Developing National Cancer Guideline: A Step Toward Standardized Multidisciplinary Management in Indonesia

Background and context: Along with the development and advancement of cancer management, multidisciplinary approach has been an essential part to achieve a better patient outcome. However, to ensure the best management for cancer patients, national clinical guidelines should be established. Clinical practice guidelines serve a great role in translating evidence from bench to bedside, as well as improving the quality of medical care throughout the country. Until 2014 , before the establishment of National Cancer Control Committee (NCCC), there have been several hospital-based and society-based guidelines, but no national guidelines available. Aim: The development of national cancer guideline aims to ensure best clinical practice on cancer in Indonesia. Strategy/Tactics: The guidelines were developed based on the strategic objective of NCCC-Ministry of Health (MoH) Republic of Indonesia and the Decree of Minister of Health Number 1438/MENKES/Per/IX/2010 about the standard of medical services. Program/Policy process: Under the decree of Minister of Health and NCCC-MoH, all cancer-related discipline represented by expert from each discipline´s professional society were gathered in a “Guideline Development Team” to develop national cancer guidelines. First, there was a discussion on the outline. Then, each specialist/discipline would develop their own management based on the related knowledge. Finally, everyone will discuss together to finalize the compiled guidelines. Outcomes: Eight national guidelines were developed in three years after NCCC established, including breast cancer, cervical cancer, lung cancer, colorectal cancer, nasopharyngeal cancer, brain tumor, prostate cancer and osteosarcoma. Experts of the related discipline were involved in writing the guidelines. Various obstacles occurred during the process of writing the guidelines, including multidiscipline teams involvement and the geographical problem of being an archipelago country. But, having one vision to develop the best medical management for cancer patients, the national guidelines were finally published on the Web site of NCCC and currently waiting for Minister of Health approval. What was learned: Gathering multidisciplinary teams to develop national guidelines was not an easy task. However, by having the same vision and inviting all cancer-related societies, we can make this achievement. Moreover, the decree of Minister of Health was also an essential part to push everyone moving forward.