[Effectiveness of cervical screening - expectation and reality]

The aim of the present study was to establish the effectiveness of the conducted in Bulgaria cervical screening program for the period 1975-1996. The dynamics of the ratio invasive cancer/in situ cancer, as well as the share of the diagnosed from cytologically signalized women were analyzed. The tendency of deterioration of each of the indices was evident. The crude incidence varies between 12.7 and 22.7 x 10(5) women, while the frequency of CIS is from 3.2 and 6.2 x 10(5) women. This defines unfavorable ratio of the cases with invasive cancer toward CIS, which varies from 2:1 for 1982 to more than 5:1 for 1996 year. The study demonstrates the prevalence of a low rate of confirmed by biopsy, cytologically signalized women--from 15.6% and 30% (total for country--33.3%), except DOD Blagoevgrad--50.6%, Plovdiv--46.4% and Sofia-city--63.8%. The results of our study demonstrate the low effectiveness of to date conducted cervical screening program. The lake of a screening register is another weakness of the program, which lead to a deteriorated registration and reading of the detected precancer lesions, as well as, their diagnostic follow and therapy.