Cancer screening in Greece. Guideline awareness and prescription behavior among Hellenic physicians

Abstract

Background Primary cancer prevention is offered by the Greek health care system to the population on an opportunistic basis. This means that screening depends on advice from primary care providers and on individuals' request for screening, since a centralized invitational register is lacking. In planning preventive services, an accurate identification of baseline levels of performance for preventive activities is fundamental, so that realistic goals can be set. Methods 366 primary care physicians (39.3% response rate) from nine Greek provinces were surveyed by means of a self-reporting questionnaire of prescription habits. Physicians' screening behaviors and screening recommendations were analyzed for both cost-effective and non-recommended tests during usual check-up visits and targeted cancer screening activities were analyzed. Results A wide variety of recommendation habits were observed among primary care physicians. With the exception of PAP test, cost-effective tests were advised at sub-optimal rates, with colorectal cancer screening being much less than desirable. Moreover, non-recommended tests were frequently advised. Conclusion Screening tests are performed sporadically and an overall understanding of primary care prevention is lacking. More focused educational interventions must be implemented if primary care is to make an impact on cancer mortality.