Prostate Cancer Data and Policy in Bulgaria
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
147.1
Bulgaria, new cases per 100,000, 20201
153.9
EU27 average, new cases per 100,000, 20201
Estimated prostate cancer incidence 2020
(crude rate per 100,000 population)
(crude rate per 100,000 population)
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 100,000, 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
35.9
Bulgaria, deaths per 100,000, 20201
32.1
EU27 average, deaths per 100,000, 20201
Prostate cancer mortality 2020
(crude rate per 100,000 population)
(crude rate per 100,000 population)
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
68.3%
Bulgaria, five-year survival, 2010-141
Lowest
Five-year survival in the EU, 2010-141
Prostate cancer age-standardised 5-year net survival (%)
National policies
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
- Not included
Support from a specialist nurse
- Not included
Holistic needs assessment
- Not included
A tailored treatment plan
- Not included
Nutrition and exercise advice
- Not included
Psychological support
- Not included
Regular care reviews
- Not included
Cancer care
Access to specialists
For every 1 urologist in Bulgaria, there are 32,156 citizens.1 Ireland is at the bottom of the scale with 173,913 citizens per urologist,2 while Greece has the highest number of urologists with 1 urologist for every 10,000 citizens.3
Approximate number of inhabitants per urologist - 2018*
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
Direct health cost of cancer per person - 2018 (€)
Cancer medicines spend
Bulgaria spends one of the lowest amounts per capita on cancer medicines in the EU, at €31 per capita.1
Per capita cost of cancer medicines - 2018 (€)
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/
References
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
Incidence
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)
Chart source
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
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)
Chart source
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
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)
Chart source
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)
Cancer care
Access to specialists
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
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
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)
Chart sources
*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)
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)
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)