OBJECTIVES: Previous studies (NSPH 2008,2009) demonstrated that clustering of oncology resources exceeds the spatial concentration pattern of healthcare services in Greece, thus resulting to substantial cross-regional flows of cancer patients. The objective of this study was to assess the impact of geographic accessibility on patients when selecting care and during treatment for cancer. METHODS: Face-to-face interviews with 106 patients diagnosed with cancer from 3 specialized anti-cancer hospitals (2 Athens and 1 Thesaloniki). Questionnaire was designed by a specialized Delphi panel of the NSPH to capture patient preferences. Median patient age was 54.5 years. Data were analyzed using SPSS v.15.0. RESULTS: Patients across the board choose their hospital on the basis of specialization (50%), physician reference (41.5%) and hospital reputation (35.8%). 63% of patients face access barriers, most commonly cost of health care services (44.3%), distance from place of residence (37%) and demand on time (33%). 76.4% of patients return to place of residence at treatment intervals and 43.4% immediately after treatment. To receive treatment 23.6% stay at homes of relatives, 14.2% at hotels and 1% in hospital owned hospices. 50% of patients undergo treatment cycles repeating every 15-30 days. Patients travel predominately by own car (48.1%). 4.7% travel by taxi reimbursed by their insurance fund and 1% by hospital ambulance. 84% of patients travel accompanied by one or more carers. At treatment intervals, only 8% of patients are supported by physicians at place of residence. CONCLUSIONS: Significant cross regional flows of cancer patients to access adequate treatment lead to substantial direct and indirect costs for patients and their carers in a strained financial environment. Patients also face significant gaps in integrated support during treatment intervals. A shift in the organization of cancer services is essential for the system to be responsive to expressed patient needs especially during treatment.