NCCN Guidelines® Insights - Colon Cancer, Version 3.2026

Colorectal cancer is the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States. Treatment of localized disease usually includes surgery, sometimes followed by adjuvant systemic therapy, while advanced or metastatic disease is often treated with multiple lines of systemic therapy, based on biomarker status. These NCCN Guidelines Insights detail recent updates to the NCCN Guidelines for Colon Cancer, including recommendations for pretreatment DPYD testing to decrease the risk of severe fluoropyrimidine toxicity; updates to adjuvant therapy of nonmetastatic colon cancer based on the results of recent clinical trials; and a reorganization of the systemic therapies for advanced or metastatic disease based on biomarker status, highlighting changes to the treatment recommendations for BRAF V600Emutation–positive disease.

Target Audience

This journal article is designed to meet the educational needs of oncologists, nurses, pharmacists, and other healthcare professionals who manage patients with cancer. 

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Integrate into professional practice the updates to the NCCN Guidelines for Colon Cancer
  • Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Colon Cancer
Additional information
Supporters: 

This activity is supported by educational grants from AstraZeneca, Johnson & Johnson, Lantheus, Lilly, Novartis, and Recordati Rare Diseases Inc. This activity is supported by an independent medical education grant from GSK. This activity is supported by a medical education grant from Exelixis, Inc.

Course summary

Available credit: 
  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC contact hours
  • 1.00 Participation
Course opens: 
11/10/2026
Course expires: 
11/10/2027
Part of: 
Behind the Guidelines: Insights into the Standard of Care in Oncology 2026 (NCCN Guidelines® Insights 2026)

NCCN Continuing Education Disclosure Policy
It is the policy of NCCN that all planners, faculty, moderators, authors, reviewers and anyone involved in the planning and delivery of NCCN continuing education activities are expected to disclose ALL financial relationships they have had in the past 24 months with ineligible companies. The ACCME Standards for Integrity and Independence require that individuals who refuse to provide this information will be disqualified from involvement in the planning and implementation of accredited continuing education presented by NCCN. NCCN identifies, mitigates and discloses to learners all relevant financial relationships.

In addition, all content has been reviewed to ensure education promotes safe, effective patient care and does not promote the products or services of an ineligible company. Content, including any presentation of therapeutic options, is fair, balanced, evidence-based, scientifically accurate, and free of commercial bias and marketing. 

Definitions  

Ineligible Company: An ineligible company is any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

Relevant Financial Relationships: Financial relationships of any dollar amount occurring within the past 24 months are defined as relevant if the educational content an individual can control is related to the business lines or products of an ineligible company. There is no minimum financial threshold. We ask for disclosure of ALL financial relationships with ineligible companies, regardless of the amount and regardless of the potential relevance of each relationship to the education.

Faculty Disclaimers  

All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.

Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling or marketing.

Individuals Who Provided Content Development and/or Authorship Assistance:
 
The faculty listed below have no relevant financial relationship(s) with ineligible companies to disclose.
 
J. Kevin Hicks, PharmD, PhD, Panel Member
Frankie Jones, Guidelines Coordinator, NCCN
Lisa Gurski, PhD, Senior Operations Manager, Licensed Content and Support, NCCN
 
The faculty listed below have the following relevant financial relationship(s) with ineligible companies to disclose. All of the relevant financial relationships listed for these individuals have been mitigated.
 
Al B. Benson III, MD, Panel Chair, has disclosed receiving grant/research support from AbbVie, Inc., Amgen Inc., Apexigen, Inc., Artemida Pharma Ltd, Cardiff Oncology, Inc., Elevar Therapeutics, Infinity Pharmaceuticals, Inc., ITM Solucin GmbH, Janssen Pharmaceuticals, MedImmune, Inc., Merck Sharpe & Dohme Ltd, Pfizer Inc., Raphael Pharmaceutical Ltd., ST Pharm Co Ltd, SynCore Biotechnology Co., Ltd, and TYME Technologies Inc.; receiving consulting fees from AVEO Oncology, Boston Scientific Corporation, Bristol Myers Squibb, GRAIL, Inc., GSK, Janssen Pharmaceuticals, Mirati Therapeutics, Inc., Nuvation Bio, Inc., Pfizer Inc., Samsung Bioepis, Seagen Inc., Taiho Pharmaceutical Co., Ltd., and Xencor, Inc.; and serving as a scientific advisor for AIM ImmunoTech, Array BioPharma Inc., Astellas Pharma US, Inc., Boston Scientific Corporation, HUTCHMED, Mirati Therapeutics, Inc., Natera, Inc., Novartis Pharmaceuticals Corporation, Seagen Inc., Tempus, and TheraBionic.
Alan P. Venook, MD, Panel Vice-Chair, has disclosed serving as a scientific advisor for Amgen Inc., Exact Sciences, Exelixis, Inc., GSK, Intera Oncology, and Pfizer Inc.
Kristen K. Ciombor, MD, Panel Member, has disclosed serving as a scientific advisor for AbbVie, Inc., Blueprint Medicines Corporation, Bristol Myers Squibb, Exact Sciences, Exelixis, Inc., Natera, Inc., Pfizer Inc., Servier Laboratories, and Summit Therapeutics, Inc.
Stacey A. Cohen, MD, Panel Member, has disclosed receiving grant/research support from AbbVie, Inc., BioNTech US Inc., Mabwell Therapeutics, Inc., Merck & Co., Inc., Natera, Inc., Pfizer Inc., and Tempus; and receiving consulting fees from AbbVie, Inc., Boston Scientific Corporation, Caris Life Sciences, Delcath Systems, Inc., Eisai Co., Ltd., Exact Sciences, GSK, Hexagon Bio, Inc., Incyte Corporation, Merck & Co., Inc., Pfizer Inc., and Roche Laboratories, Inc.
 

View all of the conflicts of interest for the NCCN Guidelines panel 

NCCN Staff Disclosures

None of the other planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

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In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Physicians
NCCN designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
NCCN designates this educational activity for a maximum of 1.0 contact hour. 

Pharmacists
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.1 CEUs) of continuing education credit. UAN: JA4008196-0000-26-011-H01-P

PAs
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit. Approval is valid until November 10, 2027. PAs should only claim credit commensurate with the extent of their participation.

Available Credit

  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 ANCC contact hours
  • 1.00 Participation
Please login or register to take this course.

Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing