Introduction

In a landmark step, on 3 October the Ministry of Health, in collaboration with the National and Kapodistrian University of Athens (EKPA), announced the development of a new National Cancer Plan for the period of 2024-2028. This initiative is set to align with European Union guidelines, including Europe’s Beating Cancer Plan, and the latest scientific advancements, promising a cohesive and patient-centered approach to cancer care.

Building on Past Initiatives

Greece has previously undertaken initiatives to address cancer, but these have been largely fragmented and reactive. A key milestone was the National Cancer Action Plan (2011-2015), which laid the groundwork for a more coordinated approach. The plan prioritised prevention and early diagnosis, introduced standardized diagnostic and therapeutic protocols, and proposed the creation of a National Cancer Registry to systematically monitor cancer trends. Despite these ambitious goals, implementation was hindered by systemic inefficiencies, underfunding, and uneven execution, leaving significant gaps in care.

The Current State of Cancer in Greece

Cancer remains one of the most significant public health challenges in Greece. It is the second leading cause of death, following cardiovascular diseases, with nearly 8,600 premature deaths annually attributed to the disease. According to OECD estimates, one-third of premature deaths before the age of 75 will be cancer-related between 2023 and 2050. The human lose is compounded by substantial economic losses: €464 million in annual healthcare expenditures, a reduction of the labor force equivalent to 16,700 full-time workers, and €248 million in lost productivity. The emotional toll is no less severe, with an estimated 2,800 annual cases of depression linked to cancer diagnoses.

Geographic and systemic disparities further complicate the situation, as rural and underserved areas often lack access to adequate diagnostic and treatment facilities, leaving patients at a disadvantage. Preventive measures, such as screenings for breast, cervical, and colorectal cancers, remain underutilized, while HPV vaccination rates fall short of the levels required for herd immunity. Together, these shortcomings reveal a healthcare system struggling to cope with the growing burden of cancer.

Announcing a New Era: Greece’s National Cancer Plan

The initial agreement seeks to establish a strategic framework for cancer prevention, diagnosis, treatment, and the development and implementation of palliative care in Greece. To facilitate this, The National Cancer Action Plan will prioritise collaboration among key stakeholders, including public health authorities, patient associations, and civil society, to ensure an inclusive and tailored strategy that aligns with European standards. A pivotal next step involves establishing a comprehensive cancer registry to provide reliable data for tracking progress and refining policies. Prevention will remain central, with an expanded focus on initiatives like the “PROLAMVANO” screening program, offering free cancer tests and addressing public awareness gaps, particularly around HPV vaccination. Nationwide campaigns will combat vaccine hesitancy and promote early detection, bolstering efforts to reduce cancer incidence.

Simultaneously, the government will invest in infrastructure and funding to enhance access to innovative treatments. The creation of an innovation fund will facilitate the introduction of cost-effective therapies, while ongoing projects like the Cancer Survivors Clinic and Recovery Fund allocations will strengthen patient care. By advancing these initiatives, Greece aims to transform oncology care, achieving better prevention, equitable access, and sustainable healthcare innovation.

The basic principles of the National Cancer Action Plan will be finalised by end of 2024 and is poised to transition from its strategic framework to actionable implementation, with clear next steps that aim to achieve measurable results by 2025.

Systemic Gaps of the Greek NHS: A burden to effectively tackling cancer?

Greece’s centralised healthcare system provides nearly universal coverage through the National Health System (NHS). While this ensures citizens and legal residents access to a unified benefits package, systemic inefficiencies and inequities persist. Public health expenditure, at just 9.2% of GDP in 2021, is one of the lowest in the EU, with households covering 33% of healthcare costs out-of-pocket—more than double the EU average. This reliance on private spending, coupled with informal payments, creates barriers to equitable access, particularly for preventive care and early detection of diseases like cancer.

Additionally, while Greece has a high number of doctors, most are specialists, with general practitioners comprising only 6%, the lowest share in the EU. In addition, the nursing workforce is critically low, and investment in preventive and outpatient care is significantly below EU averages. These workforce imbalances and underfunded preventive programs exacerbate disparities in healthcare access and quality.

Conclusion: A Unique Opportunity to Upgrade Healthcare Delivery

The announcement of Greece’s National Cancer Plan signals a pivotal opportunity not only to address the pressing challenge of cancer but also to catalyse broader improvements in the country’s healthcare system. By focusing on prevention, early detection, and equitable access to cutting-edge treatments, the plan lays the basis for a transformative shift in cancer care. However, its success hinges on addressing longstanding systemic deficiencies in the NHS, such as inadequate funding, workforce imbalances, and inequitable access to primary care and preventive services.

For Greece to effectively tackle cancer, it must significantly increase public health expenditure and prioritise the modernisation of the NHS. Investments in diagnostic infrastructure, a stronger focus on preventive care, and the equitable distribution of healthcare resources will ensure that every citizen, regardless of location or income, benefits from the advancements outlined in the plan.