwright_fetch_retries_through_a_transient_navigation_race() -> None: + """A transient 'page is navigating' error from page.content() is retried, not raised.""" + page = _FakePage("ok", fail_times=1) + + result = playwright_fetch(page, f"{BASE_URL}/en/guidelines-advice/types-of-cancer/1") + + assert result == "ok" + + +def test_playwright_fetch_raises_after_exhausting_retries() -> None: + """A persistently failing page eventually raises rather than retrying forever.""" + page = _FakePage("ok", fail_times=99) + + with pytest.raises(CcoFetchError): + playwright_fetch(page, f"{BASE_URL}/en/guidelines-advice/types-of-cancer/1") + + +def test_discover_guidelines_with_retries_retries_a_suspiciously_thin_result() -> None: + """A thin first discovery (likely a load failure) is retried until a full result comes back.""" + thin_html = f'One' + full_html = ( + "" + + "".join(f'G{i}' for i in range(100, 160)) + + "" + ) + calls = {"count": 0} + + def fetch(url: str) -> str: + calls["count"] += 1 + return thin_html if calls["count"] == 1 else full_html + + refs = _discover_guidelines_with_retries(fetch) + + assert len(refs) == 60 + assert calls["count"] == 2 + + +def test_discover_guidelines_with_retries_raises_rather_than_report_a_thin_result() -> None: + """A persistently thin discovery raises instead of silently reporting a near-empty success.""" + thin_html = f'One' + + with pytest.raises(CcoFetchError): + _discover_guidelines_with_retries(lambda url: thin_html) + + +def test_scrape_guideline_or_placeholder_survives_a_bad_page() -> None: + """An unparseable guideline yields a flagged placeholder instead of aborting the run.""" + ref = GuidelineRef(id="999", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/999") + fetch = _fake_fetch({ref.page_url: "nothing recognizable here"}) + + document = _scrape_guideline_or_placeholder(fetch, ref, link_mode=LinkMode.KEEP) + + assert document.external_id == "cco-999" + assert document.content == "" + assert "scrape_error" in document.metadata + + +def test_list_cco_guidelines_follows_the_load_more_pager() -> None: + """The master listing page is paged through its Drupal 'Load more' pager, not a 'next' link.""" + index_url = f"{BASE_URL}/en/guidelines-advice/types-of-cancer" + page_2_url = f"{BASE_URL}/en/guidelines-advice/types-of-cancer?page=1" + + pages = { + index_url: ( + "" + f'Guideline A' + f'Breast Cancer' + f'' + "" + ), + page_2_url: f'Guideline B', + } + fetch = _fake_fetch(pages) + + refs = list_cco_guidelines(fetch) + + assert refs == [ + GuidelineRef(id="101", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/101"), + GuidelineRef(id="102", page_url=f"{BASE_URL}/en/guidelines-advice/types-of-cancer/102"), + ] + assert f"{BASE_URL}/en/guidelines-advice/types-of-cancer/breast" not in fetch.calls \ No newline at end of file diff --git a/datasets/test/test_scraping_cli.py b/datasets/test/test_scraping_cli.py index 44f714fa..6b59a31b 100644 --- a/datasets/test/test_scraping_cli.py +++ b/datasets/test/test_scraping_cli.py @@ -5,8 +5,6 @@ from pathlib import Path import pytest -from typer.testing import CliRunner - from amfv_datasets.scraping.base import ScrapedDocument, ScrapeRun from amfv_datasets.scraping.cli import ( ScraperSource, @@ -16,6 +14,7 @@ write_markdown_files, ) from amfv_datasets.scraping.html import LinkMode +from typer.testing import CliRunner def test_write_jsonl_serializes_documents() -> None: @@ -56,7 +55,8 @@ def test_write_markdown_files_saves_documents_to_directory(tmp_path: Path) -> No assert count == 1 assert (output_path / "nice-ng1.md").read_text(encoding="utf-8") == ( - "# Guideline 1\n\nSource: \nExternal ID: `nice-ng1`\n\ncontent\n" + "# Guideline 1\n\nSource: \n" + "External ID: `nice-ng1`\nRef: NG1\n\ncontent\n" ) @@ -236,4 +236,4 @@ def __init__(self) -> None: def write(self, text: str) -> int: self.value += text - return len(text) + return len(text) \ No newline at end of file