P-0170 - Epidemiology of rectal cancer in the regions of Varna and Dobrich, Bulgaria

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Cancer Aetiology, Epidemiology, Prevention
Rectal Cancer
Presenter Daniel Kostov
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors D. Kostov1, G. Kobakov2, D. Yankov3
  • 1Naval Hospital, Varna/BG
  • 2Clinic of Surgical Oncology, Varna/BG
  • 3Naval Hospital of Varna, Varna/BG



Incidence and prevalence rates of rectal cancer continuously grow in Bulgaria in spite of the various preventive campaigns. The objective of this study was to analyze the annual dynamics of several demographic and clinical parameters of rectal cancer in two regions in North-Eastern Bulgaria served by the Specialized Oncologic Hospital of Varna.


An epidemiological analysis of data from patient's registry of the Specialized Oncologic Hospital of Varna for 2004-2013 as well as from ‘Cancer Incidence in Bulgaria’, the official publication of the National Centre of Oncology of Sofia for 2004-2010 concerning the patients from the regions of Varna and Dobrich was carried out.


Both incidence and prevalence rates of rectal cancer in both genders and most age groups increased. Cancer incidence rate of male rectal cancer in the region of Varna increased from 26.8 in 2008 to 32.4 in 2013 while that of female one - from 14,9 to 22.3 per 100000, respectively. The corresponding figures concerning the region of Dobrich were the following: 14.8, 21.5; 9.6 and 14.7. In 2010, the region of Varna was fourth among all 30 regions in Bulgaria concerning the age-adjusted (world standard) incidence rate of female rectal cancer per 100000 and fifth concerning that of male one. There was a gradual increasing of the number and percentage of the newly-diagnosed rectal cancer cases during this period in both regions. The percentage of the early-diagnosed cases in the region of Varna increased from 41.7% in 2012 up to 49.2% in 2013 while that in the region of Dobrich did from 54.3% up to 54.5% only. All the newly-diagnosed cases were morphologically verified. In 2004-2008, males aged between 61 and 70 years and females aged between 71 and 80 years (35.65% and 30.47% of the cases, respectively) were most commonly affected. In 2009-2013, both male and female patients aged between 61 and 70 years (35.73% and 37.50% of the cases, respectively) were most affected. As a whole, this age group was most affected followed by the age group between 71 and 80 years (34.37% and 29.43% of the cases, respectively). It was an alarming fact that four patients were aged up to 30 years only and 17 ones were aged between 31 and 40 years. Male patients' mean age was similar (65.82 and 65.47 years) during these two periods while female patients' one slightly increased during the second period (from 66.91 to 67.77 years). In 2009-2013, radical surgical treatment was performed in 58.33% of the patients. The age-adjusted (world standard) mortality rate slightly decreased during the recent years for both genders in Bulgaria and in these two regions as well.


Our results revealed a relatively unfavourable socio-epidemiological picture of this disease. Despite the continuous improvement of the diagnostic capacities, surgical opportunities and preventive programs for rectal cancer in Bulgaria, this malignancy is still widely disseminated. Its prognosis remains relatively poor.