Luxembourg

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Healthcare System

Luxembourg operates under a mandatory health insurance model, with around 95% of the resident population covered by the compulsory Social Health Insurance (SHI) scheme, administered by the National Health Insurance (Caisse Nationale de Santé, CNS). This scheme includes three components: healthcare, sickness leave, and long-term care insurance.

The healthcare system is managed by the Ministry of Health, responsible for health policy and provider licensing, and the Ministry of Social Security, overseeing public funding for health services and the CNS. The Ministry of Family Affairs manages long-term care facilities and services for disabled people.

Coverage under the SHI scheme is comprehensive, including preventative healthcare, inpatient and outpatient hospital care, and more. About 65% of the population additionally purchases voluntary health insurance (VHI) for supplementary services and co-payments, such as dental care and eyeglasses.

To access these benefits, residents must be registered with social security, typically handled by employers. Patients have unrestricted access to all levels of care, with free choice of providers. Approximately 84% of health spending is publicly funded, with the remaining costs covered out-of-pocket or by VHI.

Health data, including Electronic Health Records (Dossier de Soins Partagé, DSP), is managed by the National Association of Healthcare Data (Agence eSanté), facilitating communication among healthcare providers. The CNS handles claims data for monitoring and evaluation purposes. National health registries track specific health conditions for research and public health initiatives.

Registries

Database: National Register of Cancer (RNC)

[1]

Sponsor, manager or home institution: The National Minister of Health and the Center of Expertise in Public Health (Department of Population Health of the Luxembourg Institute of Health).

Primary purpose: Collects information from all the new cases of cancer that have been diagnosed and/or treated in the Luxembourg territory (includes information about residents and non-residents of the country). With this data, it is possible to monitor and enhance the quality of care and epidemiological surveillance.

Type of information: Data Dictionary RNC - Luxembourg.

Available type of information: Crude incidence tax by 100,000 inhabitants per year; Standardized rate for the European population by 100,000 inhabitants; Year; Cumulative risk of cancer before 65 years; Cumulative risk of cancer before 75 years; Distribution of new cases of cancer; Age group; % Relative frequency of new cases of the 10 main tumor locations; Sex.

Source of Information: Main sources - Hospital Cancer Registries, and the National Health Laboratory; Auxiliary sources - National cancer screening programs (breast cancer, colorectal, other national cancer screening programs), Social Security Medical Control, the National Health Fund, the Common Health Insurance Scheme of the European Communities (JSIS), the Directorate of Health: Death certificates, Civil Registry, Private medical analysis laboratories.

Data level: Patient level.

Available data level: National level.

Number of Records: Unknown.

Date Range: 2013 onwards.

Cancer Areas of Interest: All primary in situ and invasive tumors are recorded, except for non-melanoma skin cancers; For benign tumors or tumors with uncertain evolution, only the following tumors are recorded (benign tumors with uncertain evolution of the central nervous system (C70, C71 et C72) and intracerebral endocrine glands (C75.1 à C75.5); thymomas (C37.9); ovarian's borderline tumors (C56.9); invasive hydatidiform mole (placenta tumor) (C58.9); pTa non-invasive papillary carcinoma of the bladder (C67.*), urethra (C68.0), ureters (C66.9) and renal pelvis (C65.9); low-grade mucinous neoplasia limited to the appendix (LAMN); gastro-intestinal stroma tumors). High-grade intraepithelial neoplasia of the cervix, vulva, vagina, penis, prostate, and anus are also recorded.

Data access: Partially publicly available in reports > epidemiological factsheets [2]. Instructions to request data for restricted content [3], in "Annex 2" of the document "Procedures for disclosure of results".

Contact information: Information [4].

Database: Mortality by cause of death

[5]

Primary purpose: Register the occurrence and cause of mortality in Luxembourg territory for residents and non-residents.

Sponsor, manager or home institution: Directorate of Health.

Type of information: Data Dictionary - Mortality by cause of death Luxembourg.

Available type of information: Number of deaths; Cause of death; Sex, Chapter (residents and non-residents); Distribution of deaths; Crude death rate per 100,000 population; Evolution of the number of deaths; Evolution of the crude mortality rate per 100,000 inhabitants; Block or group; Age group; Number of people residing abroad who died in Luxembourg; Country of residence; Standardized death rate per 100,000 population in European countries; Year.

Source of information: Death certificates.

Data level: Patient level.

Available data level: National level.

Number of Records: Unknown.

Date range: 1963 onwards.

Cancer Areas of Interest: Cancer areas of interest - Mortality by cause of death Luxembourg.

Data access: Partially publicly available [6]. The number of deaths by type of tumor and year is available in the table "Death by cause" in the topic "Health" of the "Social conditions" section [7]. Instructions to request data for restricted content [8].

Contact information: Information [9].

Clinical Practices Guidelines

Intitut National du Cancer Guidelines

Sponsor, manager or home institution: Intitut National du Cancer; Conseil Scientifique Domaine de la Santé.

Primary purpose: To provide recommendations for the treatment of various types of cancers.

Type of information: Recommendations, treatments, supportive care and follow up of colorectal cancer, gynecological cancer, breast cancer, pancreatic cancer, cutaneous malignant melanomas, hematological cancers, brain and central nervous system cancer.

Access to information: List of guidelines [10].

Latest Policymaking Initiatives

Reports: National Cancer Registry

Sponsor, manager or home institution: Registre National du Cancer; Institut National du Cancer.

Primary purpose: To establish and maintain the National Cancer Registry in Luxembourg, which serves various objectives such as epidemiological surveillance, evaluating public health actions, assessing the quality of cancer care, monitoring the Cancer Plan, and supporting research.

Type of information: Incidence and mortality for the main tumor locations; Evolution of the annual incidence of cancer tumors; Distribution of the stage of extension at the time of diagnosis; Number of screening mammograms performed; Screenings participation rate; Breast cancers (C50) detected through organized screening; Number of people having performed colonoscopies; Number of lesions detected; Results of cytological examinations of the cervix; Cervical specimen staging; Evolution of the 10 main causes of hospitalization of palliative care patients; Evolution of dependent people benefiting from a palliative care agreement; Number of Multidisciplinary Consultation Meetings (treatments); Evolution of Multidisciplinary Consultation Meetings.

Data level: National level.

Access to information: Access Information [11].

Report: EU Country Cancer Profile 2023

Sponsor, manager or home institution: OECD and European Commission.

Primary purpose: To provide reliable data on cancer prevention and care, identifying trends, disparities, and inequalities among EU Member States and regions to guide interventions under Europe's Beating Cancer Plan.

Type of information: National cancer burden; Cancer incidence and mortality; Risk factors for cancer; Early detection programs (screenings); Cancer care performance, The impact of COVID-19 on cancer care.

Data level: National level.

Access to information: Access Information [12].

Cancer-related Patient Associations and Resources

Compilation: ESMO Patient Guides

Sponsor, manager or home institution: European Society for Medical Oncology.

Primary purpose: To translate complex medical language into understandable information for patients.

Available guides: Cancer Treatment During the COVID-19 Pandemic; Immunotherapy Side Effects and Their Management; Personalized Medicine; Survival; Colorectal Cancer; Endometrial Cancer; Stomach Cancer; Gliomas; AML; CML; Follicular Lymphoma; Bone Sarcomas; Non-Small Cell Lung Cancer (NSCLC); Head and Neck Cancer; Soft Tissue Sarcomas.

Type of information: Information on each guide varies for each cancer type. Generally, guides provide definitions, explanations of causes, diagnosis, treatment, treatment options, care after treatment, among others.

Access to information: List of guides [13].

Quality of Life and Palliative Care Research

List of Articles: Quality of Life [14].