Bulgaria still has no working cancer registry, and the country's anti-cancer plan is not being carried out, oncologists say. They spoke in Sofia ahead of the 17th national oncology conference, MORE 2026. A new registry that meets EU standards is ready, but it has not gone live yet.
Without it, nobody has accurate data for the whole country, and officials cannot make decisions on prevention, doctors say. The data held in the National Health Information System is not enough.
"Ignoring cancer is deeply immoral," said pharmacist Ivaylo Petrov, who is coordinating the founding of the National Hub of the Cancer Mission – Bulgaria (NHMR) and sits on the board of the Joint National Oncology Network (SONM). Institutions have stayed silent for 204 days on whether to include them in the Bulgarian national hub, he said.
The hub, a non-government initiative, is meant to organise how the European and national anti-cancer plans are carried out — but it cannot start work until it is formally set up as an institution. Petrov is still waiting for replies from the ministries of education and science, health, innovation and digital transformation, and labour and social policy. In other European countries, 17 such hubs are close to being formally established.
Assoc Prof Dimitar Kalev, chairman of the MORE 2026 organising committee and vice-president of SONM, called Bulgarian oncology "a colossus with feet of clay." The three pillars of the European Commission's Cancer Mission — prevention, screening and health literacy — are all missing in Bulgaria, he said, and there is no organised screening.
Liver cancer is one of the leading causes of death worldwide, Kalev said. The disease itself is rare, affecting about 7 in every 100,000 people, but cases are rising sharply across Europe. Between 15% and 17% of patients are still alive five years after diagnosis.
Liver cancer develops most often in patients with cirrhosis, hepatitis B and C, and alcohol dependence, said Assoc Prof Alexander Katsarov, head of the first department at the gastroenterology clinic of the Military Medical Academy. The money would be better spent on prevention, he said, than on pouring far greater resources into treatment.
For liver cancer, a transplant is a well-established treatment and is fully available in Bulgaria, said Prof Ivelin Takorov, head of the First Clinic of Abdominal Surgery at the Military Medical Academy. He said the transplant programme has the lowest donor detection rate in Europe — an institutional problem, in his view, that better organisation could fix.
Assoc Prof Draga Toncheva, a medical genetics specialist and member of the Bulgarian Academy of Sciences, said Bulgaria has both targeted therapies and genetic labs, but a patient's path through the system is broken and disjointed. Genetic testing should go hand in hand with cancer diagnosis, she said, and the new procedure — for which the health insurance fund pays just 25 euros — falls far short of what patients need. About 10% of cancers have a genetic link, she said, and relatives of patients could get early prevention and timely treatment.
Catching cancer early and getting patients quick access to treatment is an investment, not a cost, said Prof Maria Dimitrova, from the department of pharmacy organisation and economics at Sofia Medical University — because people are a country's most valuable asset.
The conference runs until October 4. Oncologists, radiotherapists and pharmacologists will present new approaches, clinical results and radiotherapy options for advanced, inoperable liver cancer. The event will also unveil the National Guideline for the Clinical Management of Liver Cancer — the first in oncology to include a chapter on pharmacoeconomics.