Wood honored for role in developing cancer guidelines 

Dr. Douglas Wood, chair of the Department of Surgery at the University of Washington School of Medicine, received the National Comprehensive Cancer Network’s (NCCN) 2023 Rodger Winn Award for decades of work to develop, refine and promote the organization's Clinical Practice Guidelines in Oncology.

The award, named to honor the first leader of the NCCN guidelines, was conferred on Wood for his “expert judgment and commitment to excellence in service to the NCCN Clinical Practice Guidelines,” said Dr. Robert Carlson, the organization's chief executive.

The NCCN is an alliance of 33 leading U.S. academic cancer centers. It develops guidelines for cancer prevention, screening, diagnosis, treatment and supportive care. Its guidelines are developed by 61 panels composed of 1,800 volunteer professionals. 

Wood, a thoracic surgeon, has served on the NCCN’s Smoking Cessation Panel, its Esophageal and Gastric Cancer panel and its panel on Non-Small Cell Lung Cancer. He founded the Lung Cancer Screening panel in 2009 and has chaired it since. 

In 2011, that panel published the first guidelines recommending lung cancer screening with low-dose computer tomography (CT) for high-risk patients. Lung cancer, the leading cause of cancer death in the United States, is particularly deadly because, in most cases, it is diagnosed too late to treat successfully. The goal of screening is to identify patients early, before symptoms have developed. 

In drawing up the guidelines, Wood and colleagues drew on the results of a landmark study called the National Lung Screening Trial, which showed that screening with low-dose CT reduced mortality among high-risk patients by 20%.  In that trial, patients were considered at high-risk if they were current or former smokers aged 55 to 74 with a 30 pack-year history of smoking and, if former smokers, to have quit within the preceding 15 years. 

However, in what proved to be a controversial decision, the NCCN panel recommended screening of patients with a broader age range and lower smoking exposure if other risk factors were present, such as a history of asbestos exposure, chronic obstructive pulmonary disease or pulmonary fibrosis. This broader group became known as the "NCCN Group 2." 

At the time, many experts in the field objected, concerned that including this broader spectrum of patients, who had not been included in the trial, would expose them to unnecessary radiation and, potentially, unnecessary care in cases when an abnormality seen on CT proved not to be cancer.

“NCCN and individual panelists, particularly the chair, Dr. Douglas Wood, were widely criticized for the broadened criteria of NCCN Group 2,” Carlson noted. During those years of controversy, Wood “was unwavering in his commitment to the recommendations and served as a public representative in many forums to champion the new guidelines," he said.

Eventually, such influential organizations as the U.S. Preventive Services Task Force and the Centers for Medicare & Medicaid Services came to agree with those broader recommendations. 

“I am deeply honored and humbled by this award,” Wood said. “Hundreds of dedicated NCCN staff and volunteers work selflessly to help create guidelines the improve the quality of cancer care in the United States and worldwide. The impact of lung cancer screening has been a game changer in cancer care. We are already seeing fewer patients with advanced disease and more patients with early-stage, treatable and curable disease. Improvement in lung cancer mortality are driving record-breaking annual improvements in overall cancer mortality, with thousands of lives saved every year. It is a privilege to be in this era of seeing lung cancer victims become lung cancer survivors.”

This item was written by Michael McCarthy.

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