21 Δεκεμβρίου 2014

Austerity and its consequences on cancer screening in Greece

Austerity and its consequences on cancer screening in Greece Andreas Tsounis, Pavlos Sarafis, Evangelos C Alexopoulos DOI: http://dx.doi.org/10.1016/S0140-6736(14)62373-4 Article Info On Aug 18, 2014, the Greek Department of Health decided to control the number of presymptomatic checks for uterus, breast, and prostate cancers prescribed by doctors of the Greek National Organization for the Provision of Health Care Services.1 These checks were restricted by an upper limit to prescribed exams, which varied per medical specialty and exam category; an upper limit of expenditure per physician, which varied according to prefecture and specialty; and prohibition of certain medical specialties to prescribe at all. The argument for these new budget cuts is the necessity to control health-care costs. However, the population in Greece receiving screening services compared with that recommended by the European Council is already low.2 Greece has both non-population-based3 and non-systematic4 screening programmes. In countries with organised screening programmes, participation rates in Pap testing are up to 80% (eg, Sweden, Finland, and the UK),5 whereas in Greece, participation is less than 60%.2 Concerning mammography, less than 50% of women aged 50–69 years in Greece have been screened within the past 3 years,3 whereas European guidelines suggest a desirable target screening rate of at least 75% of eligible women.4 This target would be met if more than 1·6 million women aged 40–69 years were screened (women aged 40–69 years in Greece exceeds 2·2 million).6 Such unilateral policies without strengthened prevention actions and enhanced participation in presymptomatic exams will increase cancer cases in the near future. These policies will also disproportionately increase social security expenses—the cost of cancer treatment has been estimated in Greece to be 6·5% of the total health-care expense, largely due to hospitalisations, surgical interventions, and expensive drugs.4 We declare no competing interests. References 1.Control measures of prescribing and laboratory exams performance exam. Official Journal of the Hellenic Republic Series B.. http://www.ygeianet.gr/box/cal/44823.pdf. ((accessed Sept 30, 2014).)View in Article 2.Dimitrakaki, C, Boulamatsis, D, Mariolis, A, Kontodimopoulos, N, Niakas, D, and Tountas, Y. Use of cancer screening services in Greece and associated social factors: results from the nation-wide Hellas Health I survey. Eur J Cancer Prev. 2009; 18: 248–257View in Article | CrossRef | PubMed | Scopus (15) 3.Organisation for Economic Co-operation and Development. Health at a glance 2013: OECD indicators. Organisation for Economic Co-operation and Development Publishing, Paris; 2013View in Article 4.Hellenic Ministry of Health. National Anticancer Action Plan 2011–2015. http://www.anticancer.gov.gr. ((accessed Sept 30, 2014).)View in Article 5.Anttila, A, Ronco, G, Clifford, G, Bray, F, Hakama, M, and Arbyn, M. Cervical cancer screening programmes and policies in 18 European countries. Br J Cancer. 2004; 91: 935–941View in Article | PubMed 6.Hellenic Statistical Authority. Estimated population by sex and 5-year age groups on 1st January (years 2001–2013). http://www.statistics.gr/portal/page/portal/ESYE/PAGEthemes?p_param=A1605&r_param=SPO18&y_param=2012_00&mytabs=0. ((accessed Sept 30, 2014).)View in Article