Implementing cervical cancer screening in Bulgaria: what are the health system-level constraints that should be addressed? [oral presentation]

Bulgaria has experienced a dramatic rise in the incidence of cervical cancer, from 15.8 per 100,000 in 1988, to 27.3 in 2002, among the highest rates in Europe and the Former Soviet Union (HfA, WHO 2004). Mortality from cervical cancer in all ages has grown since the 1980s, and in 2001, it was twice the EU levels (6.4 per 100,000, compared to 2.5 EU average), although it started from a lower base during the 1970s. (Figure 1).