Health technology assessment in the area of prevention - Selected screening cases in Greece

Objective: To explore the impact of health technology assessment (HTA) on h ealth policy and practice in Greece through selected screening case studies in the prevention area. The three cases studied were mammography screening , PSA screening, and routine ultrasonography in normal pregnancy. Methods: Official policy recommendations or reports, a literature review of Greek published research as well as gray literature from various sources, and interviews with specialists and medical associations were performed, an d their impact on health policy formulation was examined. Results: The implementation of the screening tests does not take the form o f structured mass screening programs. Almost all physicians (urologists-pat hologists, gynecologists) apply PSA and routine ultrasonography in normal p regnancy respectively with the purpose of either prevention or diagnosis. M ammography is applied generally for prevention or diagnosis, but there are some mass screening programs at a local level. In addition, the results sho w no evidence that the efficacy and the cost-effectiveness of the three scr eening programs have been a matter of serious concern and investigation for the purposes of policy formulation in Greece. Conclusion: The results point to a need for the implementation of HTA metho ds on mass screening preventive programs in which real value and cost remai n unclear and whose use is based on empirical and personal assessments.