Despite the PFAIA Audit, Colorectal Cancer and HPV Screening Programs to Begin in June

The Public Financial Inspection Agency (PFAIA) is conducting an audit of the national screening programs for colorectal cancer and diseases caused by the human papillomavirus (HPV). This was announced by the caretaker Minister of Health, Assoc. Prof. Mikhail Okoliyski, at a press conference.

According to him, an internal audit has already been carried out within the Ministry of Health, and a report to the prosecutor’s office has been prepared. Nevertheless, the screening programs will launch in June, utilizing the tests that have already been delivered.

To date, a public procurement process for the supply of medical devices and diagnostic kits has been conducted. For colorectal cancer screening, 51,020 tests out of a total of 160,000 have been delivered, and for cervical cancer, 22,068 out of the planned 70,000. The tests are currently held in the supplier’s warehouse and are to be distributed through the regional health inspectorates.

“Since the tests have already been paid for and have an approaching expiration date, they will be used for the screening in June,” Assoc. Prof. Okoliyski stated.

However, the Minister noted that the organizational preparation for the programs is not yet complete. “Contracts have not been signed between the NHIF and the general practitioners and laboratories that are supposed to carry out this activity. The payment procedure for diagnostics has not been established, nor has the activity itself been costed,” he said.

According to him, it is also not entirely clear how the specific type of tests included in the public procurement was determined. “There are indications that similar tests were offered at a lower price in other market studies,” the Health Minister added.

Okoliyski also commented on the algorithms for conducting the screening programs prepared by the Bulgarian Medical Association. In his view, they are based on good European practices, but some elements within them will be revised. “In this current state, we cannot move toward the effective implementation of these two screening programs,” he stated.

The Minister specified that a conversation was held with the contractor for the test supply contract, who expressed readiness to renegotiate some of the terms. According to him, test results should be entered in real-time, but currently, they are planned to be processed through a separate information system rather than directly into the National Health Information System.

The screening programs are part of the National Cancer Control Plan 2025–2030. It is planned that screenings for HPV-related diseases will be performed for women aged 25 to 65, and for colorectal cancer—for men and women between 45 and 75 years of age.

“For the first time, the state will attempt to organize a national screening that is in line with all the best practices of the World Health Organization,” emphasized Assoc. Prof. Okoliyski.

The programs will begin as a pilot in three regions, which will be determined based on epidemiological data and analyses from the National Center of Public Health and Analyses.

Dr. Iliya Tasev, Director of the Public Health Protection and Health Control Directorate at the Ministry of Health, explained that the delivered tests represent about one-third of those required for the year. “By contract, the expiration date of the delivered medical devices cannot be shorter than eight months, so they can be used until the end of the year,” he pointed out.

Dr. Tasev added that the delivery of equipment for cervical cancer screening is forthcoming, and there are at least four laboratories in the country with the necessary capacity to process colorectal cancer tests. The main challenge remains securing funding, as the state budget for the year has not yet been adopted.