Trends in incidence of main types of cancer in Bulgarian women (2010-2021)

BACKGROUND: The burden of cancer worldwide is increasing. In Bulgaria, a biggest problem concerns the cancers of women genital system and breast cancer. The aim of this survey is to analyze the recent trends in cancer incidence related to women genital system and breast cancer and to formulate appropriate conclusions. MATERIAL AND METHODS: The information for this descriptive study was retrieved from population-based cancer data collected by the National Center of Public Health and National Statistical institute. We analyzed the trends in incidence rate (per 1000000 of different types of cancer in women for 2010-2021. Data processing was performed by Microsoft Excel 2016 and IBM SPSS Statistics v.24. RESULTS: Since 1980 the incidence rate of cancer in Bulgaria has double - from 232.7 per 100000 to over 400 with the highest levels in 2011(448.7), 2013 (461.9) and 2015 (447.2). A slight decrease was observed in 2020-2021 related to lower visits to specialists during the COVID-19 pandemic. Since 2010 the highest incidence rates were registered for breast cancer (101.5 in 2013 and 103.5 in 2015) with no trend to decrease. The new cases of breast cancer account for about 11% of all new cancer cases (10.8% in 2019; 11.5% in 2021). These figures coincide with the average rates in EU-27. Cancer of the uterus takes the second rank. Its rate didn't change significantly during the last decade (varying around 30-31 per 100000). Cervical and ovarian cancers rank third and fourth. They both show slight trends of decrease since 2016: for cervical cancer - from 27.2 per 100000 to 22.5 in 2021; for ovarian cancer - from 20.4 to 15.7 per 100000 women. CONCLUSIONS: Cancers of the genital system and breast cancer account for a large proportion of all new cancer cases in Bulgaria. The heavies burden belongs to cervical cancer and cancer of the uterus. Strong changes in policy actions are needed to tackle with the burden of cancer and to increase the effectiveness of preventive measures. KEY MESSAGES: • Bulgaria is among countries with very high incidence rates of cancer among women population, especially incidence rates of breast cancer, cancer of the uterus and cervical cancer. • Due to economic and political instability, Bulgaria doesn’t have an effective national policy to cope with cancer. National Plan to Fight Cancer was published in 2022 but it is still a project.