When will Bulgaria have a programme for early detection of lung cancer?

"The National Cancer Control Plan in the Republic of Bulgaria provides for the introduction of a Lung Cancer Early Detection Programme. In order to launch the programme, it is envisaged to initially collect, examine and analyse all studies and data from other countries on lung cancer screening and the benefits of using low-dose computed tomography and/or other methods for early detection of the disease before the manifestation of its symptoms."

This is how the Ministry of Health responded to an inquiry by BNT regarding data that due to the lack of an early detection programme, 70% of those who get the disease in Bulgaria find out about it when it is late. The ministry explains:

"Early screening is done in people between the age of 55 and 74, who have smoked for at least 30 pack-years history of smoking, or those who have stopped smoking in the past 15 years. One pack-year is equivalent to 20 cigarettes smoked (one pack) per day for one year. However, CT scans are not recommended for screening people who are under 55 or over 74, who stopped smoking more than 15 years ago, or if they have serious health conditions that are life-threatening or would interfere with antitobacco treatment."

Asked why there is no early lung cancer diagnosis programme in the country, the Ministry of Health said:

"Currently in Bulgaria, the scope of regular preventive examinations includes activities for early detection (screening) of breast, cervical, prostate and colorectal cancer. The activities are defined by regulation of the Minister of Health."

BNT asked the Ministry of Health why newly diagnosed lung cancer cases are decreasing in Europe but they in Bulgaria they are not?

Here is how we were answered:

"Smoking is the biggest preventable cause of premature mortality and morbidity and is associated with the development of various cancer sites - mainly lung, oral cavity, nasal cavity and sinuses, pharynx, larynx, etc., and about 10-15% of lung cancers in non-smokers are due to passive smoking. In the EU, on average 29% of the population smoke. Data from the Eurobarometer 2021 show that 38% of people over the age of 18 in Bulgaria are currently daily smokers. Scientific evidence shows conclusively that only complete quitting can lower the risk of cancer or smoking-related death."

The MoH further informs:

"In Bulgaria, the scope of regular preventive examinations currently includes activities for early detection (screening) of breast, cervical, prostate and colorectal cancer. The activities are defined by regulation of the Minister of Health.

Mammography for breast cancer screening is regulated as part of preventive check-ups for women aged 50-69 every 2 years.

For cervical cancer screening, women aged 30-40 should have a prophylactic examination by an obstetrician and gynaecologist and a smear test.

For men over the age of 50, a PSA test is done every 2 years for early detection of prostate cancer.

All of the above examinations are paid for by the National Health Insurance Fund for all insured persons. For preventive check-ups, everyone should contact their GP."