Lung cancer prevention in Bulgaria: professional assessments, challenges and systemic deficiencies

Abstract

Lung cancer remains the leading cause of cancer mortality worldwide and represents a major public health challenge. In Bulgaria, the disease is characterized by high incidence, late-stage diagnosis, and limited preventive practices, underscoring the need for a systematic assessment of factors influencing the effectiveness of prevention. The aim of the present study is to evaluate the professional perceptions of medical specialists regarding the current state of early diagnosis and prevention of lung cancer, with emphasis on their awareness, participation in preventive activities, and assessment of access to contemporary diagnostic technologies. The study was conducted as a descriptive quantitative survey among 145 medical professionals from various clinical disciplines. A structured 36-item questionnaire was used to assess both factual knowledge and professional attitudes. The findings reveal consistent deficiencies: low patient awareness, limited engagement of specialists in preventive initiatives, skepticism regarding the effectiveness of screening, and substantial challenges in accessing modern diagnostic methods. Comparison with international practices indicates that Bulgaria aligns with countries characterized by fragmented preventive systems and insufficient structural mechanisms for the implementation of modern standards. The results highlight the urgent need to develop a national lung cancer screening program, strengthen public health information campaigns, enhance professional training, and ensure equitable access to diagnostic services. Integrating these components could improve early detection rates and contribute to reducing lung cancer mortality in Bulgaria.