Introduction Bisphosphonates (BP) have been used for several decades for the treatment of multiple myeloma, bone metastases, osteoporosis, Paget disease and others. In recent years, reports of Bisphosphonate-associated osteonecrosis of the jaw (BAONJ) have increased, most often in oncological patients (breast cancer, prostate cancer, lung cancer and multiple myeloma) receiving intravenous BP. This is an extremely difficult and multifactorial process requiring monitoring and individual approach to each patient. Aim To conduct an epidemiological study of patients with oncological diseases in Bulgaria and in the Plovdiv region and to study the application of intravenous BP in patients with malignancies in the Plovdiv region. Materials and methods Official information on the total number of patients with neoplasms and the number of newly discovered neoplasms in Bulgaria and Plovdiv region is provided from the National Cancer Registry (NRC) of Bulgaria for the period 2012–2016 (5-year period). From the pharmacies of the hospitals in the Plovdiv region, where BP therapy is administered, was provided information on the oncology patients who received intravenous BP by years for the same period. Results In Bulgaria, from 2012 to 2016, were registered between 270,942 and 285,776 neoplasms per year, with an upwards trend, and with a significantly higher proportion of women. An average of 30,235 newly registered neoplasms per year have been registered, with a decreasing tendency of the number of cases. On average, the number of newly registered females for the period is 14,668 and for men - 15,567, with the proportion of men being credibly higher. In the region of Plovdiv, for the period an average of 35,634 neoplasms were registered per year, with a tendency for cases to grow, and with a significantly higher proportion of women. Newly registered cases in the region are an average of 3553, with a tendency to decrease the number of cases. On average, the newly registered males were 1908 and the females 1644, with an increase in the number of men and a decrease in the number of women, and a significantly higher proportion of men. In Bulgaria, and in the Plovdiv reign, the most common localizations of malignancy for the 5-year period are: skin, mammary gland, female genital organs, digestive organs and respiratory organs. In the country and the district of Plovdiv, for the cases of breast and prostate cancer, there was an increase for the 5-year study. For the period, in the Plovdiv region, an average of 2.30% of cancer patients received BP, with a higher proportion of women, and a median of age from 63 (2012) to 68 (2016). Most of the BP receiving oncology patients were between 61–70 and 71–80 years old. Zoledronic acid is administered between 98.77% and 100.00% of the cases. In the Plovdiv region, the application of BP has the highest relative proportions in mammary carcinoma, lymphatic, hematopoietic and related tissues, prostate and lung cancer. There is a decline in the median of the number of applications of BF from an average of 5 to 3 per year in 2015 and 2016, with women receiving more infusions than men. Conclusion Oncological diseases, both in Bulgaria and in the Plovdiv region, have an upward trend, especially in the cases of mammary carcinoma and prostate cancer, which means an increase in patients with a potential need of BP therapy. The patients treated with BP in the Plovdiv region have an increasing tendency of age, and are treated mainly with Zoledronic acid, which increases the risk of developing BAONJ.
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