C
ancer is a big challenge for people in all countries
around the world. There are 12 million new cancer
diagnoses every year and about 20,000 cancer
deaths every day.
1 Information about cancer patients is
captured and processed by cancer registries worldwide that
have been established for this purpose. Cancer registry data
is used to estimate the cancer burden in a given population, to
monitor trends and to prepare projections and other
analyses, assisting policy-makers, cancer researchers,
patients groups and other users. The role of population
cancer registries in planning and monitoring cancer control
activities has been recognized and described in detail by
many authors.3-6 Their usefulness is demonstrated not only in
the provision of cancer statistics on population level, but also
in evaluating the effectiveness of the cancer control activities
by the calculation of indicators such as the proportion of
patients diagnosed at an early stage, the time interval until
initiation of treatment, etc. This concept of the role of cancer
registries, although acknowledged in general, is not fully
applied in some countries.4,6
In this article, the potential role of the Bulgarian National
Cancer Registry in cancer control is described and some of
the obstacles preventing its expansion are identified.
Bulgaria is situated in south-eastern Europe with a land
mass of 110,993 km2
. The population of 7.5 million people is
predominantly urban and is concentrated mainly in the
administrative centres of its 28 districts.
The Bulgarian National Cancer Registry (BNCR) started
operation in 1952. It is population-based, covers the whole
territory of the country and registers about 34,000 new
cancer cases a year. Cancer registration in Bulgaria is
compulsory and is regulated by orders and instructions from
the Ministry of Health. The registration network consists of
13 regional cancer registries that collect data from their
region (covering one, two or three districts) and record them
on a regional database. These regional databases are sent
regularly to the BNCR to form the national database, which
contains over 600,000 cancer cases diagnosed between
1993-2013. Patient data gathered before 1993 is stored on
paper only. The information for each case is structured in
more than 75 fields with details about the patient, tumour,
treatment and follow-up, which allows its use not only for
calculating incidence, prevalence and survival, but also for
different analyses and research projects in oncology, as well
as for public health purposes.
A comprehensive assessment of data quality at BNCR for
the period 1993-2010 shows that the registration of cases
follows the rules recommended for European cancer
registries regarding the coding of topography and
morphology, date of diagnosis, multiple primary and stage.
Cancer incidence in Bulgaria is lower than other countries in
south-eastern Europe, but the trends in incidence by cancer
site are similar. The curves of age-specific incidence are
identical with other south-eastern European countries and
childhood cancer incidence is within the expected range.
Completeness of registration is 94.5-96.0% for men and
91.1-93.6% for women.
An analysis of the validity indicators for the data shows a
THE UNDER-USED ROLE OF THE
BULGARIAN NATIONAL CANCER
REGISTRY IN CANCER CONTROL
NADYA DIMITROVA, NATIONAL HOSPITAL OF ONCOLOGY, BULGARIAN NATIONAL
CANCER REGISTRY
Information about cancer patients is captured by cancer registries that have been
established for this purpose. Their role in planning and monitoring cancer control activities
has been described in detail by many authors but whilst this function is generally
acknowledged, it is not always fully applied in some countries. The Bulgarian National
Cancer Registry (BNCR) has collected sufficient data to participate at each level of cancer
control, but the use of such data by policy-makers is well below the potential opportunities
that the data provides.
REGIONAL INITIATIVES
134 CANCER CONTROL 2014