Oncology in Latviathe green corridor, where care happens, and how to verify a doctor

Cancer care in Latvia covers the path from suspicion of a malignant tumour through diagnosis to treatment. The treatment methods are surgery, drug therapy and radiotherapy, and they are often combined.

• Assessing suspicion and primary diagnostic testing
• Confirming the diagnosis and establishing the stage
• Surgical, drug and radiation treatment
• Managing treatment side effects
• Follow-up after treatment ends
• Palliative care where cure is not possible

The starting point is almost always the family doctor. They assess the symptoms, issue a referral carrying a special code, and book the specialist appointment if suspicion remains.

The green corridor was introduced in Latvia in 2016. It lets people with suspected cancer receive state-funded tests outside the general waiting queue and outside the provider's allocated funding, known as the quota.

• 1. SuspicionWhat happens: A family doctor, gynaecologist or prison doctor identifies signs that could indicate a tumourDeadline: -
• 2. ReferralWhat happens: The doctor issues a referral for primary diagnostics carrying a special code beginning Z03Deadline: -
• 3. TestsWhat happens: The provider performs the primary diagnostic tests, such as mammography, ultrasound or endoscopyDeadline: 10 working days from booking
• 4. ReviewWhat happens: The family doctor reviews the resultsDeadline: -
• 5. Specialist consultationWhat happens: If suspicion remains or the diagnosis is confirmed, the family doctor phones a specialist hospital to book the patient. The patient does not bookDeadline: 10 working days

The green corridor applies to first-time suspicion and runs until the diagnosis is established. It covers any cancer, regardless of where the tumour is.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in the relevant specialty: medical oncology for drug treatment, or radiation oncology for radiotherapy. The medical oncology training route has its own page.
• Surgical treatment is delivered by surgeons in the relevant surgical specialty who have further specialised in cancer surgery.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• If a provider cannot deliver a test within 10 working days, it must inform the National Health Service, since providers are obliged to deliver the services they have contracted to provide.
• If you face a longer wait, contact the National Health Service and ask about alternative providers.
• In an audit published in 2023, the State Audit Office concluded that early detection of cancer in Latvia is not adequately ensured and that the green corridor does not always work in practice as intended. That assessment is worth bearing in mind when planning your own steps.
• The family doctor is the key ally in this process, since they issue the correctly coded referral and make the booking.
• Patients may freely choose any provider delivering the relevant state-funded service.

• Bring all test results, including imaging discs and reports, plus histology results if you already have them.
• Hospital discharge summaries and a full list of medicines are useful.
• If suspicion arose from screening, bring the screening result.
• The specialist refines the diagnosis and stage, and in complex cases the treatment plan is agreed at a multidisciplinary meeting.
• It helps to write down what the doctor says, or bring a relative, since the volume of information is usually high.

Green corridor tests are state-funded and paid outside the provider's quota. Where tests follow state cancer screening, no patient co-payment applies. Otherwise the standard co-payments apply, capped at 570.00 EUR per calendar year.

• Bowel cancer screening by faecal occult blood test, ages 50 to 74Price EUR: 0.00Source: GASTRO centrs
• Colonoscopy after a positive screening testPrice EUR: 0.00Source: GASTRO centrs
• Patient co-payment for a specialist visitPrice EUR: 4.00Source: NVD
• Patient co-payment for day hospital treatmentPrice EUR: 7.00 per daySource: NVD
• Patient co-payment for inpatient care from day twoPrice EUR: 10.00 per daySource: NVD
• Annual co-payment capPrice EUR: 570.00Source: NVD

The specialty body is the association "Latvijas Onkologu asociācija" (Latvian Association of Oncologists), registration number 40008263627, registered address Strēlnieku iela 1-2, Rīga, LV-1010, email info@onkologi.lv. It is led by Jānis Eglītis, who also heads the breast surgery ward at the Latvian Oncology Centre.

Certificates are issued by the Certification Council of the Latvian Medical Association, founded in 1988. The sector regulator is the Health Inspectorate, while the National Health Service oversees the organisation of state-funded services.

If you have doubts about the quality of care, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site. Where the problem is the availability or timing of a state-funded service, the National Health Service is the body to approach.