S502 Are We Following the Guidelines? A Study to See NCCN Compliance in Colorectal Cancer

Introduction: Although clinical guidelines to treat colorectal cancers are extensively established, the degree of adherence to National Comprehensive Cancer Network (NCCN) guidelines is not well studied. This study is conducted to assess whether all medically fit patient with localized and advanced colorectal cancer has offered treatment in adherence to NCCN guidelines and to identify the factors preventing the patients from getting the treatment in accordance with these guidelines. Methods: We conducted a retrospective study of 29 adult patients with colorectal cancer, ranging from AJCC stage 0 to IV, who were treated at our center between 2024 and 2025. Data was collected using real-world electronic health record. The primary goal of this study was to evaluate the adherence to NCCN guidelines in the treatment of these patients. Additionally, we also assessed the factors which contributed to the non-adherence to the guidelines. Results: A total of 29 patients with colorectal cancer were included in the study. Regarding cancer type distribution, 26 patients (89.66%) had Ca colon and 3 patients (10.34%) had Ca rectum. Among 29 patients, 24 patients (82.76%) received treatment according to the NCCN recommendations, showing high level of compliance. However, 5 patients (17.24%) did not receive guideline-based treatment due to various factors. These factors included poor performance status of the patients, patients refusing the treatment and 1 patient with Schizophrenia having difficulties making decisions. In terms of treatment approach, 5 patients (17.24%) with Stage 1 were treated with observation; 3 patients (10.34%) with Stage 2 and 13 patients (44.83%) with Stage 3 were treated with either CAPOX for 3 months or FOLFOX for 6 months. Seven patients (24.14%) with stage 4 were treated with chemotherapy with bevacizumab or Panitumumab depending on the KRAS status and tumor sided-ness. One patient (3.45%) had sessile polyp which was treated with colectomy. Conclusion: Significant variation exist in the treatment of colorectal cancer, particularly in the stage II and III disease. This study shows notable adherence to the NCCN guidelines and the factors that contributed to the non-adherence. Physicians adherence to the NCCN guideline has improved over time but larger studies should be done to fully elucidate the factors that lead to non-adherence.