Assoc. Prof. Silvi Kirilov: No Inflated Prices for Colorectal Screening Tests

Claims of “tenfold inflated prices” in the public procurement for colorectal cancer screening tests do not correspond to the facts. This was stated by Assoc. Prof. Silvi Kirilov regarding public comments related to the selection of tests for the national program.

According to him, an incorrect comparison is being made between rapid pharmacy tests and the quantitative fecal immunochemical test (FIT) selected for mass screening. “We are talking about different technologies and a different class of medical devices,” Kirilov emphasized.

He specified that pharmacy tests are qualitative but rely on visual results without automation, calibration, or guaranteed laboratory traceability. In mass screening, this increases the risk of false results. In contrast, the quantitative FIT is a closed laboratory system that allows for quantitative measurement, setting threshold values, and full automation with quality control. The method does not require dietary restrictions and has higher specificity and clinical efficacy compared to gFOBT.

According to Kirilov, this type of test is the internationally recommended standard according to European guidelines, as well as IARC and WHO recommendations. He further noted that the Bulgarian Medical Association has developed algorithms for the organization of the program that meet European criteria and follow the roadmap of international expert organizations, having been presented in February 2026 at the 3rd EU Cancer Screening Report Workshop.

Assoc. Prof. Kirilov emphasized that the procedure was conducted under the Public Procurement Act based on the “lowest price” criterion, and the contract was signed on October 22, 2025. The agreed price is fixed and includes all costs. According to him, a claim of a “markup” can only be made when comparing identical products with comparable characteristics, a comparison which has not been presented so far.

“Colorectal cancer screening is a policy aimed at reducing mortality. The national program is based on international standards and scientific evidence, rather than simplistic price suggestions,” he further stated.