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Background Incidence rate and mortality of breast cancer and cancer of the cervix uteri in Bulgaria are higher in comparison with most countries of European Union (EU). Moreover, during the last three decades they have been increasing, even doubled for cervix cancer, although in developed countries there are proven effective prevention programs. The aim of the study is to explore how these programs are being implemented in Bulgaria and what caused their unsatisfactory results. Methods Data were collected by documents review and direct individual self-administered questionnaire among 186 women aged 30-69 concerning types and regularity of preventive activities. Results National Health Insurance Fund in Bulgaria defines as mandatory and finances a regular check-up annually for health insured people over 18 years of age. Mammography, as a screening of a breast cancer, was included in regular check-up package from the year 2011, once at every two years, for women aged 50-69. Papanicolau test for cancer of the cervix uteri wasn’t provided in the preventive package until the year 2017 when it was included only for women who complete 30 years of age in the current calendar year with intended regularity once at every two years. Women from other age groups currently are not covered with preventive examination for cervical cancer or they should pay for it which restricts accessibility and affordability of prevention activities. Study results indicates that every fifth of the investigated women have never had a prophylactic examination for breast cancer and cervical cancer. In addition, 69.4% of those who have such examination did not comply with the recommended regularity. Conclusions Screening programs against breast cancer and cancer of the cervix uteri are consistent with the recommendations of the oncology research societies but they being applied relatively soon in Bulgaria and some age groups are out of their coverage which decreases their effectiveness. Key messages Incidence rate and mortality of breast cancer and cancer of the cervix uteri in Bulgaria are higher than in most countries of European Union although there are proven effective prevention programs. Screening programs against breast cancer and cervical cancer are not effective because of their low accessibility and affordability and because they don’t comply with the recommended regularity.

Unsatisfactory effectiveness of preventive programs for oncogynecological diseases in Bulgaria