Bulgaria has no working cancer registry, and its national anti-cancer plan is going nowhere, oncologists in Sofia said ahead of the 17th national oncology conference, MORE 2026. A new registry has been built and meets EU standards, but it still hasn't been switched on.

Without a registry, there's no accurate nationwide data, and the country can't design proper cancer-prevention policies, doctors said. The data fed into the National Health Information System simply isn't enough to shape such decisions.

The Bulgarian National Hub of Europe's Cancer Mission, a non-government network, is meant to coordinate how the EU and national anti-cancer plans are carried out. But the hub hasn't even been formally set up yet, so it hasn't started work. "For 204 days, the institutions have stayed silent about joining the Bulgarian National Hub," said pharmacist Ivaylo Petrov, who is coordinating the hub's launch and sits on the board of the Joint National Oncology Network. The hub is still waiting for answers from the education ministry, the health ministry, the ministry of innovation and digital transformation, and the labour ministry. Elsewhere in Europe, 17 similar hubs are already being set up. Petrov said it's deeply wrong to play down the scale of the cancer problem.

Bulgarian oncology is "a colossus with feet of clay," said Associate Professor Dimitar Kalev, chair of the MORE 2026 organising committee and the network's vice-president. Liver cancer cases, he said, are rising sharply across Europe, the disease is among the world's leading causes of death, and Bulgaria still has no organised prevention or screening programme. The three pillars of the European Commission's Cancer Mission — prevention, screening and health literacy — are all missing in Bulgaria, he said.

Liver cancer affects about 7 people per 100,000, and only 15% to 17% of patients survive five years after diagnosis, said Associate Professor Alexander Katsarov of the Military Medical Academy's gastroenterology clinic. The disease most often strikes people with cirrhosis, hepatitis B and C, and alcohol dependence, he said. He called for more money to go toward prevention instead of spending far larger sums later on treatment.

Liver transplants are a well-established treatment and are fully available in Bulgaria. The real problem is donors — Bulgaria has the lowest rate of donor identification in Europe, said Professor Ivelin Takorov, head of the Military Medical Academy's first clinic of abdominal surgery. This, he said, is an organisational failure that better coordination could fix.

About 10% of cancers have a genetic predisposition, said Associate Professor Draga Toncheva, a medical geneticist and member of the Bulgarian Academy of Sciences. Bulgaria has both targeted therapies and genetic labs, she said, but patients' path through the system is broken up and disjointed. She also said the 25 euros the national health fund pays for the new cancer-related procedure is far too little. Genetic testing should go hand in hand with cancer diagnosis, she added, so relatives found to carry a genetic risk could then start early preventive care.

Professor Maria Dimitrova, from the pharmacy organisation and economics department at the Medical University of Sofia's pharmacy faculty, said the hub's goal is to raise awareness of prevention and early preventive care. Catching cancer early and getting patients quick access to treatment is an investment, not a cost, she said, because people are the country's most valuable asset.

The conference opens later today and runs until October 4, organised by the Joint National Oncology Network (SONM). Bulgarian oncologists, radiotherapists and pharmacologists will discuss unresectable advanced hepatocellular carcinoma and unveil the country's first national guidelines for treating liver cancer — the first in oncology to include a dedicated chapter on pharmacoeconomics.