INCIDENCE
At 147.1 per 100,000, prostate cancer incidence in Bulgaria is below the European average of 153.9 per 100,000.1 Prostate cancer is the most frequently diagnosed cancer in Bulgarian males (24.3%), ahead of lung (16.4%) and colorectal (13.2%) cancer.2 Bulgaria has had a screening programme for prostate cancer in place since 2009.3
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1 European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-7$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)
2 WHO. International Agency for Research on Cancer. Bulgaria Factsheet. 2020. Accessible at https://gco.iarc.fr/today/data/factsheets/populations/100-bulgaria-fact-sheets.pdf (last accessed March 2022)
3 European Commission and OECD. State of Health in the EU – Bulgaria Country Health Profile 2017. 2017. Accessible at https://ec.europa.eu/health/sites/health/files/state/docs/chp_bulgaria_english.pdf (last accessed March 2022)
Estimated prostate cancer incidence 2020
(crude rate per 100,000 population)
(crude rate per 100,000 population)
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-8$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)
MORTALITY
At 35.9 per 100,000 people, mortality rates for prostate cancer in Bulgaria are slightly higher than the EU27 average of 32.1 per 100,000.1 In neighbouring Romania, the mortality rate is 25.4 per 100,00, below the EU average.1 In 2018, there were over 1,200 deaths as a result of prostate cancer in Bulgaria.2 Cancer is the second leading cause of death in Bulgaria, accounting for 19% of all deaths among men.3
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
1 European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-7$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)
2 WHO. International Agency for Research on Cancer. Bulgaria Factsheet. 2020. Accessible at https://gco.iarc.fr/today/data/factsheets/populations/100-bulgaria-fact-sheets.pdf (last accessed March 2022)
3 European Commission and OECD. State of Health in the EU – Bulgaria Country Health Profile 2017. 2017. Accessible at https://ec.europa.eu/health/sites/health/files/state/docs/chp_bulgaria_english.pdf (last accessed March 2022)
Prostate cacner mortality 2020
(crude rate per 100,000 population)
(crude rate per 100,000 population)
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
European Cancer Information System (ECIS). Estimates of cancer incidence and mortality in 2020. Accessible at https://ecis.jrc.ec.europa.eu/explorer.php?$0-0$1-All$2-All$4-1$3-34$6-0,85$5-2008,2008$7-8$CEstByCountry$X0_8-3$X0_19-AE27$X0_20-No$CEstBySexByCountry$X1_8-3$X1_19-AE27$X1_-1-1$CEstByIndiByCountry$X2_8-3$X2_19-AE27$X2_20-No$CEstRelative$X3_8-3$X3_9-AE27$X3_19-AE27$CEstByCountryTable$X4_19-AE27 (last accessed March 2022)
SURVIVAL
From 2010-2014, the 5-year net survival rate for prostate cancer patients in Bulgaria was the lowest in the EU, at 68.3%.1 At the other end of the scale, the 5-year net survival rate for prostate cancer in Cyprus is 99.2%.1
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
Prostate cacner age-standardised 5-year net survival (%)
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
NATIONAL POLICES
Bulgaria does not appear to have a national cancer plan.
CLINICAL GUIDELINES
Clinical guidelines for the treatment of prostate cancer in Bulgaria can be found in the National Medical Standards for Systemic Drug Treatment, Evaluation of Treatment Effect. The recommended care pathway, includes patient access to*:
Review by a multidisciplinary team
Support from a specialist nurse
Holistic needs assessment
A tailored treatment plan
Nutrition and exercise advice
Psychological support
Regular care reviews
Legend:
Recommendation included
Recommendation not included
CANCER CARE
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1 European Society of Residents in Urology (ESRU). Bulgaria. March 2018. Accessible at https://esru.eu/?q=bulgaria (last accessed March 2022)
2 European Society of Residents in Urology (ESRU). Countries: Ireland. March 2018. Accessible at https://esru.eu/?q=ireland (last accessed March 2022)
3 European Society of Residents in Urology (ESRU). Greece. March 2018. Accessible at https://esru.eu/?q=greece (last accessed March 2022)
Cost of cancer
In 2018, the direct cost of cancer in Bulgaria was €45 per person,1 well below the European average of €154 per person and one of the lowest in the EU.2 Other Balkan countries, such as Croatia and Slovenia, spend €61 and €113 respectively, while Romania spends even less at €36 per person.1 Whilst a number of factors contribute to improved outcomes for those affected by prostate cancer, studies have shown that those countries that invest more in cancer care tend to achieve better outcomes for patients.3
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
2 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022) – average calculated from data included for individual countrie
3 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7.
Cancer medicines spend
Bulgaria spends one of the lowest amounts per capita on cancer medicines in the EU, at €31 per capita.1
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1 Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
Approximate number of inhabitats per urologist - 2018*
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
*Different data sources were used for Belgium, Hungary, Italy, Romania and the UK, which may use data from different years. See references below. No data was found for Cyprus, Luxembourg, Malta and Slovakia.
European Society of Residents in Urology (ESRU). Countries. March 2018. Accessible at https://esru.eu/?q=countries (last accessed March 2022)
Federal Public Service of Public Health, Safety of the Food Chain and the Environment. HWF STATAN 2019 (detailed statistics). 2019. Accessible at https://organesdeconcertation.sante.belgique.be/fr/documents/hwf-statan-2019-statistiques-detaillees (last accessed March 2022)
Boszormenyi-Nagy, G. Report on urological inpatient care based on 2018 data. Urologia Hungarica. Accessible at http://urologiahungarica.hu/index.php/2020/05/12/beszamolo-az-urologiai-fekvobeteg-ellatasrol-a-2018-as-adatok-alapjan/ (last accessed March 2022)
I.Stat. Personale sanitario. Accessible at http://dati.istat.it/Index.aspx?DataSetCode=DCIS_PERS_SANIT (last accessed March 2022)
Institutul National De Statistica. Activitatea Unitatilor Sanitare in Anul 2019. 2020. Accessible at https://insse.ro/cms/sites/default/files/field/publicatii/activitatea_unitatilor_sanitare_anul_2019.pdf (last accessed March 2022)
United Nations, Population Division, Department of Economic and Social Affairs. World Population Prospects 2019. Accessible at https://population.un.org/wpp/Download/Files/1_Indicators%20(Standard)/EXCEL_FILES/1_Population/
WPP2019_POP_F01_1_TOTAL_POPULATION_BOTH_SEXES.xlsx (last accessed March 2022)
British Association of Urological Surgeons and The Specialist Advisory Committee in Urology. Workforce Report. 2018. Accessible at https://www.baus.org.uk/_userfiles/pages/files/publications/
Workforce_Report_Sep%202018%20ver%201.1.pdf (last accessed March 2022)
Direct health cost of cancer per person - 2018 (€)
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
Per capita cost of cancer medicines - 2018 (€)
Links to external websites are provided as a resource to the viewer. We accept no responsibility for the content or services of the linked site other than the information or other materials provided or reviewed by the LTPC expert group members
Hofmarcher, T et al. Comparator Report on Cancer in Europe in 2019. IHE Report 2019:7. Accessible at https://www.efpia.eu/publications/cancer-comparator-report/cancer-types/prostate-cancer/ (last accessed March 2022)
ORGANISATIONS
Patient organisations
Organisations supporting people with prostate cancer in Bulgaria include:
National Patients Organisation
https://npo.bg/
Dara Help
https://darahelp.com/
Federation Bulgarian Patients Forum
https://www.fbpf.org/
Reference Number: ONC_2021_0186_BE
Date of preparation: January 2022
