Current burden of cervical cancer in Bulgaria - epidemiological study

Background The risk factors of cervical cancer are well established and the disease is preventable through vaccination and early detection by screening. The disease ranks as leading cause of female cancer in Bulgaria. The objective of the research was to describe the current burden of cervical cancer in Bulgaria and medical decisions to improve women's health. Methods The information were summarized at the national level on the basis of official on-line database from the annual reports of the of the immunoprophylaxis activities of the National Center of Infectious and Parasitic Diseases (NCIPD), National Center for Public Health and Analyzes (NCPHA). Data for morbidity and mortality rate and vaccine coverage were analyzed and presented in tables and figures. Results Cancer registration has been compulsory in Bulgaria since 1952. National program for the primary prevention of cervical cancer was applied in 2012 (2012-2016, 2017-2020). From the same year was uses immunization against HPVs for 12 -year-old girls. Through these measures, the state guarantees the right of citizens to affordable primary prevention without imposing obligations. Despite the preventive strategy, the expected results are not observed. In 2018, the total number of registered malignancies of the cervix was 15759. The incidence of 100,000 population was 435.8. Of these, the number of newly diagnosed cases were 850, the incidence was 23.5 per 100,000 population. HPV vaccination coverage in girls by birth cohort was 15.1% - 1st dose and 14.3% - 2nd dose for 12-year-old girls and 7% - 1st dose for 13-year-old girls. Conclusions Bulgaria has a leading position in the incidence and mortality of cervical cancer among European countries, requiring mandatory screening and immunization against the Human Papilloma viruses. Key messages Cervical cancer, incidence rate, mortality rate. Vaccination coverage, HPVs, Bulgaria.