Cancer Guidelines Database

Access quality cancer guidelines from a single Canadian source

We've listed 456 guidelines under your selection of "Location". The most recent guidelines are first.

Preoperative or Postoperative Therapy for the Management of Patients With Stage II or III Rectal Cancer

Year: 2019
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline examines the appropriate preoperative staging tests and the role of postoperative radiotherapy (RT) and/or chemotherapy (CT) for patients with resected stage II or III rectal cancer. The primary outcomes of interest are increase in overall survival and delaying local recurrence.

Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline

Year: 2019
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This is a clinical practice guideline for patients with multiple myeloma. The guideline provides recommendations for the treatment of both newly diagnosed and relapsed patients. Outcomes of interest include overall survival, progression-free survival, response rate, and quality of life.

Referral of Suspected Lung Cancer by Family Physicians and Other Primary Care Providers

Year: 2019
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients presenting to primary care services with signs and/or symptoms of lung cancer. The guideline examines the referral process for this patient population. Topics of interest include factors that have been shown to increase the risk of lung cancer, symptoms that should be present in a person before referral, indications for chest computed tomography (CT) scan, and follow-up to diagnostic investigations.

Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy

Year: 2019
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients undergoing radiation treatment for localized prostate cancer. The guideline examines the use of biodegradable spacers for prostate cancer treatment. A topic of interest is biodegradable spacer insertion as a technology that may be used to decrease toxicity and maintain quality of life (QOL) in appropriately selected patients.

Evidence Based Recommendations for the Assessment and Management of Radiation-Induced Skin Toxicities in Breast Cancer: Part 5. Management of Long-Term Effects

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Manitoba
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline focuses on the management of long term effects, and provides recommendations on 1 month post-treatment and late reactions to promote cleanliness, treat the wound, prevent infections, protect from trauma and the environment, promote skin health and maintain skin flexibility.

Evidence Based Recommendations for the Assessment and Management of Radiation-Induced Skin Toxicities in Breast Cancer: Part 4. Management of Acute Radiation-Induced Skin Toxicities

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Manitoba
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline focuses on the clinical assessment and management of these patients. Outcomes of interest include improved care delivery and quality of life, enhanced treatment compliance, as well as minimized patient burden regarding dressings (i.e. cost, frequency/difficulty of dressing changes).

Evidence Based Recommendations for the Assessment and Management of Radiation-Induced Skin Toxicities in Breast Cancer: Part 3. Skin Health Promotion: Health Promotion Interventions

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Manitoba
This clinical practice guideline if part of a series of guidelines for adults with breast cancer who are experiencing radiation-induced skin toxicities. The guideline provides recommendations regarding interventions aimed at the promotion of skin health. Specific topics discussed include the promotion of skin hygiene, promotion of comfort, preventing infections, protection from trauma, and protection from the environment.

Provincial Esophageal Cancer and Gastro-Esophageal Junction Cancer Treatment Guidelines

Year: 2018
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for adult patients with esophageal cancer or cancer of the gastro-esophageal junction. The guideline provides recommendations on assessment, systemic therapy, surgical approaches, and post-curative therapy follow-up of these patients. The discussion of treatment is stratified by stage, performance status, and disease type. Chemotherapy regimens are also considered.

Recommendations for Filgrastim Use in Adults by Disease Site

Year: 2018
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

Evidence Based Recommendations for the Assessment and Management of Radiation-Induced Skin Toxicities in Breast Cancer: Part 2. Skin Assessment for Breast Cancer Patients Receiving Radiation

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for adults with breast cancer. The guideline provides recommendations on the assessment and management of radiation-induced skin toxicities in these patients. Outcomes of interest include quality of life, treatment compliance, and minimized patient burden regarding dressings (e.g. cost, frequency, and difficulty of dressing changes).

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

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with RAS wild-type unresectable metastatic colorectal cancer (mCRC) who are undergoing first-line or second-line chemotherapy. The guideline provides recommendations on 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, in addition to chemotherapy for the treatment of unresectable mCRC.

Gallium-68 PET Imaging in Neuroendocrine Tumours

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult and pediatric patients with suspected or diagnosed well-differentiated neuroendocrine tumours (NETs). The guideline discusses the clinical utility of Gallium-68 positron emission tomography (PET) compared with PET / computed tomography imaging for the initial diagnosis, staging, re-staging, response evaluation, and routine surveillance of patients with NETs.

Recommendations on Screening for Breast Cancer in Women Aged 40–74 Years Who are not at Increased Risk for Breast Cancer

Year: 2018
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
This is a clinical practice guideline for women aged 40-74 who are not at an increased risk for developing breast cancer. The guideline discusses breast cancer screening in this population, and provides specific recommendations on appropriate screening modalities. Recommendations for screening are based on age.

Influenza Immunization for Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult and pediatric patients with cancer. The guideline examines influenza immunization in these patients, including recommended vaccine, dosing, as well as the effect of age, duration, and systemic therapy on the patient's response to the vaccination. Patients undergoing hematopoietic stem cell transplant (HSCT) are further discussed, as is the immunization of individuals in contact with these patients.

Cancer Pain

Year: 2018
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with active cancer. The guideline examines screening, assessment, and management strategies for cancer-related pain of any severity in these patients. Pharmacological management options discussed include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), adjuvant analgesics, opioid drugs, and management of cancer pain in patients with renal impairment. Non-pharmacological management options including radiotherapy, vertebroplasty and kyphoplasty, anesthetic interventions, surgical interventions, and complementary therapies are also discussed. The guideline also considers supportive care of these patients.

Three-Dimensional MR-Guided Intracavitary and Interstitial Brachytherapy for Cervical Cancer

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women with potentially curable, non-operable, locally advanced cervical cancer. The guideline provides recommendations on treatment using brachytherapy (BT), and compares different forms of BT such as two-dimensional BT, computed tomography-guided BT, magnetic resonance (MR)-guided intracavitary BT, and MR-guided intracavitary/interstitial BT. Outcomes of interest include survival, local tumour control, and toxicity.

Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women at very high risk for breast cancer. The guideline examines the effectiveness of screening using magnetic resonance imaging (MRI) in these patients, in addition to standard screening (mammography). Optimal frequency of MRI screening, subgroups that may benefit more from MRI screening, and associated harms are discussed. Workup and follow-up are also considered for those patients who have abnormal findings seen only on MRI imaging.

Sentinel Lymph Node Biopsy in Vulvar Cancer Members

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women with early-stage squamous cell vulvar cancer. The guideline examines sentinel lymph node biopsy (SLNB), including its safety and effectiveness in identifying women with node-negative, early-stage vulvar cancer. The appropriate procedures for SLNB in these patients are also discussed, such as selecting appropriate patients, determining the appropriate technique, and managing patients with positive sentinel lymph nodes.

Patient Indications for Mohs Micrographic Surgery

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on the use of Mohs micrographic surgery (MMS) for adult patients diagnosed with skin cancer. MMS is compared to other surgical excision techniques, as well as other treatment modalities such as radiation. Guidance is provided on the indications and considerations for appropriate use of MMS, including disease stage, aesthetic outcomes, patient comorbidities, and patient preferences. Outcomes of interest include cure rate, recurrence rate, quality of life, and adverse events.

The Role of High Dose Rate Brachytherapy in the Palliation of Symptoms in Patients With Non-Small Cell Lung Cancer

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with symptomatic endobronchial disease in non-small cell lung cancer. The guideline examines the use of high dose rate endobronchial brachytherapy (HDREB) for the palliation of respiratory symptoms in these patients. Specific topics discussed include the appropriate dose of HDREB, toxicity, and fatal hemoptysis.

Management of Ductal Carcinoma In Situ of the Breast

Year: 2018
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women with ductal carcinoma in situ (DCIS) of the breast. The guideline examines the optimal surgical management of these patients, as well as radiotherapy in patients who have undergone breast-conserving surgery. The role of tamoxifen in the management of these patients is also discussed.

Clinical Practice Guideline on Screening for Colorectal Cancer in Individuals With a Family History of Nonhereditary Colorectal Cancer or Adenoma: The Canadian Association of Gastroenterology Banff Consensus

Year: 2018
AGREE II score: Available
Developer organization: Canadian Association of Gastroenterology
This is a clinical practice guideline for adults with a family history of nonhereditary colorectal cancer (CRC) or adenoma. The guideline discusses screening for CRC in these individuals, and provides specialized recommendations based on the number of affected relatives, whether or not the relatives have CRC or colorectal adenoma, the severity of the relatives' disease, as well as how related the relatives are to the patient (i.e. first degree versus second degree relatives).

Canadian Urological Association Guideline for Follow-up of Patients After Treatment of Non-Metastatic Renal Cell Carcinoma

Year: 2018
AGREE II score: Unavailable
Developer organization: Canadian Urological Association
This is a clinical practice guideline for patients who have been treated for non-metastatic renal cell carcinoma (RCC). The guideline examines the follow-up of these patients, and recommendations are provided for surveillance, clinical assessment, blood biochemistry tests, and imaging techniques.

Guidelines for the Management of Chemotherapy Induced Nausea and Vomiting in Children With Cancer

Year: 2018
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This clinical practice guideline discusses the prevention and management of chemotherapy induced nausea and vomiting (CINV) in pediatric cancer patients. Acute, delayed, anticipatory, breakthrough and refractory CINV are discussed. Recommendations are provided on assessment as well as pharmacological and non-pharmacological interventions. Antiemetic dosing recommendations are also provided.

Chronic Lymphocytic Leukemia

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with chronic lymphocytic leukemia. The guideline examines the diagnostic and staging criteria, treatment strategies, and follow-up and supportive care practices for these patients. First and second line treatment options are discussed for newly diagnosed, relapsed, and refractory disease.

Acute Myeloid Leukemia

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with acute myeloid leukemia (AML). The guideline examines the diagnostic criteria and prognostic markers of acute myeloid leukemias. Different management options for acute myeloid leukemia are discussed, including chemotherapy, hematopoietic stem cell transplantation, and palliation.

Lymphoma

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients who have been diagnosed with or are suspected of having lymphoma. The guideline discusses Hodgkin lymphoma, as well as the most common non-Hodgkin lymphomas (T-cell and B-cell). Recommendations are provided on diagnosis, staging, treatment, management, and follow up care.

Local Prostate Cancer

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult men with a suspicion or recent diagnosis of localized prostate cancer. The guideline examines staging, treatment options, and follow-up for these patients. Management is discussed for low, intermediate, and high-risk disease. Treatment options considered include variations of radical prostatectomy, brachytherapy, external beam radiotherapy, cryosurgery, and active surveillance.

Advanced / Metastatic Prostate Cancer

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients who have been diagnosed with or are suspected of having advanced/metastatic prostate cancer. The guideline provides guidance on the staging, treatment, and follow up procedures for these patients. Topics of interest include radiotherapy techniques, the use of bone scans to assist in staging, and follow-up using active surveillance within a cancer clinic.

Metastatic Colorectal Cancer

Year: 2018
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment options, including different chemotherapy regimens, and metastasectomy. Other topics of discussion include palliative chemotherapy regimens, and treatment of liver metastasis. Outcomes of interest include adverse effects, overall survival, and quality of life.

Provincial Consensus Recommendations for Adjuvant Systemic Therapy for Breast Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for patients with breast cancer. The guideline examines common approaches for the treatment of breast cancer with adjuvant systemic therapy. A specific topic discussed is the use of adjuvant therapy for HER2 positive breast cancer, with recommendations for both oncologists and pathologists.

Guideline for the Prevention of Acute Chemotherapy-Induced Nausea and Vomiting in Pediatric Cancer Patients: A Focused Update

Year: 2017
AGREE II score: Available
Developer organization: Pediatric Oncology Group of Ontario
This is a clinical practice guideline for the prevention of acute chemotherapy-induced nausea and vomiting (CINV) in pediatric cancer patients. The guideline provides recommendations on the use of pharmacological treatments for CINV, such as aprepitant and palonosetron. Outcomes of interest include CINV control rate and adverse events.

Staging and Surgical Approaches in Gastric Cancer

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults with Stage I to IV gastric cancer (specifically gastric adenocarcinoma) who are being considered for surgery. The guideline examines the optimal techniques to adequately stage gastric cancer, and the optimal techniques of gastric cancer surgery with curative intent. The guideline also considers indications for surgery for Stage IV gastric cancer in asymptomatic and symptomatic patients, and the relationship between surgical volumes and outcomes.

Guidance for Kyphoplasty and Vertebroplasty for Cancer Patients in Ontario: Recommendations Report 2017

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This guideline provides recommendations on use of vertebroplasty or kyphoplasty as treatment options for cancer patients with vertebral compression fractures. The guideline outlines clinical criteria for when vertebroplasty, kyphoplasty, or focal tumour ablation (FTA) assisted vertebroplasty/kyphoplasty should be performed, and provides recommendations on selecting the most appropriate procedure. The role of radiation treatment, absolute contraindications, and service provider requirements are also discussed.

Recommendations for the Safe Use and Handling of Oral Anti-Cancer Drugs (OACDs) in Community Pharmacy: A Pan-Canadian Consensus Guideline

Year: 2017
AGREE II score: Unavailable
Developer organization: Canadian Association of Provincial Cancer Agencies
This consensus guideline provides recommendations on safe handling of oral anti-cancer drugs (OACDs) in community pharmacies across the medication lifecycle, from manufacturer packaging to waste management and incident reporting. Specifically, the guideline addresses packaging, labeling, receiving and unpacking, storage, drug preparation and handling, verification and dispensing, transportation, personal protective equipment (PPE), disposal, waste management and cleaning, and incident reporting. Recommendations for training and education are also discussed, along with staffing considerations.

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

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This clinical practice guideline is an endorsement of the American Thyroid Association's 2015 guideline titled Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The guideline provides recommendations on management of patients thyroid nodules and differentiated thyroid cancers. Topics include evaluation of thyroid nodules to determine the presence of malignancy, and management of differentiated thyroid cancer including surgery, radioactive iodine (RAI) therapy, hormonal therapy, external beam radiation therapy (EBRT), and systemic treatment.

Models of Care for Cancer Survivorship

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults who have completed treatment and have been cured of cancer. The guideline examines different models of follow-up care, organized both by clinical setting, and by which health professionals are responsible for the coordination of care. The appropriateness of different models of care for different types of cancer is discussed, with focuses on clinical outcomes (e.g. surveillance, recurrence) and quality of life outcomes (e.g. quality of life, patient satisfaction).

Systemic Therapy for Advanced or Recurrent Endometrial Cancer and Advanced or Recurrent Uterine Papillary Serous Carcinoma

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult female patients diagnosed with advanced stage or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas) or uterine papillary serous carcinoma. The guideline examines chemotherapeutic and hormonal therapy options for patients with these cancers. Outcomes of interest include improved response rates and survival.

Follow-up After Primary Therapy for Endometrial Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on the follow-up of patients with endometrial cancer who are clinically disease free after receiving primary treatment. The guideline reviews symptomatic signs of possible recurrence. Recommendations are provided on follow-up intervals and diagnostic interventions, stratified by risk of recurrence.

Performance of Needle Biopsy of the Prostate for Men With Suspected or Established Prostate Cancer: Recommendation Report

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This recommendation report addresses "best practices" for prostate needle biopsies. Guidance is provided 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. Facility requirements are also reviewed.

Management of Primary Central Nervous System Diffuse Large B-Cell Lymphoma (PCNS DLBCL)

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical guideline for the treatment of primary central nervous system diffuse large B-cell lymphoma (PCNS DLBCL). The guideline provides recommendations regarding chemotherapy and radiation therapy and the optimal regimens, radiation dose and schedule. Outcomes of interest include overall survival, measure of disease control (response rates and progression-free survival), and frequency of adverse events.

Primary Excision Margins and Sentinel Lymph Node Biopsy in Cutaneous Melanoma

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults diagnosed non-metastatic cutaneous melanoma, located on the trunk, extremities, or head and neck. The guideline examines optimal excision margins and the use of sentinel lymph node biopsy (SLNB) in these patients. The recommendations are organized by location of melanoma on the body, and consider the thickness/depth of the melanoma. Outcomes of interest include recurrence rate, survival rate, morbidity, and rate of sentinel lymph node positivity.

Guidance for the Management of Gynecologic Sarcomas in Ontario: Recommendations Report 2017

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This recommendations report provides guidance on the investigation and management of suspected or proven pelvic and extra-pelvic gynecologic sarcomas. Recommendations are made on the use of pathology during investigation, while recommendations pertaining to treatment focus on surgery and adjuvant therapy. The guidance document also provides recommendations on a number of quality assurance measures to assess gynecologic sarcoma services.

Referral of Patients With Suspected Colorectal Cancer by Family Physicians and Other Primary Care Providers

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on the referral of patients with signs and/or symptoms of colorectal cancer (CRC) by family physicians and other primary care providers. The guideline reviews signs, symptoms, and other clinical features that may be indicative of CRC and that warrant additional investigation. Referral wait time recommendations are provided, along with recommendations to reduce diagnostic delay. Additionally, known risk factors that increase the likelihood of CRC in patients with signs and/or symptoms of CRC are reviewed.

Treatment of Patients With Stage III (N2 or N3) Non-Small Cell Lung Cancer

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with clinical or pathological stage III non-small cell lung cancer (NSCLC). The guideline provides recommendations for the treatment of NSCLC by comparing treatment options such as chemotherapy, radiotherapy, and surgery. Outcomes of interest include adverse effects, overall survival, progression-free survival, quality of life, and local control.

Guideline for Optimization of Surgical and Pathological Quality Performance for Radical Prostatectomy in Prostate Cancer Management

Year: 2017
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult males with potentially curable prostate cancer. The guideline examines surgical procedures and outcomes for radical prostatectomy (RP), while specifically addressing the extent of resection, acceptable positive margins, nerve-sparing techniques, pelvic lymph node dissection (PLND), and the recommended procedures for handling and processing RP specimens. Incontinence, erectile dysfunction, rectal injury, and blood transfusion are discussed as surgical complications that need to be limited.

Initial Management of Small Cell Lung Cancer (Limited and Extensive Stage) and the Role of Thoracic Radiotherapy and First Line Chemotherapy

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults with non-resected limited stage and extensive stage small cell lung cancer who can safely receive definitive radiation. The guideline examines thoracic radiotherapy and first-line chemotherapy as treatment options for these patients. The recommendations are tailored to patients' stage of cancer, and consider optimal timing of each treatment option, whether treatment should be sequential or concurrent, and appropriate dose or treatment regimen.

Role of Bone-Modifying Agents in Metastatic Breast Cancer: An American Society of Clinical Oncology-Cancer Care Ontario Focused Guideline Update

Year: 2017
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This clinical practice guideline is a focused update of the American Society of Clinical Oncology's 2016 guideline titled American Society of Clinical Oncology Clinical Practice Guideline Update: Recommendations on the Role of Bone-modifying Agents in Metastatic Breast Cancer. The guideline examines the role of bone-modifying agents (BMAs) in the treatment of patients with metastatic breast cancer, while specifically focusing on the intervals between doses of zoledronic acid, and the use of BMA's to control pain secondary to bone metastases. In addition to zolendronic acid, BMA's compared include denosumab, and pamidronate.

Breast Reconstruction Following Prophylactic or Therapeutic Mastectomy for Breast Cancer

Year: 2017
AGREE II score: Available
Developer organization: Alberta Health Services
This clinical practice guideline provides recommendations for breast reconstruction in women following mastectomy for the prevention or treatment of breast cancer. The guideline discusses patient education, eligibility for reconstruction, timing of reconstruction, factors that enhance recovery from reconstruction, post-reconstruction surveillance, and measuring outcomes of construction. The benefits and risks of implant-based, autologous flap, and combination reconstruction procedures are examined. The guideline also discusses the extent to appropriately perform mastectomy.

The Use of Targeted Therapies in Patients With Inoperable Locally Advanced or Metastatic Renal Cell Cancer: Updated Guideline 2017

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults with inoperable locally advanced or metastatic renal cell cancer. The guideline provides recommendations on optimal targeted therapies and compares different drug treatments and combinations of treatments. Outcomes of interest include overall quality of life, overall survival, toxicity, fatigue, and other adverse events.

Systemic Therapy for Recurrent Epithelial Ovarian Cancer

Year: 2017
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women with recurrent epithelial ovarian cancer (EOC), including fallopian tube and primary peritoneal cancers. The guideline examines the most up-to-date systemic therapy treatment recommendations for recurrent EOC in order to promote evidence-based practice in Ontario. Outcomes of interest include improvements in progression-free survival and symptom control.

Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non-Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update

Year: 2017
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This is a clinical practice guideline discussing adjuvant therapy for adult patients with non-small cell lung cancer (NSCLC). The guideline specifically examines the appropriateness of adjuvant systemic therapy versus adjuvant radiation therapy in adults with completely resected stage I-IIIA NSCLC. Recommendations are made based on disease stage, as well as other factors such as tumour size, genetics, and histology.

Brachytherapy for Patients With Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update

Year: 2017
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This is a clinical practice guideline for patients with newly diagnosed prostate cancer who require or choose active treatment, and are not receiving active surveillance by choice or lack of suitability. The guideline examines the efficacy of brachytherapy, as compared to and combined with external beam radiation therapy (EBRT) and radical prostatectomy (RP). The guideline also considers which isotopes should be used for low-dose rate (LDR) brachytherapy to maximize clinical outcomes.

Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer: A Cancer Care Ontario and American Society of Clinical Oncology Clinical Practice Guideline

Year: 2017
AGREE II score: Available
Developer organization: American Society of Clinical Oncology
This is a clinical practice guideline for patients with early or locally advanced (nonmetastatic) breast cancer. The guideline examines the use of bisphosphonates and other bone-modifying agents as adjuvant therapy in patients with breast cancer. Outcomes of interest include recurrence and survival, with focus on the dependency of effectiveness on age or menopausal status.

Indications for Use of Breast Magnetic Resonance Imaging (MRI)

Year: 2017
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for the appropriate use of breast magnetic resonance imaging (MRI). The guideline examines indications for breast MRI use, such as for the screening of high risk individuals, for problem solving when mammographic, sonographic or clinical findings are suspicious but inconclusive, for the assessment of positive margins following breast cancer surgery or neoadjuvant chemotherapy, and for the assessment of breast implant integrity.

Guideline: Influenza Vaccine for Ambulatory Oncology Patients

Year: 2017
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for adult patients with solid tumour malignancies. The guideline provides recommendations for administering influenza vaccines to these patients. The timing of vaccination, and for whom vaccination is appropriate, are both discussed.

Guidelines for the Management of Febrile Neutropenia in Children

Year: 2017
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This is a clinical practice guideline for the management of febrile neutropenia in children, including those with cancer, and/or those who are undergoing hematopoietic stem cell transplantation (HSCT). The guideline examines the signs and symptoms of febrile neutropenia, as well as the evaluation of affected patients. Antibiotic selection and dose are recommended based on factors related to patient's condition, including stability on presentation, presence of penicillin allergy, and current treatment. Continued management of inpatients and management based on culture results are also discussed.

Guidelines for the Prevention and Management of Mucositis in Children Receiving Cancer Therapy

Year: 2017
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This is a clinical practice guideline for children with cancer who are receiving chemotherapy and/or radiation therapy. Recommendations are provided for the prevention of mucositis through oral care management, and various treatment options are considered for the management of mucositis in affected patients. The guideline also lists the risk factors for mucositis, and provides an oral assessment tool.

Guidelines on the Prevention and Management of Chemotherapy Associated Diarrhea

Year: 2017
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This is a clinical practice guideline for pediatric cancer patients who are receiving chemotherapy. Guidance is provided for the diagnosis and treatment of chemotherapy-induced diarrhea in these patients. Risk factors, grading of diarrhea, dietary modifications during diarrhea, and anti-diarrheal agents are also discussed.

Clinical Practice Guideline on the Prevention and Management of Constipation in Children With Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This is a clinical practice guideline for the prevention and management of constipation in pediatric cancer patients. Pharmacological and non-pharmacological treatment options (including dosing recommendations) are discussed. The management of refractory opioid-induced constipation is also examined.

Provincial Differentiated Thyroid Cancer (DTC) Treatment Guidelines

Year: 2017
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for patients with thyroid cancer. The guideline examines the diagnosis, treatment, management, and follow-up of these patients. Topics of interest include a shift towards a standardized ultrasound/cytologic concordance system to guide investigation and management of thyroid nodules, acceptance of thyroid lobectomy as an option for many low risk thyroid cancers, acceptance of either no or lower dose radio-iodine treatment for many low risk thyroid cancers, and dynamic risk stratified follow-up for thyroid cancer.

Cancer-Related Fatigue

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults with cancer-related fatigue. The guideline examines the appropriate screening, assessment, and management of these patients. Interventions discussed include pharmacological management, physical activity, functional and occupational therapy interventions, psychosocial and educational interventions, complementary therapies, nutrition, and management of anemia. Recommendations are provided based on the severity of fatigue.

Prophylaxis and Treatment of Venous Thrombemolism in Patients Undergoing Treatment for Solid Tumours

Year: 2017
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline discussing the treatment and prophylaxis of venous thromboembolism (VTE) in patients receiving treatment for solid (i.e. non-hematologic) tumours. The guideline examines the pharmacologic therapy and dosing options for both inpatients and ambulatory patients with established VTE or who are at risk for VTE (i.e. prophylaxis). The guideline also discusses common complications associated with antithrombotic therapy, as well as the follow-up of patients during its administration.

Pneumococcal Immunization in Adult and Pedtric Patients Undergoing Cancer Treatment

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline on pneumococcal immunization for adult and pediatric cancer patients with solid tumours or hematologic cancers. The guideline provides recommendations on the type of vaccine and timing of immunization in relation to the type of treatment, therapy cycle, and severity of immunosuppression. Guidance is also provided on restrictions for immunization.

Desmoid Tumours

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with desmoid tumours. The guideline provides recommendations for diagnosis, staging procedures, treatment, and follow-up. Treatment options including active surveillance, surgery, radiation therapy, and chemotherapy are examined. Topics of interest include desmoid tumours occurring during pregnancy, pain management, and rehabilitation.

Soft-Tissue Sarcoma: Management of Metastatic Disease

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with soft-tissue sarcoma who are being considered for chemotherapy. The guideline provides recommendations for staging procedures and classifications, as well as treatment options based on staging results and other risk factors. Treatment options including surgery, systemic therapy, radiation therapy, and chemotherapy are discussed. Outcomes of interest include adverse events, performance status, progression-free survival, and overall survival.

Management of Chronic Myeloid Leukemia 

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline on the diagnosis, staging, treatment and management of adult patients who are suspected of having, or have been diagnosed with, chronic myelogenous leukemia (CML). Treatment options examined include the use of tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib, dasatinib, bosutinib, and ponatinib, as well as allogeneic stem cell transplant (SCT) and Interferon-a (IFNa). Special consideration is paid to the use of TKIs in the treatment of elderly patients with CML.

Oral and Dental Care Management in Head and Neck Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with head and neck cancer. The guideline examines oral and dental care assessment and management of patients before, during, and after cancer treatment. Topics addressed include pain, xerostomia, speech and swallowing disorders, oral hygiene, and functional capacity. The primary outcome of interest is quality of life.

Renal Cell Carcinoma

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with renal cell carcinoma (RCC). The guideline examines the clinical management of RCC, including diagnosis, treatment, and follow up. The primary outcomes of interest are survival, recurrence, and quality of life.

Hepatocellular Carcinoma

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults with hepatocellular carcinoma (HCC). The guideline examines the goals of therapy, and provides recommendations for the treatment of patients with different stages of HCC, from very early stages to terminal stage. Outcomes of interest include rendering the patient free of disease, preventing recurrence, and improving quality of life.

Adenocarcinoma of the Pancreas

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the management of adult patients with adenocarcinoma of the pancreas. The guideline provides recommendations on diagnostic work-up, staging, and treatment options based on stage of cancer. Specific topics discussed include management recommendations for unresectable adenocarcinoma, and toxicity-associated dose modification. Outcomes of interest include adverse events, overall survival, and quality of life.

Early Stage Colon Cancer

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with early stage colon cancer. The guideline discusses diagnostic work-up, staging, and treatment options. Recommendations for adjuvant chemotherapy are presented, based on cancer stage.

Brain Oligometastases

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with four or fewer brain metastases. The guideline examines the important prognostic factors for assessing and managing these patients, the role of surgery and radiotherapy in the management of oligometastatic disease, and the appropriate follow-up and surveillance strategy. Treatments considered include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), both alone and in conjunction.

Stereotactic Radiosurgery: Benign Indications

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults with benign brain tumors. The guideline examines the appropriateness of stereotactic radiosurgery for treating these patients, as well as the appropriate dose for stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). Recommendations are provided for benign brain tumors that can be treated with stereotactic radiotherapy, including vestibular schwannoma, pituitary adenomas, meningiomas, and other indications such as craniopharyngiomas and hemangioblastomas.

Influenza Immunization for Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2017
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline discussing influenza immunization for adult and pediatric cancer patients. The guideline provides guidance on the timing of influenza immunization in relation to severity of immunosuppression and chemotherapy schedules, number of administrations, types of influenza vaccines, and contraindications and precautions for immunization. Recommendations for the immunization of family members and hospital or clinic staff are also provided.

Consensus Recommendations for Management of Malignant Melanoma

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the management of malignant melanoma. Topics of interest include acceptable time intervals from referral to surgical management, which patients should be candidates for sentinel lymph node biopsy, and acceptable surgical margins.

Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy-Induced Nausea and Vomiting in Children With Cancer

Year: 2016
AGREE II score: Available
Developer organization: Pediatric Oncology Group of Ontario
This is a clinical practice guideline for children aged 1 month to 18 years who are receiving chemotherapy. The guideline examines the management of chemotherapy-induced nausea and vomiting (CINV), including the treatment of breakthrough CINV and the prevention of refractory CINV. The primary outcome of interest is a decrease in the incidence of CINV.

The Use of Adjuvant Radiation Therapy for Curatively Resected Melanoma

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with stage 1-3 cutaneous melanoma who have received curative resection. The guideline examines the appropriateness of adjuvant radiation therapy (RT) for these patients, narrowing the focus on those patients with primary melanoma, in-transit primary melanoma, recurrent melanoma, and those at high risk for regional recurrence of melanoma. The guideline also considers whether equivalent disease control is provided with a standard fractionation schedule and a hypofractionated schedule. Outcomes of interest include control rate, survival rate and adverse event rates.

Breast Cancer Reconstruction Surgery (Immediate and Delayed) Across Ontario: Patient Indications and Appropriate Surgical Options

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women with breast cancer who have chosen or been recommended for therapeutic mastectomy, and women who are at high risk for breast cancer who have chosen or been recommended prophylactic mastectomy. The guideline considers the suitability of patients for immediate or delayed breast cancer reconstruction surgery, appropriate timing of treatment, and optimal surgical techniques. Techniques examined include skin-sparing mastectomy (SSM), nipple-sparing mastectomy (NSM) and areola-sparing mastectomy, as well as autologous tissue and implant-based reconstruction.

Interventions to Address Sexual Problems in People With Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult men and women that have sexual function side effects as a result of cancer diagnoses and/or treatment. The guideline examines strategies/interventions to manage sexual function side effects with the aim of decreasing distress, and improving quality of life for cancer survivors and their partners. Both pharmacologic and non-pharmacologic interventions are discussed.

Management of a Suspicious Adnexal Mass

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women presenting with suspicious adnexal masses, either symptomatic or asymptomatic. The guideline examines the optimal strategies for preoperative identification of adnexal masses that are suspicious for ovarian cancer, and the most appropriate surgical procedures for those identified.

Surgical Management of Patients With Lymph Node Metastases from Cutaneous Melanoma of the Trunk or Extremities

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with cutaneous melanoma of the trunk or extremities. The guideline examines the optimal surgical management of patients with positive sentinel lymph nodes (SLNs) and biopsy-proven clinically palpable or biopsy-proven radiologically detected lymph nodes from cutaneous melanoma originating in the trunk or extremities. Outcomes of interest include local and regional recurrence, distant recurrence, overall survival (OS), and disease-free survival (DFS).

Systemic Treatment for Patients With Advanced Non-Small Cell Lung Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for the treatment of advanced non-small cell lung cancer (NSCLC). The guideline examines the efficacy of different therapies including chemotherapy and immune checkpoint inhibitors. Outcomes of interest include overall survival, progression-free survival, quality of life, toxicity, and response rate.

Optimization of Surgical and Pathological Quality Performance in Radical Surgery for Colon and Rectal Cancer: Margins and Lymph Nodes

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for the staging and treatment of colorectal cancer. The guideline focuses on surgical and pathological considerations for the resection of colorectal cancer and provides recommendations on the technique and extent of resection, as well as the reporting of resection results. Outcomes of interest include overall survival, disease-free survival, recurrence rates, and margin status.

Referral of Suspected Prostate Cancer by Family Physicians and Other Primary Care Providers

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline on the diagnosis of prostate cancer. The guideline examines effective diagnostic methods and provides recommendations on testing and referrals. Outcomes of interest include diagnostic accuracy, sensitivity, and specificity. Other topics of discussion include factors associated with delayed referral and risk factors that are predictive of prostate cancer.

Systemic Therapy of Incurable Gastroenteropancreatic Neuroendocrine Tumours

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults diagnosed with incurable gastroenteropancreatic neuroendocrine tumours. The guideline examines treatment options for pancreatic neuroendocrine tumours and non-pancreatic neuroendocrine tumours, including chemotherapy, targeted therapy, somatostatin analogues and interferon, and combination therapy. Outcomes of interest include progression-free and overall survival, adverse events, and quality of life.

Stem Cell Transplantation in the Treatment of Acute Lymphoblastic Leukemia

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for stem cell transplantation (SCT) in the treatment of acute lymphoblastic leukemia. The guideline establishes indications for allogeneic stem cell transplantation (allo-SCT) in the management of acute lymphoblastic leukemia (ALL) in adults. It identifies the role of reduced-intensity conditioning (RIC) regimens for SCT in the management of ALL adult patients, and the role of tyrosine-kinase inhibitors (TKIs) for patients undergoing allo-SCT for Philadelphia chromosome-positive ALL (Ph+ ALL). The guideline also discusses the role of alternative donor transplantation (haploidentical, cord blood) in the management of adult patients with ALL who lack a suitable donor. Outcomes of interest are relapse, disease-free survival, relapse-free survival, progression-free survival, and overall survival.

Systemic Therapy in the Curative Treatment of Head and Neck Squamous Cell Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with locally advanced nonmetastatic (stages III-IVB) squamous cell carcinoma of the head and neck (LASCCHN). The guideline examines the use of systemically administered drugs in combination or in sequence with radiation (RT), surgery, or both. Outcomes of interest include tumour response rate, survival rate, and organ preservation.

Clinical Utility of Multigene Profiling Assays in Invasive Early-Stage Breast Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women diagnosed with invasive early-stage breast cancer. The guideline discusses the use of different multigene profiling assays for determining risk profiles (high-risk vs low-risk) in patients with estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative tumours. The validity and clinical utility of different assays are examined, including Oncotype DX, Prosigna, MammaPrint, EndoPredict, and EPclin. In addition, assays are specifically compared to Oncotype DX, the only assay that was publicly funded and part of standard practice in Ontario at the time of publication.

Recommendations on Routine Screening Pelvic Examination: Canadian Task Force on Preventive Health Care Adoption of the American College of Physicians Guideline

Year: 2016
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
This clinical practice guideline is an adoption of the American College of Physicians' 2014 guideline title Screening Pelvic Examination in Adult Women: A Clinical Practice Guideline from the American College of Physicians. The guideline examines the use of pelvic examinations to screen for noncervical cancer, pelvic inflammatory disease, or other benign gynecologic conditions in asymptomatic, non-pregnant adult women. Speculum or bimanual examinations are specifically discussed; the use of Pap tests for cervical cancer screening is not addressed in this guideline.

Bone Health and Bone-Targeted Therapies for Prostate Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for men with prostate cancer who are receiving androgen deprivation therapy (ADT). The guideline examines the effectiveness of therapies that target bone, which can mitigate the effects of ADT on bone health. Outcomes of interest include fracture, bone mineral density (BMD), osteoporosis, skeletal-related events (SREs), bone metastasis, pain, patient-reported quality of life (QOL), and overall survival.

Testicular Germ Cell Tumours

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with testicular germ cell tumours (GCTs). The guideline examines appropriate management and follow-up strategies for different stages of the two main histological types of testicular GCTs: seminomas and nonseminomas. Outcomes of interest include recurrence and overall survival.

Metastatic Colorectal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of adult patients with metastatic colorectal cancer. The guideline examines different management options, including treatment via clinical trials, treatment chemotherapy, palliative chemotherapy, EGFR inhibitors, and regorafenib (as a fourth-line therapy). The guideline also discusses the need to test for Ras mutations before treatment. Outcomes of interest include treatment efficacy and improved survival outcomes.

Malignant Biliary Obstruction

Year: 2016
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with neoplasms causing biliary obstruction. The guideline examines the management of malignant biliary obstructions, including diagnostic work-up and treatment options. Recommendations are provided based on factors such as the resectability and location of the obstruction. Outcomes of interest include improved quality of life (QOL) and prolonged survival.

Adjuvant Systemic Therapy for Early Stage (Lymph Node Negative and Lymph Node Positive) Breast Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline examines adjuvant systemic therapy for early stage breast cancer. The guideline provides a systematic method for treatment decision-making for patients with lymph node negative breast cancer and lymph node positive breast cancer, based on level of risk and hormone receptor status. The guideline further explores chemotherapy options for these patients and considers the influence of menopausal status on treatment decisions.

Guidelines for the Investigation of Patients With Symptoms Suggestive of Colorectal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for adult patients in primary care settings or emergency departments who have signs and symptoms suggestive of colorectal cancer (CRC). The guideline examines how to define expectations for primary care providers (PCPs), endoscopists, and radiologists regarding the appropriate work up of patients who have symptoms suggestive of colorectal cancer, and outlines the communication expectations between PCPs, endoscopists, radiologists, and other health care providers and patients. Outcomes of interest include effective communication, as well as early and accurate diagnoses.

Low-Grade Gliomas

Year: 2016
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults with low-grade gliomas (LGGs). The guideline examines the diagnosis, prognosis, and treatment of these patients. Treatment modalities discussed include surgery, radiation therapy, and chemotherapy.

Management Of Fluorouracil (5-Flourouracil, 5Fu) Infusion Overdose Guideline

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A guideline for the management of fluorouracil for treating solid tumours. The guideline examines the safe management of fluorouracil in medication pumps, and recommendations for treating and monitoring patients who have overdosed. Important aspects include specific dosing regimens, fluid administration calculations, and outpatient management.

Recommendations for Filgrastim Use in Adults by Disease Site

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.

Consensus Recommendations for Management of Malignant Melanoma

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the clinical management of malignant melanoma with the aim of improving the standard of care received by this patient population. The guideline provides recommendations on referral to surgeons and associated wait times, procedures (e.g., biopsy), tumour markers, and adjuvant therapies.

Consensus Recommendations for the Management of Chronic Lymphocytic Leukemia: Primary Care Guideline

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with chronic lymphocytic leukemia (CLL), monoclonal B cell lymphocytosis (MBL) and small lymphocytic lymphoma (SLL). The guideline examines clinical assessment, staging, and treatment including supportive therapy and potential complications. Outcomes of interest include long-term remission, increases in secondary malignancies, and disease progression.

Consensus Recommendations for the Routine Use of Positron Emission Tomography (PET) Scan Imaging for Lymphoma in Manitoba

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with lymphoma, including small lymphocytic leukemia (SLL)/chronic lymphocytic leukemia (CLL), Waldenstroms, marginal zone lymphoma, and cutaneous lymphoma. The guideline examine the use of PET/CT, primarily for staging and response assessment. Outcomes of interest include survival, quality of life, and appropriate use.

Tobacco Screening and Treatment for Adult Cancer Patients

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.

Pneumococcal Immunization for Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult and pediatric patients with cancer, including hematological cancers and solid tumours. The guideline examines pneumococcal immunization in order to prevent secondary infections. Outcomes of interest include reduced pneumonial mortality and improved immunization scheduling.

Influenza Immunization For Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline provides recommendations on influenza vaccinations for children and adults with solid tumours or hematologic malignancies. Recommendations are provided for vaccine type (live versus inactivated) and administration in relation to the therapy cycle, and are stratified by patient age (adult versus pediatric). Topics of discussion include the effects of age, duration, and type of systemic therapy in regards to response of patients to the influenza vaccine, as well as contraindications and precautions for immunization.

Gastrointestinal Stromal Tumours (GIST)

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with gastrointestinal stromal tumours. The guideline examines appropriate imaging modalities, and treatment for newly diagnosed and metastatic tumours. Outcomes of interest include disease progression and recommended imaging.

Palliative Radiotherapy: Bleeding and Gastrointestinal Obstruction

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for palliative oncology patients 18 years of age or older with low grade/ low volume/ malignancy-associated urogenital or gastrointestinal bleeding, or with malignant gastrointestinal obstruction, compression or invasion. External beam radiotherapy (EBRT) with or without , brachytherapy, stent placement, and surgical bypass are discussed as therapeutic options. Outcomes of interest include clinical improvement of symptoms, quality of life, and survival.

Lymphoma

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline addressing lymphoma in the adult population. The guideline focuses on diagnosis and pathology, staging, and treatment of Non-Hodgkin Lymphomas, Hodgkin Lymphoma, HDCT and hematopoietic stem cell transplantation for lymphoma. Supportive and follow-up care is also addressed. The guideline updates the 2015 guideline of the same title.

Chronic Lymphocytic Leukemia

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with chronic lymphocytic leukemia. The guideline examines diagnosis, staging, and treatment of newly diagnosed, relapsed, and refractory leukemia. Outcomes of interest include progression-free survival, reduced adverse events, and treatment response.

Acute Lymphoblastic Leukemia

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the diagnosis and treatment of acute lymphoblastic leukemia in adult and pediatric patients. The guideline examines diagnostic methods, treatment by age group, and special considerations including allogeneic stem cell transplantation and the role of cranial radiation. Outcomes of interest include probability of survival and incidence of hematological relapse.

Guidelines for the Diagnosis and Referral of Suspected Lung Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for the investigation and diagnosis of suspected lung cancer and referral for treatment, particularly for patients residing in Nova Scotia. The guideline reviews the investigation process from initial presentation to treatment referral. Topics include principles of communication between patient-provider and among providers throughout the diagnostic process, standards for initial investigation, appropriate use of imaging (CT, MRI, PET, bone scan) and biopsy and laboratory testing, as well as recommendations regarding treatment referral upon diagnosis. Referrals to diagnostic specialists (thoracic surgery or respirology) and to psychosocial and supportive care are also reviewed.

Clinical Standards for the Treatment of Rectal Cancer in Nova Scotia

Year: 2016
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This guideline discusses the clinical standards of care for the treatment of rectal cancer in Nova Scotia with all aspects of rectal cancer care covered, from diagnosis to survivorship and/or palliation. This includes recommended standards for professionals involved in care, pretreatment investigations, and surgical, neo-adjuvant, and adjuvant treatments. Other topics covered include lynch syndrome screening and referral to medical genetics. Psychosocial health services and supportive care recommendations are also reviewed.

Molecular Biomarker Discordance between Primary and Recurrent/Metastatic Breast Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for patients with a history of breast cancer. The guideline examine the use of biopsies and retesting of estrogen receptor (ER), progesterone receptor (PR) and HER2-neu receptor (HER2) to determine recurrence or metastases. Outcomes of interest include progression-free and overall survival.

Genital Tract Cancers in Females: Human Papillomavirus Related Cancers (Cervical, Vaginal & Vulvar)

Year: 2016
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing. Provincial resources are provided.

Palliative Radiotherapy: Bone Metastases and Spinal Cord Compression

Year: 2016
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice guideline for patients with bone metastases and spinal compression as common causes of cancer-related pain. The guideline examines radiotherapy and prophylactic steroids to reduce pain and pain flares. Outcomes of interest include improved neurological outcomes, survival, and reduced functional interference.

Palliative Radiotherapy: Superior Vena Cava Obstruction, Dyspnea, and Hemoptysis

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
The guideline provides recommendations for management and treatment of patients 18 years of age and older who have malignant superior vena cava obstruction (SVCO) or airway obstruction, compression, or invasion, or those experiencing hemoptysis. The course of management is dependent on symptoms, primary histology, urgency of histology, previous treatment, and access to resources. External beam radiotherapy (EBRT), endobronchial brachytherapy, chemotherapy, radiotherapy, bronchoscopic debulking, surgical resection, photodynamic therapy, and Neodymium-doped yttrium aluminum garnet (Nd:YAG) are discussed as treatment options. For superior vena cava obstruction, external beam radiation EBRT, RT dose fractionation, SVC stent insertion, steroids, and palliative intent chemotherapy are discussed.

Sentinel Node Biopsy in Primary Cutaneous Melanoma

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline reviews the use of sentinel node biopsy (SLNB) as a diagnostic tool for adult patients with malignant melanoma. Topics of discussion include indications and contraindications of SLNB, pathological examination of the sentinel nodes, and indications for therapeutic node dissection and recommended extent of dissection. The use of ultrasound-guided fine-needle aspiration is also discussed. Outcomes of interest include test sensitivity, specificity, and positive and negative predictive value, as well as rate of nodal recurrence and survival.

Esophageal Cancer

Year: 2016
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with esophageal cancer, including both squamous cell and adenocarcinoma. The guideline provides recommendations on diagnostic work-up, staging, treatment options for potentially curable cancer stratified by stage, and management options for incurable cancer. Esophagectomy, endoscopic therapy, primary chemoradiotherapy, radiotherapy, pre-operative chemoradiotherapy followed by esophagectomy and pre-operative chemotherapy are discussed, as well as supportive care. Outcomes of interest include survival (overall, progression-free, 5-year), morbidity, toxicity, and rate of sudden death.

Magnetic Resonance Imaging for Pre-Treatment Local Staging of Prostate Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for magnetic resonance imaging (MRI) for pre-treatment local staging of prostate cancer. The use of MRI for pre-treatment local staging is juxtaposed with the ways in which prostate cancer is conventionally detected which includes prostate-specific antigen (PSA) screening, digital rectal examination (DRE), and biopsy-confirmed diagnosis by transrectal ultrasonography (TRUS). The guideline therefore explores the performance and diagnostic accuracy of MRI, as well as the impact of pre-treatment local staging by MRI on patient on patient outcomes, biochemical recurrence, changes in treatment planning (including nerve- sparing 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.

Radiotherapy with Curative Intent in Patients with Early Stage, Medically Inoperable, Non-Small Cell Lung Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult 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. The guideline provides discusses the use of stereotactic body radiation therapy (SBRT)/stereotactic ablative radiation therapy with curative intent and provides recommendations on fractionation schemes. Outcomes of interest include tumour control and survival as well as toxicity.

Adjuvant Care for Stage I Ovarian Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for women with stage I ovarian cancer. The guideline examines adjuvant therapy, primarily systemic therapies, in relation to surgical staging. Outcomes of interest include overall and disease-free survival.

Preoperative or Postoperative Therapy for Resectable Esophageal Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline reviews the use of pre- and post-operative therapy including chemotherapy and radiotherapy as treatment options. Outcomes of interest include survival (overall, cause-specific), quality of life, acute and late toxicities, and postoperative morbidity (within 30 days of surgery).

Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations for follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer. The guideline addresses the following questions which include: what evaluations (e.g., colonoscopy, computed tomography [CT], carcinoembryonic antigen [CEA], liver function, complete blood count [CBC], chest x-ray, history, physical exam) should be performed for surveillance for recurrence of cancer? What is a reasonable frequency of these evaluations for surveillance? Which symptoms and/or signs potentially signify a recurrence of CRC and warrant investigation?

Systemic Treatment of Acute Myeloid Leukemia (AML)

Year: 2016
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with acute myeloid leukemia (AML), excluding acute promyelocytic leukemia, who are deemed suitable for intensive treatment. The guideline includes consideration of the most effective systemic post-remission treatment - consolidation and/or maintenance - for adults with previously untreated AML. The guideline also considers which patient characteristics are most important when making treatment decisions.

Recommendations on Screening for Colorectal Cancer in Primary Care

Year: 2016
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
This is a clinical practice guideline for asymptomatic adults aged 50 years and older who are not at high risk for colorectal cancer. The guideline provides screening recommendations stratified by age group (aged 50-74, and 74 and older). Various screening procedures are discussed and compared including fecal occult blood testing (gFOBT), fecal immunochemical testing, flexible sigmoidoscopy, and colonoscopy. Outcomes of interest include mortality and morbidity, adverse outcomes of screening procedures, test sensitivity and specificity, and positive and negative predictive values.

Recommendations on Screening for Lung Cancer

Year: 2016
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
A clinical practice guideline for lung cancer screening of adults at high risk. The guideline examines computed tomography screening and screening intervals, and criteria for high risk screening. Outcomes of interest include reduction in harms from chest radiography and improved screening economy.

Guideline for the Prevention of Oral and Oropharyngeal Mucositis in Children Receiving Treatment for Cancer or Undergoing Haematopoietic Stem Cell Transplantation

Year: 2015
AGREE II score: Available
Developer organization: Pediatric Oncology Group of Ontario
This is a clinical practice guideline for children receiving chemotherapy or undergoing hematopoietic stem call transplantation (HSCT) for cancer. The guideline examines the effectiveness of prophylactic interventions for preventing or reducing the severity of oral and oropharyngeal mucositis in these patients. Interventions considered include cryotherapy, low-level light therapy and the use of keratinocyte growth factor (KGF).

Focal Tumour Ablation in Ontario: Recommendations Report 2015

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with a variety of cancers, including lung, liver, and kidney tumours, with a specific focus on patients with hepatocellular carcinoma (HCC) or liver metastases. The guideline examines the effectiveness of thermal ablation, which encompasses radiofrequency ablation (RFA) and microwave ablation, as well as transcatheter arterial chemoembolization (TACE), alone or in combination with other strategies. The guideline outlines patient clinical criteria, criteria for service providers, and system-level criteria.

Follow-up Care and Psychosocial Needs of Survivors of Prostate Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for men with prostate cancer who have received treatment with curative intent. The frequency by which prostate-specific antigen (PSA) levels should be tested in these patients is discussed, and the guideline also examines appropriate diagnostic testing techniques for instances in which biochemical (BC) recurrence occurs. The guideline also discusses psychosocial issues, sexual health, fatigue, urinary health, and bowel heath outcomes associated with prostate cancer treatment.

Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline is for the treatment of patients with stage II and III colon cancer who have undergone complete resection with curative intent. The guideline examines the impact of different adjuvant chemotherapy regimens. Outcomes of interest include overall survival, disease-free survival, adverse events, and quality of life.

Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This guideline provides recommendations on the use of advanced practice nurses (APNs) to optimize patient, provider, and health system outcomes across the cancer care continuum. Specifically, the guideline reviews patient populations and situations (types of needs, practice settings, phase of the cancer care continuum) for which APN roles have demonstrated equivalent or improved outcomes, or reduced harms in cancer care. Outcomes of interest include quality of life, physical, functional, psychosocial, and mental health, as well as morbidity, mortality, symptom management, patient and provider satisfaction, health care utilization, costs, and quality of care.

Follow-up of Patients with Cutaneous Melanoma who were Treated with Curative Intent

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with cutaneous melanoma after treatment with curative intent. The guideline provides recommendations on follow-up schedules, involving appropriate evaluations and timing for early detection of local-regional recurrence, distant metastases, and new primary melanomas. Diagnostic imaging modalities such as ultrasound (US), computed tomography (CT), positron emission tomography (PET), and PET/CT, laboratory tests such as LDH and S100B, skin self-examinations, and dermoscopy/dermatoscopy are discussed.

Smoking Cessation in Oncology Care

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with any type of cancer. The guideline examines the benefits of smoking cessation, and education for quitting once a patient has been diagnosed with cancer. Outcomes of interest include quality of life and treatment-related toxicity.

Non-Melanoma Skin Cancer in Canada Chapter 5: Management of Squamous Cell Carcinoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Non-melanoma Skin Cancer Guidelines Committee
A clinical practice guideline for the staging and treatment of squamous cell carcinoma. The guideline examines treatment options, primarily surgical excision, and provides guidelines for immunocompromised and high-risk patients. Outcomes of interest include improved tissue sparing through Mohs micrographic surgery, and improved understandings of surgical margins. This guideline is Chapter 5 of 5 of the Non-melanoma Skin Cancer in Canada guideline series.

Non-Melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Non-melanoma Skin Cancer Guidelines Committee
A clinical practice guide for the staging and treatment of basal cell carcinoma. The guideline examines numerous treatment options, including cryosurgery, topical, and photodynamic approaches. Outcomes of interest include reduced recurrence rates with surgical excision and Mohs micrographic surgery. This guideline is Chapter 4 of 5 of the Non-melanoma Skin Cancer in Canada guideline series.

Non-Melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Non-melanoma Skin Cancer Guidelines Committee
A clinical practice guideline for the treatment of actinic keratosis and cheilitis as precursors to invasive squamous cell carcinomas. The guideline examines treatment options including surgical and topical removal, and considers the use of combined modalities. There is also specific information for the monitoring and treatment of long-term immunosuppressed patients. Outcomes of interest include improved cosmetic results through the use of topical methods. This guideline is Chapter 3 of 5 of the Non-melanoma Skin Cancer in Canada guideline series.

Non-Melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-Melanoma Skin Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Non-melanoma Skin Cancer Guidelines Committee
A clinical practice guideline for the primary prevention of non-melanoma skin cancer, including basal and squamous cell carcinoma. The guideline examines modifiable risk factors for developing skin cancer, focusing primarily on photoprotection at an individual and public health level. Outcomes of interest include reduced actinic keratoses through daily sunscreen use and clarification of labelling standards. This guideline is Chapter 2 of 5 of the Non-melanoma Skin Cancer in Canada guideline series.

Influenza Immunization For Adult And Pediatric Patients Undergoing Cancer Treatment

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult and pediatric patients with solid tumours or hematologic cancers. The guideline provides recommendations on influenza immunization including immunization interval and dosage, type of vaccine (activated versus inactive), and timing of administration in relation to the cancer treatment cycle. Special topics of interest include immunization of patients undergoing blood and marrow transplant (BMT, autologous and allogeneic), as well as immunization of family members and hospital or clinic staff who are in contact with cancer patients.

Tobacco Screening And Treatment For Adult Cancer Patients

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. The guideline provides recommendations on implementation of the brief tobacco intervention, using the evidence-based 5 A’s model (ASK, ADVISE, ASSESS, ASSIST, ARRANGE) which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes. The impact of tobacco use on cancer treatment is also reviewed with a specific focus on erlotinib and irinotecan.

Multiple Myeloma

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is an update to the 2013 clinical practice guideline for the management of multiple myeloma in adult patients. The guideline examines diagnosis and treatment for multiple myeloma, monoclonal gammopathy, smoldering myeloma, and amyloidosis, including prognostic criteria. Outcomes of interest include improved survival outcomes through triple drug based induction regimens and improved dose reduction options for elderly patients.

Lymphoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline addressing lymphoma in the adult population. The guideline focuses on the following areas: Diagnosis and Pathologic Classification, Staging, Treatment of Non-Hodgkin Lymphomas, Hodgkin Lymphoma, HDCT and hematopoietic stem cell transplantation for lymphoma, supportive care in the treatment of lymphoma, and follow-up care in the treatment of lymphoma. Additionally, it seeks to provide recommendations to the following questions: what are the diagnostic criteria for the most common lymphomas; what are the staging and re-staging procedures for Hodgkin and non-Hodgkin lymphomas; what are the recommended treatment and management options for Hodgkin and non-Hodgkin lymphomas; and what are the recommended follow-up procedures for patients with malignant Hodgkin and non-Hodgkin lymphoma.

Management of Chronic Myeloid Leukemia

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the management of chronic myeloid leukemia (CML) in adult patients over 18 years of age. The 2015 update incorporates new evidence from research involving tyrosine kinase inhibitors for the treatment of CML. Guideline recommendations stem from the following three questions: what diagnostic and baseline investigations are recommended for adult patients with suspected or confirmed CML; what are the recommended treatment options for CML; and what are the criteria for monitoring response to treatment?

Acute Promyelocytic Leukemia

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the diagnosis and management of acute promyelocytic leukemia (APL) in adult patients over the age of 18 years. As a unique subtype of acute myeloid leukemia (AML), APL has distinct clinical features and management when compared to other forms of AML and therefore, these guidelines serve as a supplement to the AML guidelines. The guideline recommendations are drawn from the following questions: what are the diagnostic criteria for APL; what is the recommended management for adult patients in Alberta with APL; and what is the recommended follow-up for adult patients in Alberta with APL.

The Organization and Delivery of Healthcare Services for Head and Neck Cancer Patients

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the organization and delivery of health-care services for head and neck cancer patients in Alberta. The recommendations centre around responses to a number of guideline questions including: what does the health-care team treating head and neck cancer patients look like; what are the minimum qualifications required by core team members; what are the minimum cancer centre and team member volumes that optimize clinical outcomes; and what are the unique infrastructure requirements of team members.

Oropharyngeal Cancer Treatment

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the diagnosis, treatment, and follow-up of oropharyngeal cancer. The guideline examines baseline assessment and imaging, and treatment options based on patient staging. Important aspects include patient treatment preference and prioritization of treatment options based on risk features.

Metastatic Colorectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with metastatic colorectal cancer. The guideline examines treatment, primarily though palliative chemotherapy regimens. Outcomes of interest include delayed disease progression through monoclonal antibodies and improved treatment planning through the identification of RAS testing.

Influenza Immunization For Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline provides recommendations on influenza vaccinations for children and adults with solid tumours or hematologic malignancies. Recommendations are provided for vaccine type (live versus inactivated) and administration in relation to the therapy cycle, and are stratified by patient age (adult versus pediatric). Topics of discussion include the effects of age, duration, and type of systemic therapy in regards to response of patients to the influenza vaccine, as well as contraindications and precautions for immunization.

Systemic Therapy for Unresectable Stage III or Metastatic Cutaneous Melanoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over the age of 18 years with unresectable stage III and stage IV cutaneous melanoma, without involvement of the central nervous system (CNS). The guideline reviews the use of BRAF biomarker testing, and provides recommendations for first- and second-line systemic therapy options. BRAF Inhibitors, MEK inhibitors, immune checkpoint Inhibitors, other biological agents (e.g. imatinib and bevacizumab), and chemotherapy agents are reviewed.

Merkel Cell Carcinoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over the age of 18 years with Merkel cell carcinoma of the skin. The guideline provides recommendations on staging and work-up, treatment options including surgery, radiation, and chemotherapy, and follow-up care. The guideline also provides recommendations on management of recurrences, and reviews sentinel lymph node biopsy protocol.

Follow-Up Care For Early-Stage Breast Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients who have completed active medical or radiation oncology treatment for early-stage breast cancer and who have been discharged by the cancer care centre for care by the referring physician. The guideline provides recommendations on responsibilities regarding follow-up care, follow-up investigations and surveillance, and signs and symptoms indicative of a breast cancer recurrence. Potential complications from cancer treatment and common survivorship concerns and challenges are also reviewed.

Genital Tract Cancers in Females: Human Papillomavirus Related Cancers (Cervical, Vaginal & Vulvar)

Year: 2015
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing.

Breast Cancer Risk Reduction, Version 2.2015

Year: 2015
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for women who are at increased risk of developing breast cancer. The guideline provides an overview on risk assessment, risk-reduction interventions including lifestyle interventions, risk-reduction surgery, and risk-reduction agents (tamoxifen, raloxifene, aromatase inhibitors). Recommendations are also provided for managing side effects of risk-reduction agents and monitoring for complications. Risk-reduction counselling is also discussed.

Ovarian Cancer: Including Fallopian Tube Cancer and Primary Peritoneal Cancer, Version 2.2015

Year: 2015
AGREE II score: Unavailable
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with epithelial ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Less common histopathologies including ovarian low malignant potential (LMP) tumour, malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumours [MMMTs] of the ovary), and malignant sex cord-stromal tumours, are also discussed. The guideline provides recommendations on diagnosis, treatment, follow-up, and relapse. Primary treatment options for ovarian cancer include surgery (risk-reducing or cytoreductive), chemotherapy (neoadjuvant and adjuvant), incomplete surgery and/or staging, anti-angiogenesis agents, and radiation therapy. The number of chemotherapy cycles and agents are reviewed, along with drug reactions.

Rectal Cancer, Version 1.2016

Year: 2015
AGREE II score: Available
Developer organization: National Comprehensive Cancer Network
This is a clinical practice guideline for patients with colon cancer. The guideline reviews risk assessment, TNM staging, and pathology, and provides recommendations on the clinical presentation and treatment of nonmetastatic disease as well as recommendations on management of metastatic disease. Treatment for locally recurrent disease and survivorship are also discussed, as is the role of vitamin D in colorectal cancer.

Endometrial Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for women with endometrial cancer, including uterine carcinosarcoma. The guideline provides recommendations on lynch syndrome screening, surgery, adjuvant treatment for completely surgically staged endometrioid carcinoma, and adjuvant treatment for surgically staged high risk histotypes including endometrial serous, clear cell, dedifferentiated/undifferentiated carcinomas and carcinosarcomas. The guideline also reviews therapy for relapsed patients, and follow-up and surveillance of women without evidence of disease after primary potentially curative treatment for any stage of endometrial cancer.

Cancer Of The Uterine Cervix

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of adult patients with cancer of the uterine cervix, including squamous, adenocarcinomas, and adenosquamous carcinomas. The guideline examines treatment, primarily through surgery and radiotherapy, staging, and follow-up. Outcomes of interest include improved survival benefits through chemoradiotherapy and improved outcomes thought the addition of ifosamide to recommended chemotherapies.

Guideline for the Ordering, Preparation and Administration of Chemotherapy

Year: 2015
AGREE II score: Unavailable
Developer organization: Eastern Health
An organizational guideline for the processing and administration of chemotherapy to cancer patients. This guideline is an update to the 2013 guideline of the same title. The guideline examines the different stages and stakeholders in the chemotherapy treatment process, and the roles and responsibilities therein. Important aspects include accountability checks and staff safety procedures.

The Management of Uterine Leiomyomas

Year: 2015
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This clinical practice guideline provides recommendations on the assessment and management of uterine leiomyomas. Treatment options reviewed include medical management, surgical therapies, uterine artery embolization, focused energy delivery systems, MR-guided focused ultrasound, and radiofrequency myolysis. Special considerations are given towards concerns about malignancy and acute uterine bleeding.

Technical Update on Tissue Morcellation During Gynaecologic Surgery: Its Uses, Complications, and Risks of Unsuspected Malignancy

Year: 2015
AGREE II score: Available
Developer organization: Society of Obstetricians and Gynaecologists of Canada (SOGC)
This guideline reviews the use of gynecological surgery for hysterectomy and myomectomy. Specific topics include morcellation techniques, diagnosis of uterine malignancy, and prognosis following surgery for uterine sarcomas. Complications with uterine morcellation are also discussed. Outcomes of interest include 5-year survival, abdominopelvic recurrence, and rate of complications.

Rituximab in Lymphoma and Chronic Lymphocytic Leukemia: A Clinical Practice Guideline, Version 3

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline discusses the use of rituximab as a treatment option for adult patients with lymphoma or chronic lymphocytic leukemia (CLL), including combination chemotherapy, rituximab monotherapy, and rituximab maintenance therapy for patients who respond to treatment with combination chemotherapy and/or rituximab. Screening for surface antigen for hepatitis B (HBsAg) and hepatitis B core antibody (HBcAb) prior to treatment with rituximab is also discussed. Outcomes of interest are overall survival, disease control (overall, progression free, failure-free, or disease free survival; response duration), response rate, quality of life, and toxicity.

Exercise for People with Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on exercise for adult patients living with cancer (including those on active treatment and who have completed treatment). Benefits of specific types of exercise are considered along with safety concerns, and recommendations are provided for delivery models and exercise regimens for patients living with cancer at different points in the cancer journey, as well as pre-screening requirements for new referrals. Outcomes of interest include quality of life, safety, and muscular and aerobic fitness.

The 2015 CUA-CUOG Guidelines for the Management of Castration-Resistant Prostate Cancer (CRPC)

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Urological Association
This is a clinical practice guideline for the management of castration-resistant prostate cancer (CRPC). The guideline considers the role of bone supportive agents and palliative radiation in the overall management of CRPC. Due to the fact CRPC includes a wide range of disease types, different management options are considered including for those with rising PSA non metastatic CRPC, metastatic CRPC without symptoms or minimally symptomatic, metastatic CRPC with symptoms, and for patients with CRPC and bone metastases.

A Pan Canadian Practice Guideline for Screening, Assessment, and Management of Cancer-Related Fatigue in Adults: Version 2-2015

Year: 2015
AGREE II score: Available
Developer organization: Canadian Association of Psychosocial Oncology
This is a clinical practice guideline for the screening, assessment and management of cancer-related fatigue in adults. The guideline examines the efficacy of interventions (pharmacological, non-pharmacological, and/or combinations) for reducing cancer-related fatigue in adults and comparisons are made to usual care and attention control. Outcomes of interest include clinically significant improvement in fatigue or clinically significant reduction in cancer-related fatigue (measured by severity) or differences in fatigue severity between intervention group and controls using self-reported outcome measures.

Panitumumab And Cetuximab Toxicity Management Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with advanced colorectal cancer. The guideline reviews the safe administration of Panitumumab or Cetuximab (anti-EGFR therapy). Monitoring and treatment of adverse treatment effects are reviewed, including cutaneous toxicities, diarrhea, hypomagnesemia, fatigue, asthenia, lethargy, or malaise, hypersensitivity reactions, and interstitial lung disease.

Adjuvant Radiotherapy for Ductal Carcinoma In Situ

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This guideline provides recommendations on adjuvant radiotherapy for adult patients with ductal carcinoma in situ (DCIS) who have undergone breast conserving surgery (BCS) or mastectomy. The handling of close radial margin of excision after BCS is considered. Dose/fractionation schedule and acute toxicity are discussed, as are the side effects of radiotherapy.

Systemic Therapy for Well and Moderately Differentiated Unresectable Pancreatic Neuroendocrine Tumours

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients diagnosed with well or moderately differentiated (grade 1 or 2) pancreatic neuroendocrine tumours (PNETs). The guideline reviews the use of targeted therapies for PNETs including sunitinib malate, everolimus, and combination treatment with capecitabine/temozolomide. Recommendations are provided on use, dose, and schedule. Outcomes of interest include progression free survival (versus placebo) and toxicity.

Somatostatin Analogues for the Management of Neuroendocrine Tumours

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline looks at the use of somatostatin analogues in management of neuroendocrine tumours. Topics reviewed include the use of somatostatin analogues for management of secretory syndromes as a result of tumours, the effectiveness in use for delaying tumour progression, and effectiveness in use for management of carcinoid heart disease. Otreotide is looked at for effectiveness in management of symptoms secondary to elevated calcitonin in medullary thyroid carcinoma. Outcomes of interest include treatment response, survival, and adverse events.

Adenocarcinoma of the Pancreas

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with adenocarcinoma of the pancreas. The guideline discusses diagnostic workup, treatment options for potentially curable adenocarcinoma of the pancreas, and management of unresectable adenocarcinoma of the pancreas including locally advanced and metastatic disease. Surgical and first and second line systemic treatment options are discussed. Toxicity of systemic therapy regimes is also reviewed.

Adjuvant Radiation Therapy For Invasive Breast Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with invasive breast cancer who have had breast conserving surgery (BCS) or a mastectomy. The guideline reviews radiotherapy treatment according to lymph node status (positive or negative). Additionally, recommendations are provided for radiotherapy treatment with neoadjuvant chemotherapy, and the guideline discusses the risk of cardiac dose for patients with left-sided breast cancer and how this risk might be minimized.

Prostate Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline provides recommendations on management of prostate cancer, including diagnosis and screening, management stratified by risk, and follow up care. Active surveillance, surgery (radical prostatectomy), external beam radiotherapy (EBRT), low dose rate (LDR) brachytherapy, cryosurgery, High Intensity Focused Ultrasound (HIFU), Androgen Deprivation Therapy (ADT), and systemic therapies are discussed as treatment options. Bone health is also reviewed. Outcomes of interest include survival and recurrence.

Acute Myeloid Leukemia

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients over the age of 18 years with acute myeloid leukemia. The guideline reviews diagnosis, classification, ancillary tests, response criteria, prognosis/risk stratification, risk groups as per cytogenetic or molecular status, and management options. Treatments reviewed include chemotherapy, hematopoietic stem cell transplantation, and palliation. Follow up care is also discussed.

Guidelines for the Management of Febrile Neutropenia in Children

Year: 2015
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This is a guideline for management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem cell transplantation. The guideline reviews patient evaluation and provides recommendations on initial management, with considerations made to patient condition and whether or not they are already receiving empiric antibiotics. Recommendations are also provided for continued management of inpatients, management based on culture results, and management of fever in hematology/oncology patients who have completed therapy or are on therapy but are not neutropenic.

Second-Line Treatment of Metastatic Non-Small Cell Lung Cancer with Pemetrexed

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the treatment of metastatic non-small cell lung cancer. The guideline facilitates the safe and effective clinical use of pemetrexed for this population. The treatment intent is non-curative and meant to prolong overall survival and progression-free survival, as well as improve quality of life.

Evidence-Based Recommendations for the Management of Potentially Curable Esophageal Carcinoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for adult patients with potentially curable esophageal carcinoma. The guideline examines diagnosis with FDG-PET/CT, staging, and treatment options including chemoradiotherapy and brachytherapy. Outcomes of interest include staging accuracy and treatment response.

Treatment of BRAF V600 Mutated Advanced Melanoma with Trametinib

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the treatment of mutated advanced melanoma. The guideline facilitates the safe and effective clinical use of the systemic therapy trametinib. The treatment intent is to improve quality of life and decrease symptom burden.

Second-Line Treatment of Metastatic Melanoma with Ipilimumab

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the second line treatment of metastatic melanoma. The guideline facilitates the safe and effective clinical use of the systemic therapy ipilimumab. The treatment intent of this guideline is non-curative and to improve overall survival, as well as progression free survival.

First-Line Treatment of BRAF V600 Mutated Metastatic Melanoma with Vemurafenib

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the treatment of mutated metastatic melanoma. The guideline facilitates the safe and effective clinical use of the systemic therapy vemurafenib. The treatment intent of this guideline is non-curative and to improve overall survival, as well as progression free survival.

Treatment of Relapsed/Refractory Hodgkin Lymphoma with Brentuximab Vedotin

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with relapsed/refractory Hodgkin's lymphoma. The guideline examines treatment with brentuximab vedotin. Outcomes of interest include progression-free and overall survival.

Treatment of Chronic Lymphocytic Leukemia With Pentostatin, Cyclophosphamide and Rituximab

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with chronic lymphocytic leukemia. The guideline examines treatment with pentostatin, cyclophosphamide and rituximab (PCR) for patients who have undergone prior treatments including allogeneic stem cell transplant and fludarabine-based therapy. Outcomes of interest include minimized myelosupression and infection risk.

Treatment of Relapsed/Refractory Anaplastic Large Cell Lymphoma with Brentuximab Vedotin

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the treatment of relapsed/refractory anaplastic large cell lymphoma. The guideline facilitates the safe and effective clinical use of brentuximab vedotin. The treatment intent is non-curative and to improve progression-free survival and overall survival.

Provincial Consensus Recommendations on the Evaluation, Diagnosis and Management of a Suspicious Lateral Neck Mass

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the evaluation, diagnosis and management of a suspicious lateral neck mass in adults. Use of history and physical exam, X-ray, CT scan, and fine needle aspiration biopsy (FNAB) are discussed along with urgency of referral depending on results. Additionally, the guideline addresses the diagnosis or suspicion of lymphoma, as well as appropriate use of open biopsy.

First- or Second-Line Treatment of Metastatic or Locally Advanced Uterine Leiomyosarcoma with Fixed-Dose Rate Gemcitabine and Docetaxel

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the systemic first- or second-line treatment of metastatic or locally advanced uterine leiomyosarcoma. The guide facilitates the safe and effective clinical use of fixed-dose rate gemcitabine and docetaxel. Treatment outcomes are non-curative and look to prolong progression-free survival and overall survival.

Adjuvant Treatment of Completely Resected Stages I-IV Uterine Leiomyosarcoma with Fixed-Dose Rate Gemcitabine and Docetaxel

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the adjuvant treatment of completely resected stages I-IV uterine leiomyosarcoma. The guideline is intended to guide the safe and effective clinical use of fixed-dose rates of gemcitabine and docetaxel. Treatment outcomes are potentially curative and to improve progression-free survival, as well as overall survival.

Dose-Dense Paclitaxel Combined With Carboplatin for Advanced/Metastatic Ovarian Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a systemic therapy summary for the use of dose-dense paclitaxel combined with carboplatintherapy to treat adults with stage 2-4 ovarian/fallopian/peritoneal cancer (with curative intent or to prolong survival). Treatment regimen, drug dose, and administration are reviewed, along with pre-medications, supportive care, suggested outpatient prescriptions, and recommendations for clinical monitoring and follow-up care. The guideline also addresses adverse events, precautions, dose modifications, and drug interactions.

Bevacizumab, Paclitaxel and Carboplatin for Metastatic Cervical Carcinoma

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a systemic therapy summary for the use of bevacizumab, paclitaxel and carboplatin as therapy options for adults with recurrent, persistent or metastatic cervical cancer. Treatment regimen, drug dose, and administration are reviewed, and recommendations provided for clinical monitoring and follow-up care. The guideline also addresses adverse events, precautions, dose modifications, and drug interactions.

Post-Docetaxel Treatment of Metastatic Castrate‐Resistant Prostate Cancer With Abiraterone and Prednisone

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for patients with metastatic castrate-resistant prostate cancer who have been previously treated with docetaxel. The guideline provides recommendations on treatment with abiraterone and prednisone including treatment regimen and recommendations for pre-medications, supportive care, clinical monitoring and follow-up care. Additionally, adverse effects, precautions, dose modifications, and drug interactions are discussed.

First-Line Treatment of Advanced Renal Cell Carcinoma With Temsirolimus

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for patients with advanced or metastatic renal cell carcinoma (both clear cell and non-clear cell histology) with poor prognosis. The guideline provides recommendations for treatment with temsirolimus, including treatment regimen and recommendations for clinical monitoring and follow-up care. Pre-medication and supportive care is discussed along with adverse events, precautions, and drug interactions.

First-Line Treatment of Advanced Renal Cell Carcinoma With Oral Sunitinib

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This clinical practice guideline discusses the use of oral sunitinib as first-line treatment in patients with advanced/metastatic renal cell carcinoma of clear-cell histology who have an Eastern Cooperative Oncology Group (ECOG) performance status of less than or equal to 2 and who are of low to intermediate risk as defined by Memorial Sloan Kettering Cancer Centre (MSKCC) risk status. The guideline provides a treatment regimen and recommendations for clinical monitoring and follow-up care. Clinical toxicity assessment is discussed along with common or clinically important adverse events and drug interactions.

Provincial Consensus on Diagnostic and Treatment Recommendations for the Management of Rectal Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This clinical practice guideline provides recommendations on the diagnosis and treatment of rectal cancer in adult patients. Imaging procedures for staging are discussed with comparisons made between ultrasound, MRI, and CT scan. Treatment options include neoadjuvant and adjuvant chemotherapy as well as rectal cancer surgery, specifically total mesorectal excision (TME). Surgical management of recurrent rectal adenocarcinoma is also discussed.

Second-Line Treatment of Advanced Pancreatic Cancer with Oxaliplatin, Fluorouracil and Leucovorin (OFF Regimen)

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with advanced or metastatic pancreatic cancer. The guideline examines the use of oxaliplatin, fluorouracil and leucovorin in patients who had received, or were intolerant to, gemcitabine-based therapy. Outcomes of interest include progression-free and overall survival.

First-Line Treatment of HER2/neu Positive Locally Advanced, Recurrent or Metastatic Adenocarcinoma of the Stomach or Gastroesophageal Junction with Trastuzumab

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with human epidermal growth factor receptor 2 (HER2)/neu positive locally advanced, recurrent or metastatic adenocarcinoma of the stomach or gastroesophageal junction. The guideline examines the use of trastuzumab in conjunction with cisplatin and fluorouracil or capecitabine as a first-line treatment. Outcomes of interest include progression-free and overall survival.

First-Line Treatment of Metastatic Pancreatic Adenocarcinoma with FOLFIRINOX

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with metastatic pancreatic adenocarcinoma. The guideline examines the use of folfirinox - a combination of fluorouracil, oxaliplatin, leucovorin and irinotecan - as a first-line treatment. Outcomes of interest include progression-free and overall survival.

Third-Line Treatment of Stage IV or Advanced, Unresectable Colorectal Carcinoma with Cetuximab

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with stage IV or advanced, unresectable colorectal carcinoma. The guideline examines the use of cetuximab as a third-line therapy once other therapies, including fluoropyrimidines, oxaliplatin, or irinotecan, had been tried or when patients are intolerant to other options. Outcomes of interest include progression-free and overall survival.

A Canadian Evidence-Based Guideline for the First-Line Treatment of Follicular Lymphoma: Joint Consensus of the Lymphoma Canada Scientific Advisory Board

Year: 2015
AGREE II score: Unavailable
Developer organization: Lymphoma Canada Scientific Advisory Board
This is a clinical practice guideline for follicular lymphoma (FL). More specifically, this guideline is for the primary treatment of adult patients with FL. Guideline recommendations are guided by the following four questions: what treatment options should be considered for localized FL; how should asymptomatic advanced-stage FL be managed; what treatment options should be considered for symptomatic advanced-stage FL; and in which patients should additional treatment be considered (i.e., maintenance, consolidation, SCT).

Guideline for Referral of Patients with Suspected Prostate Cancer by Family Physicians and Other Primary Care Providers

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for referral of patients with suspected prostate cancer by family physicians and other primary care providers. More specifically, the guidelines provide recommendations for referral based on digital rectal examination (DRE) findings and prostate-specific antigen (PSA) test results. The research questions that guided the development of recommendations included: what 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; and what major, known risk factors increase the likelihood of prostate cancer in patients presenting with signs and/or symptoms of prostate cancer.

Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer Adapted for Nova Scotia

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This clinical practice guideline addresses care of adult patients with differentiated thyroid cancer, specifically within Nova Scotia. The guideline provides recommendations on pre-surgical evaluation of thyroid nodules, surgical treatment and complications, pathology reporting, grading and tumour staging (TNM), risk prognostic systems, and post-surgical radioactive iodine (RAI) therapy. Protocols for lab and diagnostic follow-up, management of local and regional recurrences, early and long-term follow-up, and supportive and palliative care management are also addressed.

The Management of Depression in Patients with Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for cancer patients. The guideline examines the screening, diagnosis, and management of depression in patients with major depressive disorder or who have a suspected depressive disorder. Outcomes of interest include improved health outcomes and reduced adverse events.

Person-Centred Care Guideline

Year: 2015
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This guideline addresses person-centred care for adults 18 years and older in Ontario using oncology services. The guideline discusses the importance of treating patients as individuals and provides recommendations on putting patients first and ensuring that essential requirements of care such as respect for the patient, patient concerns, nutrition, pain management and personal needs, patient independence, and consent and capacity, are met. Additionally, the guideline provides recommendations on tailoring healthcare service for each patient and enabling patients to actively participate in their care.

Imatinib Mesylate (Gleevec™) for the Treatment of Adult Patients With Unresectable or Metastatic Gastrointestinal Stromal Tumours: A Clinical Practice Guideline

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for the treatment of adult patients with unresectable or metastatic gastrointestinal stromal tumours. The guideline states that unresectable or metastatic gastrointestinal stromal tumours are often resistant to traditional methods of treatment like conventional chemotherapy. As such, the guideline focuses on the benefits and harms of imatinib mesylate as a form of treatment. The guideline therefore considers whether treatment with imatinib mesylate has a benefit in terms of tumour response, disease progression, survival or quality of life.

The Use of Systemic Treatment in the Maintenance of Patients With Non-Small Cell Lung Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on use of systemic treatment in the care of advanced, stage IIIB/IV patients who have non-small cell lung cancer (NSCLC) that has not progressed (i.e., complete response, partial response or stable disease) following four to six cycles of platinum-based chemotherapy and who have maintained an Eastern Cooperative Oncology Group performance status of 0 to 2. The guideline discusses use of pemetrexed, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), and use of maintenance chemotherapies, namely docetaxel and gemcitabine. Overall survival and quality of life were critical outcomes for the development of recommendations within this guideline.

Follow-up for Cervical Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for female patients who have received potentially curative primary treatment for cervical cancer. The guideline examines appropriate follow-up strategies including minimum levels of screening and follow-up intervals. Outcomes of interest include recurrences detected during screening and survival rates.

Multiparametric Magnetic Resonance Imaging in the Diagnosis of Clinically Significant Prostate Cancer

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for the diagnostic assessment of clinically significant prostate cancer. The guideline examines Multiparametric magnetic resonance imaging as an alternative to traditional transrectal ultrasound–guided systematic biopsy in order to reduce over- or under-diagnosis of clinical results. Outcomes of interest include detection rate of clinically significant prostate cancer, improved survival, and improved predictive value.

The Organization of Colposcopy Services in Ontario: Recommended Framework

Year: 2015
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
An organizational guideline for the provision of colonoscopies to patients with abnormal cervical screening results. The guideline examines the provision of consistent quality in colonoscopies, including training and competence, practices, and quality indicators. Important aspects include training program availability, referral criteria, and group vs. individual practice requirements.

An Organizational Guideline for Gynecologic Oncology Services

Year: 2015
AGREE II score: Unavailable
Developer organization: Gynecologic Oncology Organizational Guideline Development Group
An organizational guideline for the provisions of gynecologic oncology services by multidisciplinary professionals. The guideline examines the efficacy of specialist treatment, resource allocation, and the organization of work and services. Important aspects include the role of gynecologic oncologist, annual surgical case volumes, and minimum treatment standards.

Plerixafor for Autologous Hematopoietic Stem Cell Mobilization and Transplantation for Patients in Ontario

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for the use of plerixafor for autologous hematopoietic stem cell mobilization and transplantation in patients with hematologic cancers. The guideline examines administration with granulocyte-colony stimulating factor in patients who have or have not been mobilized before. Outcomes of interest include successful apheresis harvest, number of CD34+ cells collected, and survival rate.

Approach to Fever Assessment in Ambulatory Cancer Patients Receiving Chemotherapy

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with cancer who are receiving chemotherapy and experiencing fever, including patients with a solid tumour, lymphoma/myeloma/chronic lymphocytic leukemia, living at home, and/or with an unknown neutrophil count. This excludes hospital inpatients, patients in the emergency department, patients already diagnosed with febrile neutropenia, or with hematopoietic stem cell transplantation, acute leukemia, or myelodysplastic syndrome. The guideline provides recommendations on assessment of fever and provision of patient education. The guideline focuses on unfavourable outcomes including febrile neutropenia, infection, and death.

Provincial Non-Small Cell Lung Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for the management of patients with non-small cell lung cancer. The guideline examines screening for at-risk populations, diagnostic work-up, treatment, and follow-up. Outcomes of interest include clarified current standard of care through lobectomy and mediastina lymph node dissection, with additional treatment selections based on patient population.

Provincial Small Cell Lung Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for patients diagnosed with or suspected of having small cell lung cancer. The guideline reviews screening, work-up, and treatment for limited stage and extensive stage cancer. Recommendations are also provided on follow up care.

Provincial Unknown Primary of Head and Neck Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for the treatment of unknown primary head and neck cancer. An unknown or 'occult' primary is one where a primary tumour cannot be identified after appropriate investigation, in a patient with no prior history of head and neck cancer. The guideline provides recommendations on the initial workup of all patients with a neck mass, as well as recommendations for staging, management, and cases of recurrent disease.

Provincial Oropharyngeal Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for the diagnosis, staging, and treatment of oropharyngeal cancer. The guidelines provide recommendations on staging for primary tumour, regional lymph nodes, and distant metastases; management of invasive carcinoma of oropharynx, locally advanced resectable disease; post-operative adjuvant therapy options, post chemoradiation or post radiation evaluation; salvage therapy; radiation therapy; concurrent chemotherapy; and management of residual disease, loco-regional recurrent or distant metastases.

Provincial Oral Cavity Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for the treatment of oral cavity cancer. The guideline addresses staging, pre-treatment investigations. management with recommendations given by cancer stage (stage I and II, advanced (T3) and very advanced (T4B) and by site (anterior tongue, buccal mucosa, floor of mouth, retromolar trigone, and hard palate and alveolar ridge). Follow up care is also reviewed.

Provincial Nasopharyngeal Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for the assessment and management of patients with nasopharyngeal carcinoma. The guideline explores the etiology of nasopharyngeal carcinoma as well as the pathologic classification and staging. Recommendations are provided for assessment and include discussions of imaging and specimen collection. Additionally, the guideline explores appropriate management options and provides guidance on how to proceed in cases of suspected recurrent disease.

Provincial Laryngeal Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for the treatment of patients with laryngeal cancer. The guideline provides different treatment options by the following laryngeal divisions: glottic, supraglottic, and subglottic. The role of surgery, radiotherapy and chemotherapy are explored in this guideline.

Provincial Head and Neck Cancer Treatment Guidelines

Year: 2015
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for head and neck cancers, with specific epidemiological information for nasopharyngeal cancer. The guideline examines diagnostic work-up, follow-up, and treatment, primarily through systemic and chemotherapy treatments. Outcomes of interest include reduced local and distant failures through appropriate risk identification and improved regimens for induction chemotherapy.

Imatinib Mesylate (Gleevec™) for the Treatment of Adult Patients With Unresectable or Metastatic Gastrointestinal Stromal Tumours

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline reviews the use of imatinib in the treatment of adult patients with unresectable or metastatic gastrointestinal stromal tumours (GIST) expressing KIT (CD117+). Recommendations are provided on dosage and schedule. Outcomes of interest include overall and progression free survival, and quality of life.

Lenalidomide in Multiple Myeloma

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with multiple myeloma. The guideline reviews the use of lenalidomide as a treatment option for previously untreated or relapsed/refractory multiple myeloma as compared to non-lenalidomide treatments. Use of lenalidomide as a maintenance or consolidation treatment (following transplant and non-transplant treatments) is examined and strategies for managing toxicity are discussed. Outcomes of interest include disease progression, adverse events, safety, and overall survival.

Management of Early-Stage Hodgkin Lymphoma

Year: 2015
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on management of early-stage Hodgkin lymphoma. Chemotherapy alone, radiation therapy alone, and chemoradiation therapy are all reviewed as potential treatment options and provides recommendations on strategy, optimum radiation doses and schedule, and chemotherapy regimes. Outcomes of interest include overall survival, other measures of disease control (e.g. event-free survival or failure-free survival), and long-term adverse events, among others.

CUA Guidelines on the Management of Non-Muscle Invasive Bladder Cancer

Year: 2015
AGREE II score: Unavailable
Developer organization: Canadian Urological Association
A clinical practice guideline for patients with non-muscle invasive bladder cancer. The guideline examines management, emphasizing intravesical therapy and prognostic factors. Outcomes of interest include lower recurrence and longer disease-free intervals with transurethral resection of bladder tumours.

Pan-Canadian Practice Guideline: Screening, Assessment and Management of Psychosocial Distress, Depression and Anxiety in Adults with Cancer

Year: 2015
AGREE II score: Available
Developer organization: Canadian Association of Psychosocial Oncology
A clinical practice guideline for the screening, assessment and management of psychosocial distress, depression and anxiety in adults with cancer. The guideline examines appropriate clinical intervals for psychosocial screening, contributing factors, and interdisciplinary care. Outcomes of interest include improvement in cancer-related worry and reduced post traumatic stress.

Dose Objectives for Head and Neck IMRT Treatment Planning, Recommendation Report 2014

Year: 2014
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with head and neck cancer. The guideline examines the use of intensity modulated radiation therapy (IMRT) as a treatment method, with a particular focus on dose objectives. Recommendations are provided on dose limits and dose coverage for different regions of interest, while considering tolerance and the risk of early and late side effects.

Active Surveillance for the Management of Localized Prostate Cancer: Guideline Recommendations

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with low-risk prostate cancer. The guideline examines the role of active surveillance (AS) as a management strategy for low-risk prostate cancer patients, and aims to develop a standardized protocol to ensure that AS is offered to appropriate patients. Outcomes of interest include survival, and patient compliance.

Screening

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on cancer screening. The guideline consists of sub-sections including: the definition, purpose, attributes, and impact of a cancer screening program; the “what, who, and when” of screening, follow-up, and outcomes. It also provides recommendations for the clinician in using screening tests. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Required Reports for Referrals

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on required reports for referrals for: breast, gastrointestinal (esophagus, stomach, colon-rectum, anus, pancreas, liver, biliary tract/gall bladder), genitourinary (testis, prostate, bladder), gynecology (endometrium, cervix, ovary, vulva & vagina), head and neck (parotid & submandibular gland, thyroid, mouth, palate, nasopharynx, oropharynx, hypopharynx, nose & antrum, ear), lung, lymphoma and leukemia, melanoma, musculoskeletal and sarcoma, neuro-oncology, primary unknown, and skin (basal cell & squamous cell carcinomas, mycosis fungoides – Sezary syndrome). The guideline provides recommendations on pathology reports, operative reports, laboratory reports, and imaging reports. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Supportive Care

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the supportive care for cancer patients, including oral and dental care, pain and symptom management, febrile neutropenia, and osteoporosis. Topics of discussion include prevention and treatment, and palliative care. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Skin Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of skin cancers including melanoma and non-melanoma. Topics of discussion include potential precursors, surveillance and early detection, diagnosis and staging, and management. Additionally, referral information and management policies are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Primary Unknown Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of metastatic cancer of unknown primary site including primarily adenocarcinomas and undifferentiated carcinomas. Topics of discussion include diagnosis and staging, management, and follow-up. Additionally, diagnostic pathology and special patient clusters are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Neuro-Oncology Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of neurological cancers including five primary subgroups: astrocytoma, oligodendroglioma, ependymoma, meningioma, and pituitary adenoma. Topics of discussion include prevention, diagnosis and staging, management, and follow-up. Additionally, the use of corticosteroids and anticonvulsants are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Musculoskeletal & Sarcoma Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of musculoskeletal cancers including bone cancer and soft tissue sarcoma. Topics of discussion include prevention, diagnosis and staging, management, and follow-up. Additionally, diagnostic pathology, and treatment through chemotherapy, radiotherapy, and surgery are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Lymphoma, Chronic Leukemia, Myeloma Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of hematologic cancers including amyloidosis, chronic leukemia, Hodgkin's lymphoma and other forms of lymphoma, monoclonal gammopathy of unknown significance, multiple myeloma, and solitary plasmacytoma. Topics of discussion include diagnosis and staging, management, and follow-up. Additionally, biopsy procedures, protein studies, and immunizations for this population are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Lung Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of lung cancers including mesothelioma and thymomas. Topics of discussion include prevention, early detection, diagnosis and staging, and management. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Head and Neck Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of head and neck cancers including oral and dental care. Topics of discussion include predisposing factors, prevention, screening, early detection, diagnosis and staging, management, and follow-up. Additionally, oral care through chemotherapy, radiation therapy, and bone marrow transplantation are discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Gynecology Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on the management of gynecologic cancers including gynecological sarcomas and cancers of the ovary (epithelial and non-epithelial carcinomas), endometrium, uterine cervix, vulva, fallopian tube, gestational trophoblastic neoplasia, and vagina. Topics of discussion include diagnosis and staging, management, and follow-up. Additionally, prevention and screening are discussed for ovarian, endometrial, and cervical cancers. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Genitourinary Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on genitourinary cancer, with sub-sections on: prostate, bladder, kidney, testis, penis, scrotum, renal pelvis and ureter, and female urethra. Important aspects discussed in the guideline include: predisposing factors and prevention, screening and early detection, diagnosis, staging, and management. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Gastrointestinal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This guideline set provides recommendations on gastrointestinal cancer, with sub-sections discussing the following tumour sites: anus, bile duct, colon, esophageal and esophagogastric junction, gallbladder, liver, neuroendocrine tumours, lymphoma, gastro-intestinal stromal tumours (GIST), pancreas, rectum, small bowel, and stomach. Important aspects discussed in the guideline include: screening, diagnostic and staging, surgical therapy, staging, follow up and surveillance, and considers different treatment options. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

Breast Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: BC Cancer Agency
This is a clinical practice guideline for breast cancer. The guideline examines demographics and risk factors, prevention, screening and early detection, diagnosis, staging, management, and follow-up. Other important aspects explored in the guideline include: upper extremity rehab after axillary dissection, exercise for cardiovascular fitness, as well as benefits, risks, and costs. Please note that the sub-sections within this guideline were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline was accessed online.

Prophylaxis and Treatment of Venous Thromboembolism in Patients Undergoing Treatment for Solid Tumours

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for ambulatory and inpatients undergoing treatment for solid tumours, at risk for venous thromboembolism. The guideline examines appropriate surveillance and follow up, and treatment through anticoagulants. Outcomes of interest include improved recommendations for the elderly and clarified preoperative medication timelines.

Oncologic Emergencies: A Guide for Family Physicians

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the treatment of oncological emergencies related to cancer or anticancer therapy for family physicians. The guideline examines complications associated with cancer and cancer therapy, including diagnosis and treatment. Outcomes of interest include improved patient safety and reduced unnecessary treatment.

Follow-Up Surveillance of Soft Tissue Sarcoma

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients who have undergone treatment for soft tissue sarcomas. The guideline examines appropriate surveillance and follow up methods, including regular imaging and physical examination. Outcomes of interest include preference for x-rays over MRI or CT, and increased postoperative imaging.

Management of Malignant Pleural Effusion

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with suspected or diagnosed malignant pleural effusions. The guideline examines diagnosis and treatment for symptomatic and asymptomatic patients, including therapeutic thoracentesis. Outcomes of interest include improved relief of dyspnea and reduced hospital stay time.

Oral Cavity Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with suspected or diagnosed oral cavity cancer. The guideline examines diagnosis, treatment, and potential reconstruction depending on cancer stage and site-specificity. Outcomes of interest include improved functional outcomes through reconstruction and improved adjuvant therapy for patients with increased risk factors.

Metastatic Colorectal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with metastatic colorectal cancer. The guideline reviews surveillance and treatment options including surgery, radiotherapy, palliative chemotherapy and biological therapy. Outcomes of interest include survival (overall, progression-free), and toxicity.

Hepatocellular Carcinoma

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with hepatocellular carcinoma. The guideline provides recommendations on diagnostic assessment, staging, and management. Treatment options including resection, liver transplantation, radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), transarterial chemo-embolization (TACE), transarterial radioembolization (TARE), sorafenib, and stereotactic body radiotherapy (SBRT) are reviewed.

Stages II and III Colorectal Cancer Surveillance

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over the age of 18 years with stage II or III colorectal cancer. The guideline discusses follow-up care and provides recommendations regarding the timing and appropriateness of surveillance tests/procedures including CEA testing, colonoscopy, PET scans and CT scans. The guideline also discusses how physicians can educate patients about adopting healthy lifestyle behaviours to improve survival outcomes.

Adenocarcinoma of the Pancreas

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with pancreatic cancer. The guideline reviews diagnostic work-up, staging, and treatment options for both potentially curable and unresectable pancreatic cancer. Comparisons are made between FOLFIRINOX and gemcitabine chemotherapy regimes. Outcomes of interest include survival, adverse events, and response rate.

Uveal Melanoma

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with malignant uveal melanoma. The guideline reviews diagnosis and work-up, primary management, adjuvant therapy, management of patients with metastatic disease, and management of high risk patients. Follow-up care is also discussed. Outcomes of interest include efficacy of treatments and imaging modalities.

Seizure Management in Patients with Primary and Metastatic Brain Tumours

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over the age of 18 years with primary or metastatic brain tumours. The guideline provides recommendations on the management of seizures caused by brain tumours. Treatment options discussed include antiepileptic drugs, surgery, and radiation therapy. The guideline also reviews driving guidelines for those patients experiencing seizures, particularly in the context of the province of Alberta and the associated Alberta Transportation rules and regulations.

Medulloblastoma

Year: 2014
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice guideline for the treatment of newly diagnosed and recurrent or relapsed medulloblastoma in adult patients. The guideline examines MRI workup, surgery with maximal safe resection, and management of localized and non-localized recurrence. Outcomes of interest include improved long-term survival rates with maximal excision and improved local control with postoperative radiotherapy.

Management of Primary Germ Cell Tumours of the Central Nervous System

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over the age of 18 years with primary germ cell tumours (GCTs) of the central nervous system. The guideline discusses staging and diagnosis, treatment, and follow-up care. Recommendations for treatment options are provided for germinoma and nongerminomatous GCT, and are stratified by whether disease is localized or metastatic. Additional recommendations are made for recurrent treatment, again stratified by histology.

Management of Recurrent High-Grade Gliomas

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over the age of 18 years with recurrent high-grade gliomas, including grade III anaplastic astrocytomas, anaplastic oligodendrogliomas, anaplastic oligoastrocytomas and grade IV glioblastomas. The guideline discusses diagnostic assessment for recurrence, and treatment options including systemic therapy, surgery, and re-irradiation. Factors of consideration when determining treatment course are also discussed.

Neo-Adjuvant (Pre-Operative) Therapy for Breast Cancer – General Considerations

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients 18 years or older with non-metastatic breast cancer. The guideline discusses neo-adjuvant therapy for breast cancer, including eligibility, advantages and dis-advantages, available therapies. Optimal treatment monitoring, surgical considerations, and the role of radiotherapy are also discussed. Outcomes of interest include prognostic factors, response rate, accuracy of diagnostic procedures, survival (disease-free, overall), and relapse rate.

Adjuvant Systemic Therapy for Early Stage (Lymph Node Negative and Lymph Node Positive) Breast Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a guideline for adjuvant systematic therapy for early stage (lymph node negative and lymph node positive) breast cancer. The guideline discusses risk categories for lymph node negative breast cancer, provides treatment recommendations for lymph node negative breast cancer, and explores chemotherapy options for lymph node negative breast cancer. Other areas of interest include: treatment recommendations for lymph node positive breast cancer, chemotherapy options for lymph node positive breast cancer, and adjuvant hormonal therapy for hormone receptor positive disease only.

Adjuvant Radiation Therapy for Ductal Carcinoma In Situ

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline practice guideline for adult patients with ductal carcinoma in situ (DCIS) who have had breast-conserving surgery or a mastectomy. The guideline considers what the optimal radiotherapy treatment after surgery would be for patients with DCIS, as well as how a close radial margin of excision should be handled following breast conserving surgery. Additional areas of interest include: toxicity and side effects of radiotherapy.

Adjuvant Radiation Therapy for Invasive Breast Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with invasive breast cancer who have had breast-conserving surgery or a mastectomy. The guideline examines what is the optimal radiotherapy treatment after surgery for patients with T1, T2, T3, T4 invasive breast cancer according to lymph node status. Other outcomes of interest include: the manner in which a positive margin should be handled for patients with breast conserving surgery, as well as what the optimal radiotherapy treatment after surgery should be for patients with invasive breast cancer who have had neoadjuvant chemotherapy.

Adjuvant Interferon for Malignant Melanoma

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults with malignant melanoma. The guideline considers whether adjuvant interferon alpha should be offered to patients who have been rendered disease-free following the resection of cutaneous melanomas and who are at high risk for subsequent recurrence. Issues discussed include: steps of treatment, potential side effects, special considerations (such as toxicity, and patient education), and follow-up.

Palliative Radiotherapy: Brain Metastases

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients, with single or multiple brain metastases, arising from cancer of any histology, excluding germ cell tumours and hematologic malignancies. The guideline examines strategies for the management and treatment of adults with: a newly diagnosed solitary brain metastasis, newly diagnosed multiple brain metastases, as well as progressive or recurrent brain metastases. Management and treatment options explored vary by whether the metastatic disease is solitary, multiple, recurrent or progressive but include: neurosurgery, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), as well as supportive care.

Management of Patients With Early Esophageal Cancer, Dysplastic and Non-Dysplastic Barrett’s Esophagus

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for the management of patients with early esophageal cancer, dysplastic and non-dysplastic Barrett's esophagus. This guideline examines treatment options and considers in what clinical situations endoscopic therapy is the most appropriate treatment. Treatment options explored and discussed include: endoscopic mucosal resection, radiofrequency ablation, photodynamic therapy, argon plasma coagulation, and multipolar electrocoagulation.

Guidelines for the Management of Febrile Neutropenia

Year: 2014
AGREE II score: Unavailable
Developer organization: Atlantic Provinces Pediatric Hematology Oncology Network
This clinical practice guideline is for children with cancer and/or undergoing hematopoietic stem cell transplantation. The guideline reviews evaluation and management of fever and neutropenia, including initial empiric antibiotic selection, continued management of inpatients, and management based on culture results. Management of fever in hematology/oncology patients who have completed therapy and/or are on therapy but are not neutropenic is also discussed.

Menstrual Suppression in Special Circumstances

Year: 2014
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This clinical practice guideline provides recommendations for menstrual suppression in patients undergoing cancer therapy in whom menstruation may have a deleterious effect on their health, or in patients with physical and/or cognitive challenges. The guideline reviews circumstances within which it is appropriate to suppress menstruation and discusses reversible hormonal options for suppression. Outcomes of interest include efficacy and safety of hormonal options for suppression.

Guideline for Primary Antifungal Prophylaxis for Pediatric Patients with Cancer or Hematopoietic Stem Cell Transplant Recipients

Year: 2014
AGREE II score: Available
Developer organization: C17 Children's Cancer & Blood Disorders
A clinical practice guideline for pediatric patients with hematopoietic cancer or receiving stem cell transplants. The guideline examines antifungal prophylaxis to prevent invasive fungal infections, primarily through fluconazole. Outcomes of interest include lower rates of fungal related mortality and improved optimal pediatric dosing.

Guideline for the Prevention and Treatment of Anticipatory Nausea and Vomiting due to Chemotherapy in Pediatric Cancer Patients

Year: 2014
AGREE II score: Available
Developer organization: Pediatric Oncology Group of Ontario
A clinical practice guideline for adult and pediatric patients undergoing chemotherapy for cancer. The guideline examines the prevention and treatment of chemotherapy induced nausea and vomiting through both psychosocial and pharmacological interventions. Outcomes of interest include moderate improvement with minimal risk through non-pharmacological means, and reduction of negative stimuli.

Genital Tract Cancers in Females: Ovarian, Fallopian Tube, and Primary Peritoneal Cancers

Year: 2014
AGREE II score: Unavailable
Developer organization: Guidelines and Protocols Advisory Committee
This is a clinical practice guideline for female patients aged 19 and older. The guideline provides recommendations on screening, diagnosis, treatment, and follow-up care of ovarian, fallopian tube, and primary peritoneal cancers. Prevention and risk reduction strategies are also reviewed.

Genital Tract Cancers in Females: Endometrial Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Guidelines and Protocols Advisory Committee
This is a clinical practice guideline for female patients aged 19 and older. The guideline provides recommendations on the screening, diagnosis, treatment, and follow-up care of endometrial cancer. Prevention and risk reduction strategies are also discussed.

Genital Tract Cancers in Females: Human Papillomavirus Related Cancers (Cervical, Vaginal & Vulvar)

Year: 2014
AGREE II score: Unavailable
Developer organization: Guidelines and Protocols Advisory Committee
This is a clinical practice guideline for female patients aged 9 and above. The guideline provides recommendations on screening, diagnosis, treatment, and follow-up care of human papillomavirus (HPV) related cancers including cervical, vaginal, and vulvar. Special topics of interest include an overview of HPV vaccines and a discussion on controversies in care, including screening intervals and age to stop screening.

Provincial Pancreatic Cancer Treatment Guidelines

Year: 2014
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with pancreatic cancer. The guideline examines assessment and treatment, primarily through radical resections including Whipple procedures. Outcomes of interest include reduced chemotherapy toxicity with gemcitabine and improved follow-up procedures.

Provincial Hepatocellular Cancer Treatment Guidelines

Year: 2014
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for adult and pediatric hepatocellular cancer patients. The guideline examines assessment and treatment for both curative and non-curative therapies. Outcomes of interest include clarified follow-up timing and early involvement of supportive care.

Provincial Gastric and Gastro-Esophageal Junction Cancer Treatment Guidelines

Year: 2014
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for gastric and gastro-esophageal junction cancer patients. The guidelines examines assessment by a multidisciplinary team, and treatment options including gastrectomy and endomucosal resection. Outcomes of interest include increased survival through combination therapy and potential benefit from biomarker targeted therapies.

Provincial Biliary Tract & Gall Bladder Cancer Treatment Guidelines

Year: 2014
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with biliary tract and gall bladder cancers. The guidelines examines assessment and treatment based on disease staging or re-staging, primarily thought chemotherapy or surgery. Outcomes of interest include improved nutritional supplementation and reduced need for follow-up imaging.

Provincial Esophageal and Gastro-Esophageal Junction Cancer Treatment Guidelines

Year: 2014
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with esophageal cancer and gastro-esophageal junction cancer. The guideline examines diagnostic assessment and proposed treatment based on cancer staging, with a focus on chemoradiation and surgical therapies. Outcomes of interest include improved recommendations for patients with good and poor performance.

Neoadjuvant Treatment of Primary Breast Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for patients with a pathological confirmed diagnosis of breast cancer. The guideline reviews diagnostic assessment, staging, and neoadjuvant treatment regimes depending on whether breast cancer is operable or inoperable. The guideline also discusses challenges involved with neoadjuvant therapy.

Treatment of Borderline Resectable and Locally Advanced Pancreatic Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for patients diagnosed with borderline resectable or locally advanced pancreatic cancer. The guideline reviews pre-treatment staging, therapeutic options including biliary decompression and neoadjuvant therapy, chemotherapy with and without gemcitabine, chemoradiation therapy (CRT), induction chemotherapy and CRT, and radiological re-evaluation. Outcomes of interest include survival (median, overall, progression-free), treatment toxicity, adverse events, and surgical resectability rates.

Neo-adjuvant Treatment of Stage II and Stage III Rectal Cancer

Year: 2014
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for patients with a pathological confirmed diagnosis of locally advanced rectal cancer following appropriate radiological staging investigations. The guideline reviews treatment options including chemoradiation regimes and timing (adjuvant vs neo-adjuvant). Treatment related toxicities are also discussed. Outcomes of interest include overall survival, local recurrence, tumour response, and toxicity (acute and chronic).

Follow-up and Surveillance of Curatively Treated Lung Cancer Patients

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with small cell and non-small cell lung cancer who have undergone curative treatment. The guideline examines screening and disease control through imaging and follow-up visits to prevent recurrence. Outcomes of interest include increased follow-up recommendations for the first two years after treatment, when recurrence is most likely to occur.

Arsenic Trioxide for Acute Promyelocytic Leukemia

Year: 2014
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline for the treatment of acute promyelocytic leukemia with arsenic trioxide. The treatment is intended to be curative and to decrease regimen toxicity. Developers noted that acute promyelocytic leukemia is a rare subtype of acute leukemia (2.5 new cases in Manitoba per year in the last 10 years).

The Use of Indoor Tanning Devices and the Risk of Developing Cutaneous Malignant Melanoma: A Systematic Review and Clinical Practice Guideline

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients at risk of developing melanoma due to the use of indoor tanning devices. The guideline examines risk due to use, impact of age, and frequency of use as it relates to cutaneous malignant melanoma. Outcomes of interest include relative risk and increased risk.

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib (Iressa®), Erlotinib (Tarceva®), Afatinib, Dacomitinib or Icotinib in the Treatment of Non–Small-Cell Lung Cancer: A Clinical Practice Guideline

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This practice guideline examines the use of EGFR tyrosine kinase inhibitors (EGFR TKI) for treatment of adult patients with advanced (stage IIIB or IV) non– small-cell lung cancer. The guideline provides recommendations on the sequence of chemotherapy and EGFR TKIs is reviewed, and discusses whether clinical characteristics (i.e. Asian ethnicity, female sex, adenocarcinoma histology and light/never smoking status) or molecular characteristics (presence of activating mutations of the EGFR gene, EGFR gene copy number, or EGFR protein overexpression) should influence use of EGFR TKIs. Outcomes of interest include overall survival, progression-free survival (PFS), response rate and quality of life.

Optimization of Preoperative Assessment in Patients Diagnosed with Rectal Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with rectal cancer who are newly diagnosed. The guideline provides recommendations on investigations to assess for metastases and synchronous lesions, imaging for local staging, optimal MRI protocol and criteria for local staging, optimal MRI criteria to select patients for neoadjuvant therapy, the role of multidisciplinary cancer conferences and the role of restaging MRI after neoadjuvant therapy.

Continuous versus Intermittent Chemotherapy Strategies in Inoperable, Advanced Colorectal Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients (18 years or older) with inoperable, advanced (Stage IV) colorectal cancer. The guideline provides recommendations on the use of intermittent systemic treatment strategies. Outcomes of interest include overall response rate, survival (overall, progression-free, failure free), toxicity, and quality of life.

Strategies of Sequential Therapies in Unresectable, Metastatic Colorectal Cancer Treated With Palliative Intent

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients (18 years or older) with unresectable metastatic colorectal cancer. The guideline provides recommendations on sequential chemotherapy strategies for treatment with palliative intent. The cytotoxic agents discussed include initial fluoropyrimidine (5-FU or capecitabine) either alone or in combination, irinotecan and oxaliplatin. Outcomes of interest are overall survival, toxicity, and quality of life.

Systemic Therapy for Recurrent, Metastatic, or Persistent Cervical Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations on use of systemic therapy for women with metastatic, recurrent, or persistent cervical cancer including women with squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix. The guideline discusses use of cisplatin-paclitaxel, cisplatin-vinorelbine, cisplatin gemcitabine, and cisplatin-topotecan, and reviews the substitution of carboplatin for cisplatin in any of these combinations. Additionally, the indications for use of bevacizumab in combination with cisplatin-paclitaxel or carboplatin-paclitaxel are discussed. Primary outcomes of interest are overall survival and quality of life, with other outcomes of consideration including response rate, progression-free survival rate, and adverse effects

Optimal Systemic Therapy for Early Female Breast Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for female patients with early stage invasive breast cancer. The guideline examines systemic therapy selection based on patient and disease characteristics, and recurrence risk. Outcomes of interest include breast cancer-free intervals, disease-free survival, and clinically complete response.

Sentinel Lymph Node Biopsy in Vulvar Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline provides recommendations in relation to sentinel lymph node biopsy (SLNB) in vulvar cancer. The guideline seeks to determine whether 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). Additionally, the guideline provides guidance with respect to the appropriate techniques and procedures in SLNB for women with early-stage vulvar cancer. These include: the selection of appropriate patients; determining the appropriate technique, and management of patients with positive sentinel lymph nodes.

Sentinel Node Biopsy in Primary Cutaneous Melanoma

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline reviews the use of sentinel node biopsy (SLNB) as a diagnostic tool for adult patients with malignant melanoma. The guideline reviews indications and contraindications of SLNB, pathological examination of the sentinel nodes, and indications for therapeutic node dissection and recommended extent of dissection. The use of ultrasound-guided fine-needle aspiration is also discussed. Outcomes of interest include test sensitivity, specificity, and positive and negative predictive value, as well as rate of nodal recurrence and survival.

Management of Febrile Neutropenia in Adult Cancer Patients

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline reviews the risk factors, assessment, treatment and overall management of febrile neutropenia in adult cancer patients. Combination therapy, monotherapy, and empiric vancomycin are discussed as treatment options and recommendations are provided for dosage and schedule. Outcomes of interest include success rate of antibiotic treatment, failure rate, survival, and mortality.

Safe Administration of Systemic Cancer Therapy Part 2: Administration of Chemotherapy and Management of Preventable Adverse Events

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A practice and professional guideline for the safe administration of systemic therapies, specifically chemotherapy, to patients by organizations that provide systemic cancer treatment. The guideline examines the appropriate selection of devices for vascular access, complications factors based on points of care, and recommended nursing practices. Key aspects include reducing fatal outcomes and improved organizational safety policies.

Sunitinib Malate for Gastrointestinal Stromal Tumour (GIST) in Imatinib Mesylate Resistant Patients

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with unresectable or metastatic/recurrent gastrointestinal stromal tumours that have become resistant or intolerant to imatinib mesylate. The guideline examines the efficacy of sunitinib malate as an alternative, and reviews what dosing regimens could be observed. Outcomes of interest include partial response, but no difference in quality of life.

The Management of Thymoma: A Systematic Review and Practice Guideline

Year: 2014
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with locally advanced, unresectable, and recurrent thymoma. The guideline examines treatment options, primarily surgical resection, as well as preferred approaches to therapy. Outcomes of interest include ranged overall survival, and improved recommendations for patients medically unfit for surgery.

Alemtuzumab in Chronic Lymphocytic Leukemia

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with chronic lymphocytic leukemia (CLL). This guideline examines the use of alemtuzumab, and its associated adverse treatment-related toxicities. Although no definitive data on quality of life or overall survival was identified, case-series studies suggest alemtuzumab could still be a reasonable option for patients with progressive and symptomatic CLL.

Systemic Therapy for Advanced or Recurrent Endometrial Cancer, and Advanced or Recurrent Uterine Papillary Serous Carcinoma

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with advanced stage or recurrent endometrial cancer. The guideline examines the use of chemotherapy, specifically combination chemotherapy, and hormonal therapy with a specific focus on the use of cisplatin, doxorubicin, and paclitaxel. Outcomes of interest include reduced adverse effects, and improvements in progression-free survival and overall survival.

Management of Stage I Seminoma

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with stage 1 testicular seminoma. The guideline outlines treatment options including radiotherapy and chemotherapy, and provides recommendations on follow-up surveillance. Outcomes of interest include cancer-specific survival, long-term toxicity (including second malignancy), and quality of life.

Adjuvant Radiotherapy Following Radical Prostatectomy for Pathologic T3 or Margin-Positive Prostate Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for male patients who have undergone radical prostatectomy for clinically localized prostate cancer and who have been found to have either positive surgical resection margins (R1), tumour extension beyond the prostatic capsule (pT3a), seminal vesicle invasion (pT3b), or more than one of these features. The guideline provides recommendations on the use of adjuvant radiotherapy following radical prostatectomy. Outcomes of interest include survival (prostate cancer-specific, metastasis-free, biochemical progression-free, and locoregional recurrence-free), time to initiation of androgen deprivation therapy, toxicity (acute and late), and quality of life.

Systemic Therapy for Advanced Gastric Cancer

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with advanced (non-resectable; either locally advanced or metastatic) adenocarcinoma of the gastroesophageal junction (but not with squamous cell carcinoma). The guideline provides recommendations on chemotherapy treatment with review of chemotherapy agents by class, as well as comparison of 5-fluorouracil (CIV)/epirubicin/cisplatin regimens vs. other chemotherapy. The guideline also discusses the contribution of targeted therapies. Outcomes of interest including overall survival, objective response rate (complete plus partial response), time to disease progression, adverse effects, and quality of life.

Chronic Lymphocytic Leukemia

Year: 2014
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients over 18 years of age with possible chronic lymphocytic leukemia. The guideline reviews the management of chronic lymphocytic leukemia, including diagnosis and prognosis, first-line and second-line treatment options, and follow-up and supportive care. Outcomes of interest include survival (overall and progression-free), toxicity, overall response, and quality of life.

Locoregional Therapy of Locally Advanced Breast Cancer (LABC)

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for the treatment of female patients with locally advanced breast cancer. The guideline includes consideration of the role of breast-conserving surgery as compared with mastectomy. Other important aspects explored in the guideline include the role of radiotherapy following a mastectomy, as well as the treatment options for those female patients with locally advanced breast cancer who do not respond to initial neoadjuvant therapy.

Best Practice Guideline for the Management of Cancer-Related Distress in Adults

Year: 2014
AGREE II score: Available
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for health-care providers (HCPs) to help screen, identify and manage cancer-related distress experienced by individuals diagnosed with cancer and their families. This guideline seeks to assist HCPs to become aware/sensitive to cancer-related distress; educate HCPs about management strategies for cancer-related distress; identify referral options for management of cancer-related distress by front-line HCPs; provide direction for cancer-related distress management and treatment options; assist front-line HCPs to identify and access appropriate specialist psychosocial care referral; and support the provision of person-centred care with a focus on cancer-related distress.

The Organization and Delivery of Healthcare Services for Head and Neck Cancer Patients

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical and organizational guideline for the management and delivery of services to head and neck cancer patients. The guideline examines delivery of care, healthcare qualifications, and infrastructure factors related to treatment and follow up. Important aspect include multidisciplinary team requirements including certifications and minimum patient volumes, and appropriate wait times for assessments and therapies.

Gastric Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over the age of 18 with gastric cancer. The guideline discusses diagnostic work-up, staging, and treatment recommendations. Outcomes of interest include survival (overall and five-year progression-free), and side effects of therapy.

Esophageal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with esophageal cancer, including both squamous cell and adenocarcinoma. The guideline provides recommendations on diagnostic work-up, staging, treatment options for potentially curable cancer, and management options for incurable cancer. Outcomes of interest include survival (overall, progression-free, 5-year), morbidity, toxicity, and rate of sudden death.

Early Stage Rectal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with early stage rectal cancer. The guideline reviews diagnostic work-up, staging, and treatment options including surgical resection and chemotherapy.

Early Stage Colon Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over 18 years of age with early stage colon cancer. The guideline provides recommendations on diagnostic work-up, staging, and treatment including a review of recommended chemotherapy regimes.

Anal Canal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over 18 years of age with squamous cell carcinomas that arise in the anal canal. The guideline discusses diagnostic work-up, staging, and the goals of therapy and recommendations for both potentially curable, locally recurrent, and metastatic cancer of the anal canal. Follow-up care is also reviewed.

Cholangiocarcinoma and Gallbladder Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with biliary tract cancer. The guideline examines management, with specific focus on surgical resection for potentially resectable disease and palliative radiotherapy for unresectable disease. Outcomes of interest include improved recommendations for establishing resectability and reductions in endoscopic retrograde cholangiopancreatogram.

Therapeutic Use of Myeloid Growth Factors for Chemotherapy-Induced Neutropenia in High Risk and Intermediate Risk Patients

Year: 2013
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for patients who are receiving systemic therapy for solid tumors, lymphoma and non-myeloid malignancies, and that are deemed at increased risk for developing febrile neutropenia as a result of myelosuppression. The guideline reviews the therapeutic use of myeloid growth factors (granulocyte-colony stimulating factors (G-CSFs), filgrastim and pegfilgrastim) in the prevention of chemotherapy induced neutropenia (CIN) according to patient risk for developing CIN.

Sentinel Node Biopsy in Breast Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a guideline for patients who have been diagnosed with cancer of the breast and meet the selection criteria for sentinel lymph node biopsy (SLNB). The guideline reviews SLNB versus axillary lymph node dissection (ALND) and provides recommendations on patient selection, optimal technique for the use of SLNB, and surgical training. Recommendations are provided for managing challenging situations including ALND when SN is positive, intraoperative assessment of SN(s), ductal carcinoma in situ (DCIS), and multiple sentinel nodes.

Pre-operative Staging of Primary Rectal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Eastern Health
This clinical practice guideline provides recommendations on optimal staging investigations for patients with newly diagnosed primary cancer of the rectum. Diagnostic procedures are reviewed including digital rectal examination (DRE), rigid proctoscopy, total colonoscopy, Intraluminal Endoscopic Ultrasound (EUS), Magnetic Resonance Imaging (MRI), Computed Tomography (CT) , and Fluorodeoxyglucose Positron Emission Tomography (FDG-PET)/CT Scanning. Outcomes of interest include test sensitivity and specificity.

The Role of Surgery in Endometrial Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This is a clinical practice guideline for patients with endometrial cancer. The guideline discusses limited surgery and extended surgical staging, with recommendations on the extent of surgery depending on low- or high-risk disease type. Outcomes of interest include prognostic value, survival (disease-free and overall), and negative predictive value and sensitivity of staging techniques.

The Role of Adjuvant Therapy in Endometrial Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This is a clinical practice guideline for women with endometrial cancer. The guideline provides recommendations on adjuvant therapy after surgical treatment. Radiotherapy and chemotherapy options are discussed. Postoperative progression-free and overall survival are the primary outcomes of interest.

Epidemiology and Investigations for Suspected Endometrial Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This is a clinical practice guideline for women with possible endometrial cancer. The guideline reviews the epidemiology of endometrial cancer and provides recommendations on diagnostic workup. Diagnostic procedures include biopsy, hysteroscopy, dilation and curettage, pelvic ultrasound, CT scan, and MRI. Outcomes of interest include accuracy, sensitivity, and specificity of diagnostic tests.

Breast Disease and Cancer: Diagnosis

Year: 2013
AGREE II score: Unavailable
Developer organization: Guidelines and Protocols Advisory Committee
This is a clinical practice guideline for women aged 19 or greater. The guideline reviews investigation of breast complaints and/or symptoms, diagnostic assessment stratified by age and risk, and management of common breast diseases. Referral criteria for genetic counselling is also discussed.

Breast Cancer: Management and Follow-up

Year: 2013
AGREE II score: Unavailable
Developer organization: Guidelines and Protocols Advisory Committee
This is a clinical practice guideline for women over 19 years of age who have biopsy-proven breast cancer. The guideline provides recommendations on specialist referral, treatment, and follow-up care including surveillance for breast cancer recurrence or new cancer, monitoring and treating complications and/or treatment side effects, and providing patient support.

Guidelines for the Management of Malignant Melanoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline for patients with malignant melanoma. The guideline examines management from diagnosis to follow-up, including referral processes, recommendations for pregnant patients, and supportive care. Outcomes of interest include improved recommendations for the timing and efficacy of sentinel lymph node biopsy, which is generally recommended as a first-line staging tool.

Canadian Guidelines for Postoperative Surveillance of Upper Urinary Tract Urothelial Carcinoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Canadian Urological Association
A clinical practice guideline for postoperative patients treated for upper urinary tract urothelial carcinoma. The guideline examines postoperative surveillance based on risk of recurrence, including standard physical examination, laboratory pathology, cytology, and uteroscopy. Outcomes of interest include optimal surveillance duration and reduced recurrence.

CUA-CUOG Guidelines for the Management of Castration-resistant Prostate Cancer (CRPC): 2013 Update

Year: 2013
AGREE II score: Unavailable
Developer organization: Canadian Urological Association
This is a clinical practice guideline for patients with castration-resistant prostate cancer. The guideline reviews management options including detection of metastases and imaging, androgen receptor (AR) signalling therapeutic options, first- and second-line systemic corticosteroid therapy, palliative radiation, and bone targeted therapy. Outcomes of interest include survival, pain, quality of life, skeletal-related events, and disease control.

A Pan-Canadian Practice Guideline: Prevention, Screening, Assessment and Treatment of Sleep Disturbances in Adults With Cancer

Year: 2013
AGREE II score: Available
Developer organization: Canadian Partnership Against Cancer
This is a clinical practice guideline for adult patients with cancer. The guideline reviews screening, assessment, and management of cancer-related sleep disturbance (insomnia and insomnia syndrome). Both pharmacological and non-pharmacological interventions are reviewed. Outcomes of interest include sleep quality, efficiency, onset latency, duration, and disturbance.

Recommendations on Screening for Prostate Cancer With the Prostate-specific Antigen Test

Year: 2013
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
A clinical practice guideline for men in the general population at risk for prostate cancer. The guideline examines prostate-specific antigen testing with or without digital rectal examination, and when prostate-specific antigen testing is considered a necessary and appropriate screening technique. Outcomes of interest include reduced overdiagnosis and false-positive testing.

Provincial Colorectal Cancer Treatment Guidelines

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with colorectal cancer. The guideline examines work up steps, and includes recommendations for resectable and unresectable colon and rectal cancers. Outcomes of interest include high response rates with combination chemotherapy and improved therapies for K-RAS mutated tumours.

Practice Guidelines for the Management and Prophylaxis of Thrombosis in Cancer Patients

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with cancer who may be at risk for pulmonary embolism or deep venous thrombosis. The guideline examines treatment and dosage recommendations for deep venous thrombosis and special treatment circumstances, including treatment for patients on anticoagulants. Outcomes of interest include improved dosing recommendations for patients with renal impairments.

Provincial Vulva Cancer Treatment Guidelines

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for adult patients with squamous cell carcinoma of the vulva. The guideline examines management of vulvar cancer based on staging, and follow-up protocols. Outcomes of interest include endorsement of sentinel lymph node biopsy as a standard of care and improved referral recommendations.

Provincial Gestational Trophoblastic Neoplasia

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for adult patients with gestational trophoblastic neoplasia including invasive mole, gestational choriocarcinoma, and placental site trophoblastic tumours. The guideline examines management, including concurrent diagnoses and chemotherapy recommendations. Outcomes of interest include reduced congenital malformations in future pregnancies, and improved response rates in maintenance chemotherapy.

Provincial Endometrium Cancer Treatment Guidelines

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with endometrial cancer. The guideline examines diagnosis and treatment options for pre- and post-menopausal women, with specific focus on the surgical extent of treatment. Outcomes of interest include improved recommendations for laparoscopy and improved accuracy of lymphadenectomy for staging.

Provincial Cervical Cancer Treatment Guidelines

Year: 2013
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with a positive diagnosis for cervical cancer. The guideline examines diagnosis and staging, and provides treatment recommendations based on cancer stage. Specific recommendations are also provided for pregnant patients. Outcomes of interest include improved use of adjuvant post-operative radiotherapy based on pathological findings.

First-Line Treatment of Newly Diagnosed Chronic Lymphocytic Leukemia (CLL) with Fludarabine, Cyclophosphamide, and Rituximab (FCR Regimen)

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
A clinical practice guideline for patients with newly diagnosed chronic lymphocytic leukemia (CLL). The guideline examines first-line treatment of CLL with fludarabine, cyclophosphamide, and rituximab (FCR Regimen). Outcomes of interest include progression-free and overall survival.

Primary Curative Therapy for Head and Neck Squamous Cell Carcinoma with Cetuximab in Combination with Radiation

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This is a clinical practice guideline that facilitates the safe and effective clinical use of cetuximab in combination with radiation as the primary curative therapy for head and neck squamous cell carcinoma in the adult population. This guidelines specifically considers patients with contraindications to platinum based chemotherapy and/or those over the age of 70.

First-Line Palliative Treatment of Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma With Cetuximab, Platinum, and 5 FU

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Manitoba
This practice guideline reviews first-line palliative treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma. The use of cisplatin with 5-fluorouracil with or without cetuximab is compared, and recommendations are provided for treatment regimen, laboratory tests (baseline, weekly, and per cycle), clinical considerations, and assessment of treatment response. Dose modifications are also discussed.

Screening High-Risk Populations for Lung Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline on the screening of high-risk patients for lung cancer using LDCT scanning. Risk factors are reviewed and recommendations are provided for duration and interval of screening. The guideline also discusses positive results and appropriate follow-up procedures. Outcomes of interest include effectiveness of screening, false positive rate, complication rate, and risk of death from radiation exposure.

Guidelines for Breast, Cervical and Colorectal Cancer Screening

Year: 2013
AGREE II score: Unavailable
Developer organization: CancerCare Manitoba
This guideline provides screening recommendations for breast, cervical, and colorectal cancer, based on age and risk factors. Management of test results including mammography, cytology, occult blood test (FOBT) and colonoscopy are discussed, and potential benefits and harms are reviewed. Other testing procedures include ultrasound, stereotactic core biopsy, colposcopy, endocervical curettage, endometrial biopsy, flexible sigmoidoscopy, and colonoscopy.

Recommendations on Screening for Cervical Cancer

Year: 2013
AGREE II score: Available
Developer organization: Canadian Task Force on Preventive Health Care
A clinical practice guideline for adult women with no symptoms of cervical cancer who are or who have been sexually active. The guideline examines cervical cancer screening by use of the Pap test, and provides recommendations for screening intervals based on age. Outcomes of interest include mortality and/or morbidity, harms, and resource implications.

Guideline for Colonoscopy Quality Assurance in Ontario

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A professional guideline for colonoscopy training as part of fecal occult blood test based colorectal cancer screening. The guideline examines training, competency maintenance, and quality assurance measures for colonoscopies and related patient assessment procedures. Outcomes of interest include improved auditable outcomes and clearer pre-assessment standards.

Safe Handling of Cytotoxics

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A professional guideline for health-care workers who may come into contact with cytotoxic drugs. The guideline examines safety measures, with particular attention paid to protective equipment, receiving, transport, and preparation. Outcomes of interest include reduced risk for pregnant workers and improved closed-system handling.

Liposomal Anthracyclines in the Management of Patients with HIV-Positive Kaposi’s Sarcoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with HIV-positive Kaposi’s sarcoma. The guideline examines the use of liposomal anthracycline therapy in aggressive cutaneous or visceral disease sites and comparisons are made to combination chemotherapy. Outcomes of interest include no significant differences between liposomal therapy and conventional combination therapy.

Optimal Treatment Options and Follow-up Strategies in Patients with Desmoid Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with desmoid tumours who are either pursuing active treatment or have already received primary treatment. The guideline examines treatment and follow-up strategies, including recommendations for multiple concurrent treatment options and appropriate rehabilitation. Outcomes of interest include lack of statistically significant information for optimal treatment choice, and increased focus on multidisciplinary sarcoma teams.

Systemic Adjuvant Therapy for Patient at High Risk for Recurrent Melanoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with resected melanoma at high risk for recurrence. The guideline examines systemic therapy options, specifically with interferon, and highlights the importance of novel therapeutic trials. Outcomes of interest include improved melanoma staging and improved event-free survival.

The Role of High Dose Rate Brachytherapy in the Palliation of Symptom in Patients with Non-Small Cell Lung Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with symptomatic endobronchial disease in non-small cell lung cancer. The guideline examines the use of high dose rate endobronchial brachytherapy for respiratory symptoms. Outcomes of interest include improved local control with combined therapies, and no increased toxicity complications.

The Role of Photodynamic Therapy in Patients With Non-Small Cell Lung Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with primary, non-small cell lung tumours. The guideline examines the use of photodynamic therapy in treatment and palliative care, and comparisons are made to traditional radiotherapy. Outcomes of interest include improved tumour response rates and reduced treatment failures in late stage lung cancer.

Altered Fractionation of Radical Radiation Therapy in the Management of Unresectable Non-Small Cell Lung Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with locally advanced, unresectable stage III non-small cell lung cancer. The guideline examines radical radiation therapy, specifically continuous hyperfractionated accelerated radiation therapy, in comparison to traditional radiotherapy. Outcomes of interest include a improved survival benefit over radiotherapy and improved control rates.

Use of Preoperative Chemotherapy With or Without Postoperative Radiotherapy in Technically Resectable Stage IIIA Non-Small Cell Lung Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with technically resectable stage IIIA non-small cell lung cancer. The guideline examines the use of preoperative chemotherapy in conjunction with, or instead of, radiotherapy. Outcomes of interest include improved survival rates with no significant increases in toxicity.

The Use of Chemotherapy and Growth Factors in Older Patients with Newly Diagnosed, Advanced-Stage, Aggressive Histology Non-Hodgkin’s Lymphoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients over the age of 60, with newly diagnosed, advanced-stage, aggressive histology non-Hodgkin’s lymphoma. The guideline examines optimal treatment for this patient group, particularly with the use of granulocyte-colony stimulating factor and combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone. Outcomes of interest include a reduction in infection risk and risk of severe neutropenia.

Chemotherapy with Radiotherapy for Nasopharyngeal Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with newly diagnosed locally advanced squamous cell or undifferentiated nasopharyngeal cancer. The guideline examines treatment through the addition of chemotherapy to the recommended radiotherapy treatment. Outcomes of interest include significant differences in local control and improved progression-free survival.

Preoperative or Postoperative Therapy for Resectable Esophageal Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with resectable, operable, and potentially curable thoracic (lower two thirds of esophagus) esophageal cancer for whom surgery is considered appropriate. The guideline compares treatment regimes including pre- and postoperative chemotherapy and/or radiotherapy versus surgery alone. Outcomes of interest include treatment related mortality, local control, survival benefits, and adverse effects.

Chemotherapy or Radiotherapy for Resectable Pancreatic Adenocarcinoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with resectable pancreatic adenocarcinoma for whom a pancreatectomy is planned. The guideline reviews pre- and post-operative treatment options including radiotherapy and chemotherapy. Outcomes of interest include overall survival, quality of life, and adverse effects.

Preoperative or Postoperative Therapy for the Management of Patients with Stage II or III Rectal Cancer

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with clinically resectable or resected stage II or III rectal cancer. The guideline reviews the use of pre- and post-operative therapy including chemotherapy and radiotherapy as treatment options. Outcomes of interest include survival (overall, cause-specific), quality of life, acute and late toxicities, and postoperative morbidity (within 30 days of surgery).

Management of Squamous Cell Cancer of the Anal Canal

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with a primary diagnosis of biopsy-proven squamous cell cancer of the anal canal, including basaloid, cloacogenic, and transitional cell tumours. The guideline reviews treatment and follow-up care for squamous cell cancer, with radiotherapy and chemotherapy discussed as treatment options. Outcomes of interest include colostomy rate, local failure, survival, adverse effects (acute and late), and quality of life.

Testicular Germ Cell Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with testicular germ cell tumours. The guideline reviews diagnostic assessment, staging, management, and follow-up care for both seminoma and nonseminomas. Outcomes of interest include survival (overall, disease free), complete response rate, recurrence rates, and toxicity.

Prevention of Skin Cancer

Year: 2013
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for individuals at high risk of sustaining UV damage, leading to the development of skin cancer later in life. The guideline reviews risk assessment and sun protection strategies, and provides recommendations on counselling and interventions for limiting UV exposure in high-risk individuals, such as legislation on indoor tanning, policies on use of sun protection in high risk settings, social marketing and mass media campaigns, and education on sun protection. Outcomes of interest include effectiveness of interventions (measured by sunscreen use, use of hats, etc.), ultraviolet (UV) rates, and skin cancer rates.

Preoperative and Pretreatment Investigations for Malignant Melanoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients 18 years of age or older with malignant melanoma. The guideline reviews clinical presentation and preliminary work-up for malignant melanoma as well as additional work-up depending on stage. Outcomes of interest include cost-effectiveness, and specificity and sensitivity of diagnostic procedures.

Octreotide for the Management of Neuroendocrine Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of neuroendocrine tumours of the gastrointestinal tract, pancreas, lungs, thyroid, parathyroid, adrenal glands, and pituitary gland, and of unknown origin. The guideline examines symptom management and dosing regimens for treatment with octreotide. Outcomes of interest include slowed tumour progression and improved prophylactic use.

Nonmuscle Invasive Bladder Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of patients with nonmuscle invasive bladder cancer, identified as stages Tis, Ta, and T1. The guideline examines adjuvant therapy, recurrence prevention, and appropriate follow-up, with specific focus on maintenance therapy and treatment failure. Outcomes of interest include improved recommendations for bacillus calmette-guerin therapy and its use in improved maintenance therapy.

Nasopharyngeal Cancer Treatment

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of patients with, or suspected of having, nasopharyngeal cancer. The guideline examines baseline investigation procedures, treatment options with a specific focus on radiotherapy, and follow-up. Outcomes of interest include improved treatment strategies for advanced stage patients, and improved concurrent chemotherapy options.

Multiple Myeloma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of multiple myeloma in adult patients. The guideline examines diagnosis and treatment for multiple myeloma, monoclonal gammopathy, smoldering myeloma, and amyloidosis, including prognostic criteria. Outcomes of interest include improved survival outcomes through triple drug based induction regimens and improved dose reduction options for elderly patients.

Mitotane for the Management of Adrenocortical Carcinoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of patients diagnosed with adrenocortical carcinoma. The guideline examines the use of adjuvant mitotane therapy in resectable and unresectable carcinomas, and options for combination therapy. Outcomes of interest include lower rate of recurrence post-surgery and prolonged survival in children.

Management of Resectable Stage IV Primary Cutaneous Melanoma Without Nodal Disease

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with resectable stage IV primary cutaneous melanoma without nodal disease. The guideline examines treatment options, including chemoimmunotherapy and surgical resection of distant sites. Outcomes of interest include improved survival times and improved patient selection for chemoimmunotherapy.

Follow-Up Care for Early-Stage Breast Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients who have completed treatment for early-stage breast cancer. The guideline examines surveillance follow-up for potential recurrence, with specific focus on potential complications from previous treatment. Outcomes of interest include improved management of endocrine therapy complications and improved lymphadema management.

Biopsy of a Suspicious Pigmented Lesion

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients presenting with a mole or lesion that is suspicious for melanoma. The guideline examines biopsy techniques and diagnostic elements. Outcomes of interest include reducing misdiagnosis and testing inaccuracy.

Management of In-Transit Disease of the Limbs

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with melanoma with in-transit disease of the limbs. The guideline examines treatment options, including surgical resection and systemic therapy, depended on staging. Outcomes of interest include improved recommendations for isolated limb infusion, with no consensus on preferred systemic therapy.

The Use Of Dexamethasone In Patients With High Grade Gliomas

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the use of dexamethasone in corticosteroid therapy for patients with high-grade gliomas. The guideline examines optimal dose ranges and adverse events associated with dexamethasone, and its overall management including tapering. Outcomes of interest include improved monitoring of and prevention of associated illnesses and improved follow-up for adrenal symptoms.

Upper Tract Urothelial Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with upper tract urothelial carcinoma. The guideline examines staging, treatment, and follow-up, focusing on laboratory work-ups and primary therapy. Outcomes of interest include reduction of tumour recurrence through open bladder cuff excision and higher response rates with neoadjuvant chemotherapy.

Extragonadal Germ Cell Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with primary mediastinal or retroperitoneal germ cell tumours. The guideline examines diagnosis and treatment, via chemotherapy and surgery, and suggested follow-up via prognosis. Outcomes of interest include improved reduction of disease recurrence and reduced hepatobiliary toxicity.

Systemic Therapy for Unresectable Stage III or Metastatic Cutaneous Melanoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult patients with metastatic or unresectable stage III melanoma with possible metastatic sites in distant skin, lymph nodes, liver, lungs, bone, and the brain. The guideline examines appropriate systemic therapies and dosing regimens for first- and second-line treatments. Outcomes of interest include improved survival outcomes and increased efficacy of combination therapies.

Uterine Sarcoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for adult female patients with uterine sarcomas, including leiomyosarcoma, endometrial stromal sarcoma, and adenosarcoma. The guideline examines optimal surgical staging, adjuvant therapy, and palliative therapy. Outcomes of interest include improved progression-free survival rates and improved survival with the combination of gemcitabine and docetaxel.

Lymphoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with lymphoma. The guideline examines diagnostic assessment and staging procedures as well as treatment and management options. Follow-up and supportive care are also reviewed. Outcomes of interest include response rate (complete and overall), survival (progression-free and overall), time to disease progression, remission duration, freedom from treatment failure, impact of treatment on fertility, and toxicity from treatment.

Ovarian Germ Cell Tumours

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline reviews management/treatment of and follow-up care for women with ovarian germ cell tumours. Topics of interest include the efficacy of four cycles of etoposide and cisplatin as compared to the standard therapy with three cycles of bleomycin, etoposide, and cisplatin. Supportive care for myelosuppression is also discussed. Outcomes of interest include survival, mortality, relapse, time to progression, treatment response, and treatment complications and side effects.

Optimal Excision Margins for Primary Cutaneous Melanoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with malignant melanoma. The guideline discusses minimal optimal excision margins for melanoma, in general, with special consideration to melanomas of the face and distal extremities. Interventions considered include excisional biopsy, radiotherapy, topical imiquimod, Mohs micrographic surgery, sentinel node biopsy (SNB) and wide local excision. Outcomes of interest include survival, recurrence rate, and rate of local control.

Optimal Use of Taxanes in Metastatic Breast Cancer (MBC)

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adults over the age of 18 years with metastatic breast cancer who are anthracycline naïve or pre-treated/resistant. The guideline examines the use of taxane treatment for women depending on whether they have previously been treated with anthracycline, and whether or not the tumour shows HER2 overexpression. The guideline also reviews the use of taxanes to treat women who are anthracycline naïve or pretreated/resistant and paclitaxel or docetaxel intolerant. Outcomes of interest include risk of disease progression, toxicity rates, adverse effects of treatment, response rates, mortality, and quality of life.

Squamous Cell Carcinoma of the Vulva

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with squamous cell carcinoma of the vulva. The guideline reviews pre-operative investigations, primary treatment, adjuvant treatment, and follow-up and surveillance, with general and stage-specific recommendations provided. Outcomes of interest include cancer-related death rate, survival (overall and disease-free), progression-free interval, local control, and recurrence rate.

Breast Reconstruction Following Prophylactic or Therapeutic Mastectomy for Breast Cancer

Year: 2013
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult women who are candidates for mastectomy, either for the treatment of breast cancer or for the prophylaxis of breast cancer in patients at high genetic risk. The guideline reviews eligibility for post-mastectomy breast reconstruction and provides recommendations on type and timing of reconstruction after review of the benefits and risks. Post-breast reconstruction surveillance is also reviewed. Outcomes of interest include post-reconstruction complications (short and long term), quality of life, local recurrence, failure rate, cost effectiveness, and aesthetic outcomes.

Bortezomib in Multiple Myeloma and Lymphoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with multiple myeloma or lymphoma. The guideline examines the efficacy of bortezomib as a single-agent or combination therapy. Outcomes of interest include improved time to progression and improved outcomes for relapsing patients.

Muscle Invasive and Locally Advanced/Metastatic Bladder Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with muscle invasive bladder cancer (i.e., stages T2a/b, T3a/b, T4a and N0-X, M0). The guideline reviews evaluation and staging, treatment, and follow-up care according to stage. Outcomes of interest include survival, recurrence rate, bladder preservation rate, rate of metastasis, and presence of residual disease.

Referral and Follow-up Surveillance of Cutaneous Melanoma

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients 18 years of age or older with malignant melanoma. Referral of patients to the cancer treatment centre is reviewed and follow-up and surveillance are discussed, with stage-specific recommendations provided. Outcomes of interest include quality of life, overall survival, regional control, time and expense of surveillance, and test sensitivity and false positive rates.

Cancer Chemotherapy and Pregnancy

Year: 2013
AGREE II score: Unavailable
Developer organization: Society of Obstetricians and Gynaecologists of Canada (SOGC)/ Government of Canada (GOC)
This is a clinical practice guideline for women of child-bearing age who are receiving, or are about to receive chemotherapy. The guideline reviews pregnancy and chemotherapy, including prevention of pregnancy during chemotherapy, and management of risks of chemotherapy in pregnancy. Chemotherapy and postpartum care are also discussed. Outcomes of interest include maternal survival rates, fetal outcomes following maternal chemotherapy, and cancer incidence during pregnancy.

Routine HPV Testing in Head and Neck Squamous Cell Carcinoma

Year: 2013
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with head and neck squamous cell carcinoma. The guideline examines routine testing for human papilloma virus status and its appropriateness for these patients. Outcomes of interest include improved recognition of human papilloma virus status, resulting in improved overall survival.

Non-Small Cell Lung Cancer Stage IV

Year: 2013
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with Stage IV non-small cell lung cancer. Treatment options are discussed including the role of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in first-line treatment, options for second-line therapy, and the role of palliative radiotherapy. Outcomes of interest include tumour response rate, survival (1-year, overall), time to progression, quality of life, and treatment-related adverse events.

Cancer of the Uterine Cervix

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with cancer of the uterine cervix, including squamous, adenocarcinomas, and adenosquamous carcinomas. The guideline reviews evaluation and staging, treatment, and follow-up procedures. Management of recurrent disease is also discussed. Outcomes of interest include survival (overall, disease-free, and progression-free), overall response rate, and toxicity.

Colorectal Screening For Cancer Prevention in Asymptomatic Patients

Year: 2013
AGREE II score: Unavailable
Developer organization: British Columbia Medical Services Commission
This is a clinical practice guideline for asymptomatic patients over 19 years of age. The guideline provides recommendations on screening for colorectal cancer stratified by age and risk. Risk factors are discussed, and screening procedures are reviewed including fecal occult blood test (FOBT), colonoscopy, flexible sigmoidoscopy, and CT colonography.

Proton Beam Radiation Therapy

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This clinical practice guideline reviews the use of proton beam radiation therapy to treat cancers in pediatric, adolescent, and adult patients. The guideline examines the benefits of proton beam radiation therapy for different cancer types, and discusses the referral and funding process for out-of-country treatment. Outcomes of interest include local control, survival (progression-free and overall), acute and late toxicities, and recurrence rates.

Epithelial Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients over 18 years of age with epithelial ovarian cancer. The guideline provides treatment recommendations with consideration to stage, grade, and tumour type. Treatment options are discussed including various chemotherapy regimes, surgery, and radiotherapy. Treatment of recurrent disease and post-treatment follow up and surveillance are also reviewed. Outcomes of interest include overall and progression-free survival, and clinical remission.

Endometrial Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients with endometrial cancer including uterine carcinosarcoma. The guideline examines treatment options including surgery, radiotherapy, chemotherapy and hormone therapy. Therapy for relapse and follow-up and surveillance care are also reviewed. Outcomes of interest include recurrence, 5-year progression-free survival, 5-year overall survival, and toxicity.

Prostate Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for men with prostate cancer or suspected prostate cancer. The guideline provides an overview of early diagnostic and screening procedures, management and treatment options, and follow-up care for low-risk, intermediate-risk, and advanced disease. The guideline also reviews bone health and the use of bisphosphonates as treatment for castrate resistant disease. Outcomes of interest include mortality, quality of life, morbidity, treatment complications, and toxicity.

Influenza Immunization for Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2013
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice guideline for influenza immunization in patients undergoing cancer treatment or palliative cancer care. The guideline examines the use of live vaccines and timelines for immunization based on ongoing treatment. Outcomes of interest include higher immunization response and reduced disease transmission risk.

Follow-up of Colorectal Polyps or Cancer

Year: 2013
AGREE II score: Unavailable
Developer organization: British Columbia Medical Association
This is a guideline for patients who have received curative resection of colorectal cancer (CRC) or polypectomy. The guideline provides recommendations on follow-up procedures and intervals depending on risk group. Follow-up visits are outlined and procedures including colonoscopy, imaging and x-rays, tumour markers, and fecal occult blood tests are reviewed. Long-term surveillance is also discussed.

Thymic Neoplasms

Year: 2012
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with thymic neoplasms. The guideline examines staging based treatment and follow up, focusing on surgical resection and postoperative radiotherapy. Outcomes of interest include reduced relapse and improved multimodal treatment regimens.

Renal Cell Carcinoma

Year: 2012
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for the management of patients with renal cell carcinoma. The guideline examines diagnostic assessment and appropriate first and second line therapies, including surgical and minimally invasive therapies. Outcomes of interest include increased assessment for treatment tolerance, and improved median survival.

Adjuvant Radiation for Malignant Melanoma

Year: 2012
AGREE II score: Unavailable
Developer organization: Alberta Health Services
This is a clinical practice guideline for patients over 18 years of age with malignant melanoma. The guideline discusses the use of adjuvant radiation therapy with consideration to cancer stage and whether the cancer being treated is recurrent. Contraindications are also reviewed. Outcomes of interest include survival and control rates.

Provincial Melanoma Treatment Guidelines

Year: 2012
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for patients with suspected or confirmed melanoma. The guideline examines management, including pathology, and imaging and treatment recommendations based on staging. Outcomes of interest include special considerations for Braff mutations and reduced unnecessary follow up testing.

Guideline for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation

Year: 2012
AGREE II score: Available
Developer organization: SickKids
This is a clinical guideline for children and adolescents with cancer and/or undergoing hematopoietic stem cell transplantation who have fever and neutropenia (FN). The guideline discusses management of FN, including risk stratification schemas, diagnostic techniques, and treatment strategies for high- and low-risk cases. Risk assessment, diagnosis, and treatment of invasive fungal disease are also discussed. Outcomes of interest include death, serious medical complications, secondary syndromes, infections, toxicity, clinical deterioration, and resolution of FN with and without modification of therapy.

Hormonal Treatment of In-Situ Breast Carcinoma

Year: 2012
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for the hormonal treatment of ductal carcinoma in situ. The guideline examines the use of tamoxifen for patients with ductal carcinoma in situ or lobular carcinoma in situ, and provides a recommended treatment plan.

Guideline for the Ordering, Preparation and Administration of Chemotherapy

Year: 2012
AGREE II score: Unavailable
Developer organization: Eastern Health
An organizational guideline for the processing and administration of chemotherapy to cancer patients. The guideline examines the different stages and stakeholders in the chemotherapy treatment process, and the roles and responsibilities therein. Important aspects include accountability checks and staff safety procedures.

PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines January to June 2011

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A clinical practice guideline summarizing the use of positron emission tomography (PET) in the diagnosis, staging, and treatment of patients with cancer. The guideline provides literature updates on PET use for multiple types of cancer. Outcomes of interest include recurrence times and safety outcomes.

Stem Cell Transplantation in Lymphoma

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline on the use of stem cell transplantation as a treatment for lymphoma in adult patients. The report provides recommendations for treatment of the following lymphomas: Hodgkin's, non-Hodgkin's, follicular, Burkitt's, and Mantle Cell. Outcomes of interest include survival, neutrophil engraftment, graft-versus-host disease, and treatment-related mortality.

Models of Care for Cancer Survivorship

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adults without evidence of disease after primary, curative treatment for any stage of cancer. The guideline reviews models of care for cancer survivorship and looks at whether certain models are favoured for specific cancer types. Outcomes of interest include disease-free survival, mortality (cancer-related and all cause), morbidity (late effects), time to recurrence, quality of life, and patient satisfaction.

Computerized Prescriber Order Entry (CPOE) for Systemic Treatment: Best Practice Guideline

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This best practice guideline outlines the use of Computerized Prescriber Order Entry for Systemic Treatment (ST CPOE) systems to support the safe delivery of chemotherapy in an outpatient setting. The guideline provides recommendations to guide the design, selection, implementation, and/or evaluation of an ST CPOE system. Key topics include clinical and decision support, information and technology standards, and measurement plans.

Safe Administration of Systemic Cancer Therapy Part 1: Safety During Chemotherapy Ordering, Transcribing, Dispensing, and Patient Identification

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is part 1 of a 4 part evidence based series on the safe administration of chemotherapy to adult patients in hospital settings. Topics of discussion include pre-treatment planning, prescribing, scheduling, pharmacy preparation, and chemotherapy administration. Primary outcomes of interest are medication error rates.

The Role of Liver Resection in Colorectal Cancer Metastases

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline reviews surgical management of patients with liver metastases from colorectal cancer who have had or will have a complete resection of the primary cancer, and who meet the surgical criteria for the resection of liver-only metastases. The guideline examines the role of liver resection in special cases of liver plus extrahepatic metastases (EHM). The use of perioperative chemotherapy is also discussed. Outcomes of interest include median survival, three- and five-year survival, recurrence rate, postoperative complications, and chemotherapy-related hepatic injury.

Referral of Patients with Suspected Colorectal Cancer by Family Physicians and Other Primary Care Providers

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical guideline examines the management of adult patients presenting in primary care settings with signs and/or symptoms of colorectal cancer. Clinical presentation (focused history and physical examination), referral, and recommendations to reduce diagnostic delay are discussed. Assessment techniques include digital rectal examination, physical examination, complete blood count (CBC), fecal occult blood test (FOBT), computed tomographic (CT) colonography and double-contrast barium enema (DCBE). Outcomes of interest are positive predictive values for colorectal cancer.

Referral of Suspected Prostate Cancer by Family Physicians and Other Primary Care Providers

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical guideline examines the management of adult male patients presenting in primary care settings with signs or symptoms of prostate cancer. Management of patients presenting with unexplained symptoms of metastatic cancer, lower urinary tract symptoms (LUTS), or incidental PSA (defined as results not ordered by the attending family physician/primary care provider), are discussed. Assessment techniques include digital rectal examination (DRE), PSA tests, and prostate cancer nomograms.

Chemotherapy (i.e., Gemcitabine, Docetaxel Plus Gemcitabine, Doxorubicin, or Trabectedin) for Inoperable, Locally Advanced, Recurrent, or Metastatic Uterine Leiomyosarcoma

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline discusses the use of chemotherapy for the treatment of locally advanced, recurrent, or metastatic uterine leiomyosarcoma (LMS) in adult women. Gemcitabine, docetaxel plus gemcitabine, doxorubicin, and trabectedin are compared, and the use of granulocyte growth factor (G-CSF) is considered. Outcomes of interest include overall and progression-free survival time, tumour response rate, stable disease rate, progressive disease rate, and toxicity.

Appropriate Surgical Margins and Proper Handling of Soft Tissue Sarcoma of the Extremities

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This clinical practice guideline discusses limb-sparing surgery as a treatment for eligible patients with soft tissue sarcoma of the extremities. Adequate margins, appropriate number of surgical resection specimens, and appropriate handling techniques of specimens are examined. The appropriate use of pre- and post-operative radiotherapy is also discussed. Outcomes of interest include recurrent free survival and overall survival.

Lenalidomide in Multiple Myeloma

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with multiple myeloma. The guideline reviews the use of lenalidomide as a treatment option for previously untreated or relapsed/refractory multiple myeloma as compared to non-lenalidomide treatments. Use of lenalidomide as a maintenance or consolidation treatment (following transplant and non-transplant treatments) is examined and strategies for managing toxicity are discussed. Outcomes of interest include disease progression, adverse events, safety, and overall survival.

Risk Reduction of Prostate Cancer with Drugs or Nutritional Supplements

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult males 18 years of age or older who are being assessed and monitored for prostate cancer. The guideline examines the effectiveness of drugs or nutritional supplements in reducing risk of prostate cancer and prostate cancer-related death in patients without prostate cancer. Outcomes of interest include prostate cancer incidence and risk, mortality, and adverse effects of treatment.

Low-Dose Rate Brachytherapy for Patients with Low- or Intermediate-Risk Prostate Cancer

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for patients with newly diagnosed low- or intermediate-risk prostate cancer who require or choose active treatment and are not considering or are not suitable for active surveillance. The guideline discusses treatment of prostate cancer with low-dose rate brachytherapy (LDR-BT), and comparisons of LDR-BT treatment alone are made to external beam therapy (EBRT) alone, radical prostatectomy (RP) alone, and LDR-BT combined with EBRT. Different isotope options for LDR-BT are also discussed. Outcomes of interest include biochemical relapse-free and overall survival, prostate cancer-specific and overall mortality, negative biopsy rate, salvage treatment rate, toxicity, and quality of life.

Guidelines for Staging the Pelvis in Bladder Cancer

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This clinical practice guideline examines staging recommendations for determining extent of local tumour invasion and tumour spread in patients with bladder cancer. The guideline examines the use of CT and MRI imaging, both comparatively and consecutively, in the pelvic region.

Stage I NSGCT Surveillance Recommendations

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline for patients with Stage I nonseminomatous germ cell tumours. The guideline examines baseline staging procedures and subsequent follow-up post orchiectomy. The guideline also provides monthly follow-up screening recommendations based on risk associated with lymphovascular invasion.

Role of Cytoreductive Nephrectomy (CN) in Metastatic Renal Cell Cancer (mRCC)

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline examining the use of cytoreductive nephrectomy in patients with metastatic renal cell cancer. The guideline examines the use of cytoreductive surgery with Interferon, and recommends both relative and absolute contraindications for the procedure.

Follow Up Guidelines for Patients Who Have Undergone Curative Surgery for Renal Cell Carcinoma

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline detailing follow-up procedures for patients who have undergone curative renal cell carcinoma surgery. The guideline provides timelines for follow-up based on ECOG performance status, and gives detailed information for physicians about the importance of pathology results, and the surgical procedures conducted.

Prostate Cancer Screening– Position Statement

Year: 2012
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline for asymptomatic adult males at risk for prostate cancer. The guideline examines recommendations for screening on an individual basis to increase the diagnosis of early stage prostate cancer. Considerations regarding frequency of screening include life expectancy and risk factors such as family history.

Colposcopic Management of Abnormal Cervical Cytology and Histology

Year: 2012
AGREE II score: Available
Developer organization: Society of Obstetricians and Gynaecologists of Canada
This is a clinical practice guideline on the management of abnormal cytology results after screening for cervical cancer. Treatment follow-up algorithms are provided, and management options include biopsy, diagnostic excisional procedure including loop electrosurgical excision procedure (LEEP) , and hysterectomy. Outcomes of interest include risk factors for developing cancer, and benefits and harms of follow-up options.

Follow-Up Guidelines Central Nervous System

Year: 2012
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline follow-up to the Provincial Central Nervous System Cancer Treatment Guidelines produced by the Saskatchewan Cancer Agency in 2011. The guideline provides updated follow-up recommendations for patients with anaplastic gliomas, glioblastomas, or low grade gliomas.

Provincial Myelodysplastic Syndrome Treatment Guidelines

Year: 2012
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for the diagnosis and treatment of patients with myelodysplastic syndrome. The guideline examines the presentation of myelodysplastic syndrome in older and elderly patients, and treatment options for lower and higher risk patients. Outcomes of interest include improved quality of life, including prolonged survival, and improved blood cytopenia.

Provincial Hodgkin’s Lymphoma Treatment Guidelines

Year: 2012
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
This is a clinical practice guideline for Hodgkin's lymphoma patients in Saskatchewan. The guideline provides an overview of procedures related to diagnosis, staging, treatment, relapse treatment, and follow-up for Hodgkin's lymphoma. The guideline considers both remission and palliative treatment outcomes.

Breast Cancer Treatment Guidelines

Year: 2012
AGREE II score: Unavailable
Developer organization: Saskatchewan Cancer Agency
A clinical practice guideline for the screening and treatment of primary, locally recurrent, and metastatic breast cancer. The guideline identifies individuals requiring screening, and offers treatment and follow up options for multiple procedures and therapies. Outcomes of interest include reduced mortality and eliminating unnecessary lab work.

Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients

Year: 2012
AGREE II score: Available
Developer organization: Pediatric Oncology Group of Ontario
This is a guideline for pediatric patients age 1 month to 18 years who are receiving antineoplastic medication and who are at risk of experiencing antineoplastic-induced nausea and vomiting (AINV). The guideline examines methods for the prevention and optimal control of acute AINV. Recommendations for pharmacological interventions are provided based on emetic risk, and the use of adjunctive, non-pharmacological interventions is discussed. Primary outcomes of interest are therapeutic efficacy and safety.

Prevention and Treatment of Rash in Patients Treated with EGFR Inhibitor Therapies

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for adult patients with advanced non-small cell lung cancer, colorectal cancer, head/neck cancer, or breast cancer, that is treated with the epidermal growth factor receptor (EGFR) inhibitors cetuximab, erlotinib, gefitinib, panitumumab, or lapatinib, either alone or in combination with other treatments. The guideline examines the prevention and management of a papulopustular rash that commonly develops as a side effect of EGFR inhibitor therapy. Topics of discussion include prevention and prophylactic treatment of rash, clinical management, and supportive care. Outcomes of interest include rash severity, rate of recurrence, and response to treatment.

Pneumococcal Vaccination in Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline on pneumococcal immunization among adult and pediatric cancer patients. The guideline outlines vaccination types, provides recommendations on the timing of immunization with regards to cancer treatment, and reviews contraindications. Outcomes of interest include pneumococcal immunization response rates and vaccine-related adverse events.

Influenza Immunization for Adult and Pediatric Patients Undergoing Cancer Treatment

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This clinical practice guideline provides recommendations for influenza immunization among adult and pediatric cancer patients. Guideline topics include the effect of cancer treatment on immunization response, immunization contraindications and precautions, and timing of immunization with regards to chemotherapy, radiotherapy, and blood and marrow transplant. Immunization of family and hospital staff who come in contact with patients is also discussed. Outcomes of interest include influenza immunization response rates and vaccine-related adverse events.

Small Cell Lung Cancer: Limited Stage

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of limited stage small cell lung cancer in adult patients. The guideline reviews chemoradiotherapy, prophylactic cranial irradiation, second line chemotherapy, and surgery as treatment options. Outcomes of interest include tumour response, survival rates, and adverse effects.

Small Cell Lung Cancer: Extensive Stage

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of extensive stage small cell lung cancer in adult patients. The guideline reviews treatment options including platinum based combination chemotherapy, prophylactic cranial irradiation, thoracic irradiation, and second line chemotherapy. Outcomes of interest include response rate and adverse effects.

Lymphoma

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline on the diagnosis, staging, treatment, supportive interventions and follow-up care for adult patients with lymphoma. Staging techniques include immunohistochemical and fluorescence in situ hybridization (FISH) testing. Treatment and management options are discussed for Hodgkin and non-Hodgkin lymphomas, with recommendations based on cancer type and stage. Outcomes of interest include response rates, disease progression, survival, remission, and adverse effects.

Management of Chronic Myeloid Leukemia

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline on the management of chronic myeloid leukemia in patients over 18 years of age. The guideline provides recommendations on staging and prognosis, diagnosis and baseline investigations, treatment options, and treatment response assessment. First and second generation TKI's, induction chemotherapy, allogeneic stem cell transplant, and interferon-a are all discussed as treatment options. Outcomes of interest include treatment efficacy, survival rate, disease progression, and adverse events.

The Organization and Delivery of Healthcare Services for Head and Neck Cancer Patients

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a professional guideline that provides recommendations on the organization and delivery of health-care services for head and neck cancer patients in Alberta. The guideline outlines the professional health-care team involved in the treatment of head and neck cancer patients, including their roles and minimum required qualifications. It also provides guidance on minimum infrastructure requirements, optimal cancer centre and team member volumes, and wait times to care from referral to initiation of curative treatment.

Gestational Trophoblastic Neoplasia

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for women with gestational trophoblastic neoplasia, including invasive mole, choriocarcinoma, and placental site trophoblastic tumour. The guideline provides recommendations on diagnostic assessment, staging, prognostic scoring, treatment, and follow-up procedures. Outcomes of interest include diagnostic accuracy, complete response rate, survival rate, and risk of subsequent abnormal pregnancy.

Pituitary Adenomas

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of hormonally active (functioning) and non-functioning pituitary adenomas in adult patients. Surgery, postoperative radiation, and drug therapy are all reviewed as treatment options. Outcomes of interest include symptom management, tumour response, and remission rates.

Meningiomas

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for the treatment of low-grade (WHO grade I), atypical (WHO grade II), and anaplastic (WHO grade III) meningiomas in adult patients. Active surveillance, surgery, radiotherapy, and systemic therapy are all examined as treatment options. Outcomes of interest include survival and recurrence.

Glioblastoma

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline on the management of adult patients with glioblastoma. The guideline provides treatment recommendations and discusses the prognostic value of MGMT promoter methylation. Surgery, external beam radiation, and chemotherapy are discussed as treatment options. Outcomes of interest include survival rates and quality of life.

Ependymomas

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice guideline for patients over the age of 18 with WHO grades II or III anaplastic ependymomas. The guideline provides recommendations on treatment and follow-up. Specific techniques include surgery, postoperative MRI, radiotherapy, and chemotherapy. The primary outcome of interest is survival rate.

Anaplastic Astrocytomas and Oligodendrogliomas

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
This is a clinical practice guideline for the management and treatment of suspected or confirmed WHO grade III anaplastic astrocytomas or oligodendrogliomas in patients over 18 years of age. Comparisons are made between surgical resection and biopsy, and radiation therapy and chemotherapy are discussed as treatment options. Outcomes of interest include diagnostic accuracy, prognostic prediction, and overall survival.

Sentinel Lymph Node Biopsy and Axillary Node Dissection in Early Stage Breast Cancer

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice and professional guideline that seeks to establish a standard of care in Alberta for the management of axillary nodes in patients with newly diagnosed, early-stage breast cancer. The guideline compares sentinel lymph node biopsy (SLNB) with axillary lymph node dissection (ALND) for axillary staging, and provides recommendations for management of positive biopsy results. Technical and operational considerations are also discussed. Outcomes of interest include false-negative rates and survival.

Bone Health in Patients with Breast Cancer

Year: 2012
AGREE II score: Available
Developer organization: Alberta Health Services
A clinical practice guideline for breast cancer patients with bone metastases or at risk for induced bone loss. The guideline examines the use of bone-modifying agents and their administration with special considerations given to contraindicated medications and additional risk factors. Outcomes of interest include treatment efficacy, recurrence, and survival.

Appropriate Surgical Margins and Proper Handling of Soft Tissue Sarcoma of the Extremities

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for patients with soft tissue sarcoma of the extremities and who are candidates for limb-sparing surgery. The guideline examines surgical margins for limb salvage surgery and margins for surgery in combination with chemotherapy and/or radiation. Outcomes of interest include clearer surgical margins and improved radiation treatment margins.

Chemotherapy for Relapsed Small Cell Lung Cancer

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with relapsed small-cell lung cancer. The guideline examines single-agent and combination chemotherapy to improve survival and quality of life. Outcomes of interest include improved second-line treatment options, but no standard protocol.

Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for women at very high risk of breast cancer, with 'very high risk' defined as: a known mutation in BRCA1, BRCA2 or other gene predisposing to a markedly elevated breast cancer risk; an 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%; a high-risk marker on prior biopsy (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ [LCIS]); and/or radiation therapy to chest (before age 30 and at least eight years previous). The guideline discusses the use of magnetic resonance imaging (MRI) in conjunction with standard screening (mammography). Outcomes of interest include sensitivity, specificity, positive or negative predictive value, accuracy, time to diagnosis, tumour stage information (size, proportion DCIS, etc.), or improvement in patient outcome (response or survival).

Surgical Management of Malignant Pleural Mesothelioma

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for adult patients with diffuse or localized malignant pleural mesothelioma. The guideline examines surgical management, including adjuvant therapies. Outcomes of interest include improved survival times for small, epithelial-type, node-negative pleural mesotheliomas and limited evidence for surgical intervention.

The Use of Chemotherapy in Patients With Advanced Malignant Pleural Mesothelioma

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with advanced, symptomatic malignant pleural mesothelioma who have a good performance status and are not suitable for surgical resection. The guideline discusses the use of chemotherapy as palliative treatment, and provides recommendations on choice of chemotherapy agent(s), dosage, and schedule. Outcomes of interest include survival, quality of life, symptom control, and response rates.

18-Fluorodeoxyglucose Positron Emission Tomography in the Diagnosis and Staging of Lung Cancer

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
A clinical practice guideline for the use of positron emission tomography PET scans in patients in adult patients with lung cancer. The guideline examines the use of PET scans in the diagnosis and staging of solitary pulmonary nodules, small-cell lung cancer and non-small-cell lung cancer. Outcomes of interest include imaging accuracy and the impact of new PET scan technologies.

The Role of Combination Chemotherapy in the Initial Management of Limited-Stage Small-Cell Lung Cancer

Year: 2012
AGREE II score: Available
Developer organization: Cancer Care Ontario
This is a clinical practice guideline for adult patients with limited-stage small-cell carcinoma of the lung. The guideline provides recommendations on optimal combination chemotherapy regime, administration schedule, and therapy duration for first line treatment. Etoposide-cisplatin and cyclophosphamide- doxorubicin-vincristine are reviewed as combined-modality therapies. Outcomes of interest are survival and adverse effects.

Non-Small Cell Lung Cancer Stage II

Year: 2011
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with stage II non-small cell lung cancer. The guideline examines diagnostic workup, treatment, and follow up for operable and inoperable patients. Outcomes of interest include improved early detection of recurrence and reduced complications through video-assisted thoracic surgery.

Non-Small Cell Lung Cancer Stage I

Year: 2011
AGREE II score: Unavailable
Developer organization: Alberta Health Services
A clinical practice guideline for patients with non-small cell lung cancer. The guideline examines diagnosis, treatment, and follow up, with a focus on surgical resection as the preferred therapy. Outcomes of interest include fewer complications through video-assisted thoracic surgery and improved control with stereotactic body radiation therapy.

Indications for Use of Breast Magnetic Resonance Imaging (MRI)

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for the use of MRI in breast cancer screening for patients who have hereditary risk, or have had previous radiation. The guideline examines indications and contraindications for breast MRI in screening, assessment, evaluation of treatment, and follow up. Outcomes of interest include MRI sensitivity and specificity.

Breast Magnetic Resonance Imaging (MRI) and High Risk Hereditary Breast Cancer

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for women at high risk for hereditary breast cancer. The guideline examines the efficacy of breast magnetic resonance imaging and recommends screening intervals. Outcomes of interest include improved hereditary screening, reduced mortality through early screening, and reduced false positives.

Recommendations for Use of Immediate Breast Reconstruction in Early-Stage Breast Cancer

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for immediate breast reconstruction in women with early stage breast cancer. The guideline examines the oncological safety of immediate reconstruction based on recurrence, risk of delay in adjuvant chemotherapy, and complication rates. The disadvantages of reconstruction before radiation therapy are also discussed.

The Management of Cancer Pain in Adults

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline on the management of pain in cancer patients. The guideline reviews pathophysiology, assessment, and treatment of cancer related pain. Pharmacological treatment options are reviewed in detail, including drug options and corresponding administration, dosage and schedule. Opioid tolerance, independence, and addiction are also discussed, as is the recommended treatment of opioid related side effects.

The Risk Reduction and Management of Secondary Lymphedema

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for patients who are at risk for or whom have been diagnosed with secondary lymphedema. The guideline reviews staging and provides recommendations on management and risk reduction strategies for secondary lymphedema. Treatment of secondary infections is also reviewed.

Chemoprevention of Breast Cancer in High Risk Patients

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
This is a clinical practice guideline for managing patients at high risk for breast cancer. The guideline examines potential chemopreventative treatments, specifically hormonal treatments, for all premenopausal patients ≥ 35 years of age and postmenopausal patients who are deemed high risk for possible breast cancer. Outcomes of interest include risk of recurrence and treatment side effects.

Staging of Primary Breast Cancer

Year: 2011
AGREE II score: Unavailable
Developer organization: Eastern Health
A clinical practice guideline for asymptomatic patients with recently diagnosed primary breast cancer who have already undergone surgical resection. Recommendations are provided for staging investigations, and procedures including bilateral mammography, biopsy, ultrasound, and MRI are discussed.

PET Six-Month Monitoring Report 2010-2: Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2010

Year: 2011
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A clinical practice guideline for the use of positron emission tomography (PET) in the diagnosis, staging, and treatment of patients with cancer. This guideline provides an updated literature review for multiple adult cancers. Outcomes of interest include recurrence and safety outcomes.

The Use of Cabazitaxel in Men with Castrate Resistant Metastatic Prostate Cancer Previously Treated with Docetaxel

Year: 2011
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
This special advice report reviews the use of cabazitaxel, either alone or in combination, as a treatment for adult patients with castrate resistant metastatic prostate cancer who have been previously treated with a docetaxel-containing regimen. Outcomes of interest include treatment efficacy and adverse events.

Administration of Cancer Chemotherapy

Year: 2011
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This guideline provides best practices for the handling and administration of chemotherapy drugs. Safe handling procedures of chemotherapy drugs and waste are reviewed and drug administration is outlined for intravenous, subcutaneous, intravesical, and oral/topical chemotherapy treatments.

CAR CT Colonography Standards

Year: 2010
AGREE II score: Unavailable
Developer organization: Canadian Association of Radiologists
This is a clinical and professional practice guideline that recommends standards of best practice for the use of CT colonography in the screening and diagnostic assessment of colorectal cancer. The guideline discusses patient information and consent, CT technique, patient experience and safety, and interpretation of results. Additional topics include radiologist training/assessment, use of endoscopy as a post-CT test, and resource allocation.

Preparation of Cancer Chemotherapy

Year: 2009
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This guideline examines best practice procedures for the storage, handling, and preparation of chemotherapy drugs. The guideline provides step-by-step instructions for health professionals involved with chemotherapy in both treatment and emergency situations, and also provides detailed information for individual chemotherapy drugs. Outcomes of interest include protection of the patient and minimization of undue hazards.

Nova Scotia Cervical Cancer Screening Practice Guidelines

Year: 2009
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline for cervical screening in women who are, or have been, sexually active. The guideline provides screening timelines and recommendations for when screening is no longer necessary. Recommendations are also made for women in special circumstances, including immunocompromised patients, pregnant women, and women who have undergone full hysterectomies.

Screening for Cancer of the Cervix: An Office Manual for Health Professionals

Year: 2009
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
A clinical practice guideline detailing the use of pap smears as a screening tool for women at risk for cervical cancer. The guideline examines screening timelines, optimal sampling areas, and details the process for both professionals and patients. The guideline also examines when repeat testing and referrals for colposcopies should be conducted, and provides instructional materials and sample forms.

Oncology Nursing Documentation Competencies

Year: 2008
AGREE II score: Unavailable
Developer organization: Cancer Care Ontario
A professional guideline for oncology nursing competencies. The guideline examines guiding principles for nurses throughout the cancer continuum, and enumerates core competencies. Important aspects include both clinical and supportive competencies, and a focus on accountability and quality improvement.

Levels of Care for Cancer Systemic Therapy in Nova Scotia Hospitals

Year: 2008
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is an organizational and professional guideline that provides a model and provincial standard for delivery of systemic therapy to cancer patients in Nova Scotia. Minimum standards are addressed to ensure safe administration of systemic therapy, with important aspects of consideration including therapy type, physical facilities, organizational support, supportive care, and management of oncologic emergencies.

Colonoscopy Recommendations

Year: 2008
AGREE II score: Unavailable
Developer organization: Cancer Care Nova Scotia
This is a clinical practice guideline for patients requiring colon cancer screening, examining colonoscopy standards. Important aspects include ideal polyp detection conditions, monitoring during the procedure, and follow-up care.