Greece

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Healthcare System

Greece's healthcare system is a combination of public and private providers. The public sector provides universal coverage for citizens, legal residents, and visitors, while the private sector is largely for-profit and serves as a complement to the public system. The system provides a range of benefits, including preventive care, primary care, specialist care, hospitalization, prescription drugs, and mental health services. Patients also have the option to choose their own doctor or healthcare facility.

The National Organization for Healthcare Services Provision (EOPYY) manages the public healthcare system in Greece, with regional managers overseeing healthcare delivery in each of the country's administrative regions. However, the Ministry of Health oversees regulation at every level of the system, as regions currently lack resources to coordinate healthcare.

Greece is improving access and efficiency in healthcare by developing an integrated primary care system with a gatekeeping role, which will eventually require residents to see a GP first before accessing specialist services.

Despite efforts to create a Hellenic cancer registry, Greece to this date has no cancer registry in which cancer incidence information can be found.

Administrative or Claims Data

Database: ELSTAT Discharge Data

[1]

Sponsor, manager or home institution: Hellenic Statistical Authority (ELSTAT).

Primary purpose: Provide information about patient discharges.

Type of information: Data dictionary was not found.

Available type of information: Discharged patients filtered by disease category, place of residence, gender, average days of hospitalization and hospitalization outcome.

Source of Information: Annual census collecting data from public and private hospitals.

Data level: Unknown.

Available data level: Regional and national level.

Number of Records: All discharged patients. 1,484,485 patients for 2015.

Date Range: 1996 to 2015.

Cancer Areas of Interest: Cancer Areas of Interest: ELSTAT Discharge Data

Data access: Partially publicly available [2]. Instructions to request data for restricted content [3].

Contact information: Information [4].

Registries

Database: ELSTAT Cause of Death

[5] [6]

Sponsor, manager or home institution: Hellenic Statistical Authority (ELSTAT).

Primary purpose: Provide cause of death information.

Type of information: Data dictionary was not found.

Available type of information: Cause of death filtered by sex and age.

Source of Information: Administrative records (Death Certificates) provided by the Registries throughout the country and forensic reports in cases of violent or sudden deaths.

Data level: Municipal level.

Available data level: National level.

Number of Records: Unknown.

Date Range: 1956 onwards.

Cancer Areas of Interest: Malignant neoplasms (C00-C96): Malignant neoplasms of lip, oral cavity and pharynx (C00-C14); Malignant neoplasm of esophagus (C15); Malignant neoplasm of stomach (C16); Malignant neoplasms of colon, rectosigmoid junction, rectum, anus and anal canal (C18-C21); Malignant neoplasm of liver and intrahepatic bile ducts (C22); Malignant neoplasm of pancreas (C25); Malignant neoplasm of larynx (C32); Malignant neoplasms of trachea, bronchus and lung (C33-C34); Malignant melanoma of skin (C43); Malignant neoplasm of breast (C50); Malignant neoplasm of cervix (C53); Malignant neoplasm of uterus, other and unspecified (C54-C55); Malignant neoplasm of ovary (C56); Malignant neoplasm of prostate (C61); Malignant neoplasm of kidney (C64); Malignant neoplasm of bladder (C67); Malignant neoplasms of meninges, brain and other parts of central nervous system (C70-C72); Malignant neoplasm of thyroid gland (C73); Hodgkin's disease and lymphomas (C81-C85); Leukemias (C91-C95); Multiple myeloma and other malignant neoplasms of lymphoid and hematopoietic tissue (C88, C90, C96); Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80); Other neoplasms (in situ, benign, of uncertain or unknown behavior) (D00-D48).

Data access: Partially publicly available [7]. Instructions to request data for restricted content [8].

Contact information: Information [9].

Database: ELSTAT Annual Cancer Survey Statistics

Sponsor, manager or home institution: Hellenic Statistical Authority (ELSTAT).

Primary purpose: Provide information about cancer cases from a survey no longer conducted.

Type of information: Cases of cancer filtered by sex, age, region, urban, semi-urban and rural areas, and groups of occupation.

Source of Information: Unknown.

Data level: Regional and national level.

Number of Records: Unknown.

Date Range: 1967 to 1982.

Cancer Areas of Interest: Unknown.

Data access: Publicly available [10]. Access to information can be found [11] using the search query "Ετήσια στατιστική έρευνα του καρκίνου".

Contact information: Information [12].

Database: Nationwide Registry of Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)

Sponsor, manager or home institution: NARECHEM-ST.

Primary purpose: Provide information about cancer incidence in children (0-14 years old) across Greece.

Type of information: Demographic data, personal and family history of the primary child, and comprehensive details concerning the disease, such as confirmed diagnosis coded under ICD-O-3 since 2007, tumor morphology and localization, stage, metastases, and survival. Moreover, biological samples are accessible for the majority of cases and controls. The analytical list of other variables that are obtainable through interviews for cases and controls or furnished by treating physicians is electronically preserved. If applicable, bone marrow aspiration slides and biopsy reports are provided, while biopsy specimens are stored in their respective Pathology Departments. There is also follow-up data on all patients as well as biological materials collected and stored.

Available type of information: Annual Crude and Age-Standardized Incidence Rates per 1,000,000; Annual Age-Standardized Incidence Rates (AIR) per 1,000,000 by histological subtype; Age-Standardized Incidence Rates (AIR) per 1,000,000 by histological subtype and gender; Incidence Rates per 1,000,000 by age group and gender; Incidence Rates per 1,000,000 by age group and histological subtype; Number of cases by behavior Age-standardized Incidence Rates (AIR) per 1,000,000 by behavior and gender; Annual Age-Standardized Incidence Rates (AIR) per 1,000,000 by behavior; Number of cases by ICCC-3 group III histological subtype; Number of cases by histological subtype; Age-Standardized Incidence Rates (AIR) per 1,000,000 by gender and ICCC-3 group III histological subtype; Percentage of cases by stage of INRG; Percentage of cases by anatomical stage.

Source of Information: Reports mainly from seven pediatric hematology-oncology departments across Greece, and personal interviews with children or their guardians.

Data level: Patient level.

Available data level: National level.

Number of Records: About 4000 patients.

Date Range: 1996 to 2019.

Cancer Areas of Interest: Leukemias, lymphomas, CNS tumors, liver tumors, neuroblastomas, and nephroblastomas (Wilm’s tumors)

Data access: Partially publicly available [13]. Instructions to request data for restricted content [14].

Contact information: Information [15].

Latest Policymaking Initiatives

Report: EU Country Cancer Profile 2023 (Greece)

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 [16].

Cancer-related Patient Associations and Resources

Resource: ESMO Patient Guides

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

Primary purpose: Provide patients, their relatives and caregivers guides to better understand complex medical information about different types of cancer.

Available guides: Cancer Treatment During the COVID-19 Pandemic; Cancer Pain Management; Immunotherapy Side Effects; Survivorship; Breast Cancer; Ovarian Cancer; Cervical Cancer; Biliary Tract Cancer; Bone Sarcoma; Colorectal Cancer; Endometrial Cancer; Glioma; Head and Neck Cancer; Hepatocellular Carcinoma; Multiple Myeloma; Non-Small-Cell Lung Cancer; Testicular Cancer; Pancreatic Cancer; Soft Tissue Sarcoma.

Type of information: Laymen-directed descriptions of specific cancers, their causes, diagnoses, treatment, screening, and side effects, among other relevant information for patients, their relatives and caregivers.

Access to information: Patient Guides [17].

Quality of Life and Palliative Care Research

List of Articles: Quality of Life [18] and Palliative Care [19].