Mapping the landscape of breast cancer care in Bulgaria: a scoping review
File(s)
Accepted version
Author(s)
Dimitrova, Mihaela
Tabche, Celine
Type
Journal Article
Abstract
Background: Breast cancer ranks as one of the most common cancer types in the
world, and in Bulgaria, it represents a quarter of all malignant diagnoses in women.
Breast cancer screening in Bulgaria is the lowest among all European Union (EU)
countries. Existing literature on breast cancer care in Bulgaria is scarce. This study
aims to explore the current trends, patterns, and gaps in breast cancer care in
Bulgaria.
Methods: This study is a scoping review from peer-reviewed databases and grey
literature. The results were screened against the SPIDER methodology's inclusion and
exclusion criteria. Covidence was used in screening and full-text review. The study
included 39 sources.
Results: Breast cancer is the leading cause of cancer mortality in Bulgaria and the
incidence remains lower than the European average due to underreporting. Bulgaria
lacks a structured breast cancer screening programme, leading to low service use,
although essential prophylactic exams are covered by the National Health Insurance
Fund. Barriers like the underuse of treatment and significant delays in reimbursement
of new cancer therapies exist. with lower survival rates compared to the rest of the EU.
While policies focus on increasing screening and improving prevention, practical steps
towards achieving this have not yet been taken.
Conclusion: There is low screening and underreporting of breast cancer rates in
Bulgaria. The lack of full reimbursement of diagnostic methods, limited adoption of the
multidisciplinary approach, and complex market access processes are barriers to
developing efficient treatment plans. Efficient screening and prevention are crucial for
positive outcomes.
world, and in Bulgaria, it represents a quarter of all malignant diagnoses in women.
Breast cancer screening in Bulgaria is the lowest among all European Union (EU)
countries. Existing literature on breast cancer care in Bulgaria is scarce. This study
aims to explore the current trends, patterns, and gaps in breast cancer care in
Bulgaria.
Methods: This study is a scoping review from peer-reviewed databases and grey
literature. The results were screened against the SPIDER methodology's inclusion and
exclusion criteria. Covidence was used in screening and full-text review. The study
included 39 sources.
Results: Breast cancer is the leading cause of cancer mortality in Bulgaria and the
incidence remains lower than the European average due to underreporting. Bulgaria
lacks a structured breast cancer screening programme, leading to low service use,
although essential prophylactic exams are covered by the National Health Insurance
Fund. Barriers like the underuse of treatment and significant delays in reimbursement
of new cancer therapies exist. with lower survival rates compared to the rest of the EU.
While policies focus on increasing screening and improving prevention, practical steps
towards achieving this have not yet been taken.
Conclusion: There is low screening and underreporting of breast cancer rates in
Bulgaria. The lack of full reimbursement of diagnostic methods, limited adoption of the
multidisciplinary approach, and complex market access processes are barriers to
developing efficient treatment plans. Efficient screening and prevention are crucial for
positive outcomes.
Date Acceptance
2025-05-24
Citation
Cancer Treatment and Research Communications
ISSN
2468-2942
Publisher
Elsevier
Journal / Book Title
Cancer Treatment and Research Communications
Copyright Statement
Copyright This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
License URL
Publication Status
Accepted