Mortality by causes, sex, statistical regions and districts

Table

MORTALITY BY CAUSES, SEX AND STATISTICAL REGIONS IN 2024

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Bulgaria			Severozapaden
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 563.9	1 677.0	1 459.2	2 027.5	2 173.3	1 891.8
Infectious and parasitic diseases (A00-B99)	8.0	9.4	6.7	8.3	12.3	4.7
Tuberculosis (A15-A19, B90)	0.9	1.5	0.3	1.7	2.5	0.9
AIDS (HIV-disease) (B20-B24)	0.2	0.3	0.0	0.2	0.3	-
Viral hepatitis (B15-B19, B94.2)	0.3	0.5	0.1	0.9	1.9	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	6.6	7.1	6.2	5.6	7.5	3.8
Neoplasms (C00-D48)	265.8	313.7	221.5	338.9	399.8	282.3
Malignant neoplasms (C00-C97)	264.4	312.5	219.9	336.4	396.9	280.0
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	6.1	9.7	2.9	6.4	9.4	3.5
Malignant neoplasm of oesophagus (C15)	3.2	5.2	1.4	4.1	7.2	1.2
Malignant neoplasm of stomach (C16)	13.4	17.4	9.7	13.6	18.2	9.4
Malignant neoplasm of colon, rectum and anus (C18-C21)	39.7	49.2	30.9	48.5	63.8	34.2
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	10.5	13.2	8.0	14.1	16.7	11.7
Malignant neoplasm of pancreas (C25)	18.2	20.0	16.5	23.2	21.1	25.2
Malignant neoplasm of larynx (C32)	4.6	8.7	0.8	9.2	17.0	2.0
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	52.3	77.6	28.8	71.8	109.5	36.9
Malignant melanoma of skin (C43)	2.8	3.4	2.3	3.0	3.5	2.6
Malignant neoplasm of breast (C50)	18.9	0.7	35.8	25.6	1.3	48.3
Malignant neoplasm of cervix uteri (C53)	5.0	-	9.6	7.9	-	15.2
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	4.7	-	9.1	4.9	-	9.4
Malignant neoplasm of ovary (C56)	6.1	-	11.7	6.8	-	13.2
Malignant neoplasm of prostate (C61)	15.8	32.8	-	17.6	36.5	-
Malignant neoplasm of kidney (C64)	6.4	8.8	4.2	8.6	9.4	7.9
Malignant neoplasm of bladder (C67)	9.2	14.8	4.0	11.4	19.2	4.1
Malignant neoplasm of brain and central nervous system (C70-C72)	9.5	10.4	8.7	11.1	11.6	10.5
Malignant neoplasm of thyroid (C73)	0.7	0.5	0.7	0.6	0.6	0.6
Hodgkin disease and lymphomas (C81-C86)	3.5	4.1	2.9	4.5	6.9	2.3
Leukaemia (C91-C95)	6.0	6.8	5.3	7.1	8.2	6.1
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.1	2.3	2.0	2.4	2.2	2.6
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	25.6	27.1	24.3	33.8	34.3	33.4
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.4	1.2	1.6	2.6	2.8	2.3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.4	1.5	1.3	1.8	2.2	1.5
Endocrine, nutritional and metabolic diseases (E00-E89)	22.8	21.8	23.7	62.3	63.8	60.9
Diabetes mellitus (E10-E14)	22.2	21.2	23.1	61.1	62.6	59.7
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.6	0.5	0.6	1.2	1.3	1.2
Mental and behavioural disorders (F01-F99)	1.2	1.4	1.0	3.3	4.4	2.3
Dementia (F01, F03)	0.5	0.2	0.7	1.4	1.3	1.5
Alcohol abuse (including alcoholic psychosis) (F10)	0.4	0.7	0.0	1.1	1.9	0.3
Drug dependence, toxicomania (F11-F16, F18-F19)	0.0	0.1	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.3	0.4	0.2	0.9	1.3	0.6
Diseases of the nervous system and the sense organs (G00-H95)	13.9	15.6	12.3	18.9	23.3	14.9
Parkinson’s disease (G20)	2.0	1.9	2.0	5.3	4.7	5.9
Alzheimer’s disease (G30)	0.6	0.5	0.7	1.5	1.9	1.2
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	11.3	13.1	9.6	12.1	16.7	7.9
Diseases of the circulatory system (I00-I99)	948.5	948.8	948.3	1 185.2	1 165.3	1 203.7
Ischaemic heart diseases (I20-I25)	201.2	222.0	181.9	230.4	239.7	221.8
of which:
Acute myocardial infarction (I21-I22)	72.0	94.0	51.6	44.9	56.9	33.6
Other ischaemic heart diseases (I20, I23-I25)	129.2	128.0	130.3	185.5	182.7	188.1
Other heart diseases (I30-I51)	301.9	303.4	300.4	420.8	418.0	423.4
Cerebrovascular diseases (I60-I69)	272.2	253.1	289.9	369.5	338.4	398.5
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	173.3	170.3	176.1	164.5	169.2	160.0
Diseases of the respiratory system (J00-J99)	77.4	93.8	62.2	100.0	120.8	80.8
Influenza (J09-J11)	0.8	0.9	0.6	0.2	0.3	-
Pneumonia (J12-J18)	36.5	44.2	29.4	34.1	39.0	29.6
Chronic lower respiratory diseases (J40-J47)	18.5	23.3	14.1	42.4	51.6	33.9
of which:
Asthma (J45-J46)	0.4	0.3	0.4	0.9	0.9	0.9
Other chronic lower respiratory diseases (J40-J44, J47)	18.2	23.0	13.7	41.5	50.6	33.1
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	21.6	25.3	18.1	23.3	29.9	17.3
Diseases of the digestive system (K00-K92)	66.6	88.5	46.4	84.3	112.0	58.5
Ulcer of stomach, duodenum and jejunum (К25-К28)	2.9	3.3	2.6	4.1	3.5	4.7
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	27.2	44.4	11.4	31.1	50.6	12.9
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	36.5	40.8	32.5	49.1	57.9	41.0
Diseases of the skin and subcutaneous tissue (L00-L99)	1.4	1.2	1.6	1.5	1.9	1.2
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.7	0.7	0.7	1.4	1.3	1.5
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.2	0.1	0.2	0.2	0.3	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.6	0.6	0.5	1.2	0.9	1.5
Diseases of the genitourinary system (N00-N99)	32.0	34.8	29.4	40.8	45.6	36.3
Diseases of kidney and ureter (N00-N29)	31.4	34.0	29.1	39.4	43.4	35.7
Other diseases of the genitourinary system (N30-N99)	0.6	0.9	0.4	1.4	2.2	0.6
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.1	-	0.2	0.3	-	0.6
Certain conditions originating in the perinatal period (P00-P96)	1.9	2.5	1.3	2.4	3.1	1.8
Congenital malformations and chromosomal abnormalities (Q00-Q99)	1.0	1.2	0.8	0.8	1.3	0.3
Symptoms, signs, ill-defined causes (R00-R99)	78.7	79.7	77.8	116.4	133.0	100.9
Sudden infant death syndrome (R95)	0.0	0.1	-	0.2	0.3	-
Unknown and unspecified causes (R96-R99)	50.0	59.2	41.4	84.0	107.3	62.3
Other symptoms, signs, ill-defined causes (R00-R94)	28.7	20.4	36.4	32.3	25.5	38.6
External causes of morbidity and mortality (V01-Y98)	36.3	55.1	18.9	55.0	77.4	34.2
Accidents (V01-X59, Y85-Y86)	20.1	29.6	11.3	35.3	50.0	21.7
of which:
Transport accidents (V01-V99,Y85)	6.9	11.1	3.0	11.4	20.4	2.9
Accidental falls (W00-W19)	5.8	6.9	4.7	13.9	13.5	14.3
Drowning and accidental submersion '(W65-W74)	1.2	2.1	0.3	1.4	2.5	0.3
Accidental poisoning (W65-W74)	1.1	1.7	0.6	1.1	1.6	0.6
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.2	7.8	2.8	7.6	12.0	3.5
Suicide and intentional self-harm (X60-X84, Y87.0)	7.0	11.6	2.9	10.0	14.2	6.1
Homicide, assault (X85-Y09, Y87.1)	0.7	0.9	0.5	1.1	1.3	0.9
Events of undetermined intent (Y10-Y34, Y87.2)	7.3	11.3	3.6	5.6	7.2	4.1
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.1	1.7	0.6	3.0	4.7	1.5
Codes for special purposes (U00-U85)	6.1	7.5	4.8	5.8	6.0	5.6
of which COVID-19 (U07.1-U07.2)	6.1	7.5	4.8	5.8	6.0	5.6

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Severen tsentralen			Severoiztochen
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 899.7	2 019.1	1 790.4	1 575.6	1 727.7	1 434.5
Infectious and parasitic diseases (A00-B99)	9.6	9.6	9.6	13.8	16.6	11.2
Tuberculosis (A15-A19, B90)	1.2	1.5	0.8	0.6	1.0	0.2
AIDS (HIV-disease) (B20-B24)	-	-	-	0.1	0.3	-
Viral hepatitis (B15-B19, B94.2)	0.3	-	0.6	0.2	0.3	0.2
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	8.1	8.0	8.2	12.8	15.1	10.7
Neoplasms (C00-D48)	322.7	373.4	276.2	281.3	335.8	230.8
Malignant neoplasms (C00-C97)	320.2	371.9	272.8	279.3	334.0	228.5
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	7.5	11.4	4.0	8.6	14.8	2.8
Malignant neoplasm of oesophagus (C15)	2.2	3.4	1.1	3.4	5.5	1.4
Malignant neoplasm of stomach (C16)	17.3	20.4	14.4	13.2	17.6	9.1
Malignant neoplasm of colon, rectum and anus (C18-C21)	53.2	64.6	42.7	42.1	53.8	31.2
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	12.0	16.1	8.2	8.8	11.1	6.8
Malignant neoplasm of pancreas (C25)	19.9	21.3	18.7	18.3	21.4	15.4
Malignant neoplasm of larynx (C32)	4.9	9.9	0.3	4.0	7.3	0.9
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	64.1	97.4	33.7	54.0	82.7	27.3
Malignant melanoma of skin (C43)	2.1	3.1	1.1	1.8	2.5	1.2
Malignant neoplasm of breast (C50)	25.3	-	48.4	19.8	0.3	38.0
Malignant neoplasm of cervix uteri (C53)	6.5	-	12.5	6.3	-	12.1
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	6.5	-	12.5	4.2	-	8.2
Malignant neoplasm of ovary (C56)	6.1	-	11.6	7.3	-	14.0
Malignant neoplasm of prostate (C61)	19.2	40.2	-	15.2	31.7	-
Malignant neoplasm of kidney (C64)	6.2	8.3	4.2	7.4	11.1	4.0
Malignant neoplasm of bladder (C67)	12.0	19.2	5.4	10.6	17.4	4.4
Malignant neoplasm of brain and central nervous system (C70-C72)	10.3	11.1	9.6	8.5	8.6	8.4
Malignant neoplasm of thyroid (C73)	0.9	0.3	1.4	0.5	0.3	0.7
Hodgkin disease and lymphomas (C81-C86)	4.6	3.7	5.4	4.0	4.8	3.3
Leukaemia (C91-C95)	5.3	5.9	4.8	5.7	4.5	6.8
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.8	2.2	3.4	1.8	1.0	2.6
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	31.3	33.4	29.4	33.8	38.7	29.1
Non-malignant neoplasms (benign and uncertain) (D00-D48)	2.5	1.5	3.4	2.1	1.8	2.3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	3.1	3.1	3.1	2.3	2.0	2.6
Endocrine, nutritional and metabolic diseases (E00-E89)	21.1	20.7	21.5	36.3	32.2	40.1
Diabetes mellitus (E10-E14)	20.2	19.8	20.7	35.6	31.4	39.4
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.9	0.9	0.8	0.7	0.8	0.7
Mental and behavioural disorders (F01-F99)	1.8	1.9	1.7	2.3	3.8	0.9
Dementia (F01, F03)	1.0	0.3	1.7	0.1	-	0.2
Alcohol abuse (including alcoholic psychosis) (F10)	0.6	1.2	-	1.3	2.8	-
Drug dependence, toxicomania (F11-F16, F18-F19)	0.1	0.3	-	0.2	0.5	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	0.6	0.5	0.7
Diseases of the nervous system and the sense organs (G00-H95)	17.0	21.0	13.3	16.5	18.1	14.9
Parkinson’s disease (G20)	3.0	2.5	3.4	2.3	2.0	2.6
Alzheimer’s disease (G30)	0.7	0.3	1.1	1.1	1.0	1.2
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	13.3	18.2	8.8	13.1	15.1	11.2
Diseases of the circulatory system (I00-I99)	1 122.0	1 110.3	1 132.6	924.1	947.2	902.6
Ischaemic heart diseases (I20-I25)	194.9	219.2	172.6	169.9	206.5	135.9
of which:
Acute myocardial infarction (I21-I22)	75.8	99.5	54.1	82.6	115.7	52.0
Other ischaemic heart diseases (I20, I23-I25)	119.1	119.6	118.6	87.2	90.8	83.9
Other heart diseases (I30-I51)	372.3	361.3	382.4	168.7	183.4	155.1
Cerebrovascular diseases (I60-I69)	303.8	285.9	320.1	246.8	243.0	250.4
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	251.0	243.9	257.5	338.7	314.4	361.2
Diseases of the respiratory system (J00-J99)	115.5	139.4	93.7	66.4	81.2	52.7
Influenza (J09-J11)	1.2	1.5	0.8	0.4	0.3	0.5
Pneumonia (J12-J18)	71.7	82.5	61.7	35.3	42.5	28.7
Chronic lower respiratory diseases (J40-J47)	21.7	29.7	14.4	14.4	19.9	9.3
of which:
Asthma (J45-J46)	0.7	0.3	1.1	0.8	0.5	1.2
Other chronic lower respiratory diseases (J40-J44, J47)	21.0	29.4	13.3	13.6	19.4	8.2
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	21.0	25.7	16.7	16.3	18.6	14.2
Diseases of the digestive system (K00-K92)	80.8	109.4	54.6	78.3	104.4	54.1
Ulcer of stomach, duodenum and jejunum (К25-К28)	4.6	6.8	2.5	4.7	5.0	4.4
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	31.9	52.5	13.0	35.2	55.8	16.1
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	44.3	50.1	39.1	38.4	43.5	33.6
Diseases of the skin and subcutaneous tissue (L00-L99)	3.7	2.5	4.8	1.5	1.8	1.2
Diseases of the musculoskeletal system/connective tissue (M00-M99)	1.5	1.2	1.7	1.2	1.3	1.2
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.7	0.3	1.1	0.4	0.3	0.5
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.7	0.9	0.6	0.8	1.0	0.7
Diseases of the genitourinary system (N00-N99)	40.5	38.0	42.7	35.8	40.0	31.9
Diseases of kidney and ureter (N00-N29)	39.6	37.1	41.9	34.8	38.2	31.7
Other diseases of the genitourinary system (N30-N99)	0.9	0.9	0.8	1.0	1.8	0.2
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	0.2	-	0.5
Certain conditions originating in the perinatal period (P00-P96)	1.9	2.8	1.1	1.9	2.3	1.6
Congenital malformations and chromosomal abnormalities (Q00-Q99)	1.2	1.5	0.8	0.8	1.3	0.5
Symptoms, signs, ill-defined causes (R00-R99)	106.5	106.6	106.4	68.7	74.2	63.7
Sudden infant death syndrome (R95)	-	-	-	0.1	0.3	-
Unknown and unspecified causes (R96-R99)	76.2	82.5	70.5	50.2	60.4	40.8
Other symptoms, signs, ill-defined causes (R00-R94)	30.3	24.1	35.9	18.4	13.6	22.9
External causes of morbidity and mortality (V01-Y98)	44.5	70.5	20.7	38.6	58.6	20.1
Accidents (V01-X59, Y85-Y86)	29.0	44.8	14.4	20.7	30.2	11.9
of which:
Transport accidents (V01-V99,Y85)	8.0	12.7	3.7	7.9	14.1	2.1
Accidental falls (W00-W19)	9.6	13.3	6.2	3.4	4.3	2.6
Drowning and accidental submersion '(W65-W74)	1.2	2.2	0.3	1.0	1.8	0.2
Accidental poisoning (W65-W74)	2.2	3.1	1.4	1.2	2.0	0.5
Other accidents (W20-W64, W75- X39, X50-59, Y86)	8.0	13.6	2.8	7.3	8.0	6.5
Suicide and intentional self-harm (X60-X84, Y87.0)	8.9	15.5	2.8	7.9	13.3	2.8
Homicide, assault (X85-Y09, Y87.1)	0.6	0.9	0.3	0.6	0.5	0.7
Events of undetermined intent (Y10-Y34, Y87.2)	5.0	7.7	2.5	9.3	14.6	4.4
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.0	1.5	0.6	0.1	-	0.2
Codes for special purposes (U00-U85)	6.4	7.1	5.7	5.4	7.0	4.0
of which COVID-19 (U07.1-U07.2)	6.4	7.1	5.7	5.4	7.0	4.0

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Yugoiztochen			Yugozapaden
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 512.3	1 627.2	1 405.9	1 328.5	1 410.7	1 252.5
Infectious and parasitic diseases (A00-B99)	12.2	13.8	10.7	4.0	4.0	4.0
Tuberculosis (A15-A19, B90)	1.3	2.4	0.2	0.3	0.6	0.1
AIDS (HIV-disease) (B20-B24)	0.2	0.4	-	0.1	0.2	-
Viral hepatitis (B15-B19, B94.2)	0.8	1.3	0.4	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	9.9	9.6	10.1	3.6	3.2	3.9
Neoplasms (C00-D48)	250.2	301.8	202.4	211.2	238.6	185.9
Malignant neoplasms (C00-C97)	249.2	300.9	201.4	210.7	238.1	185.4
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	5.1	8.5	2.0	4.5	7.3	1.8
Malignant neoplasm of oesophagus (C15)	3.7	6.1	1.4	3.1	4.3	2.0
Malignant neoplasm of stomach (C16)	14.0	18.6	9.7	9.3	11.4	7.3
Malignant neoplasm of colon, rectum and anus (C18-C21)	38.1	48.7	28.3	31.4	38.2	25.1
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	9.6	13.1	6.3	8.2	10.2	6.3
Malignant neoplasm of pancreas (C25)	17.2	19.0	15.6	16.8	18.7	15.0
Malignant neoplasm of larynx (C32)	4.1	7.9	0.6	3.3	5.9	0.9
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	53.5	78.2	30.6	37.0	50.3	24.7
Malignant melanoma of skin (C43)	2.1	2.2	2.0	3.8	4.1	3.4
Malignant neoplasm of breast (C50)	16.2	0.2	31.0	16.1	1.0	30.0
Malignant neoplasm of cervix uteri (C53)	4.3	-	8.3	3.7	-	7.0
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	4.5	-	8.7	4.5	-	8.6
Malignant neoplasm of ovary (C56)	5.5	-	10.5	4.7	-	9.1
Malignant neoplasm of prostate (C61)	12.9	26.9	-	12.9	26.9	-
Malignant neoplasm of kidney (C64)	5.6	6.3	4.9	5.0	7.2	3.0
Malignant neoplasm of bladder (C67)	8.0	13.5	2.8	7.4	11.6	3.5
Malignant neoplasm of brain and central nervous system (C70-C72)	8.9	11.1	6.9	9.3	9.9	8.8
Malignant neoplasm of thyroid (C73)	0.7	1.1	0.4	0.5	0.5	0.6
Hodgkin disease and lymphomas (C81-C86)	3.4	4.2	2.6	2.7	3.0	2.5
Leukaemia (C91-C95)	5.0	7.9	2.4	6.0	6.6	5.4
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.0	2.8	1.2	1.6	1.9	1.3
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	24.8	23.6	25.9	19.0	19.6	18.6
Non-malignant neoplasms (benign and uncertain) (D00-D48)	0.9	0.9	1.0	0.5	0.5	0.5
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.8	2.2	1.4	0.6	0.8	0.4
Endocrine, nutritional and metabolic diseases (E00-E89)	14.1	12.9	15.2	17.5	17.1	17.9
Diabetes mellitus (E10-E14)	13.2	12.5	14.0	17.2	16.7	17.7
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.8	0.4	1.2	0.3	0.4	0.2
Mental and behavioural disorders (F01-F99)	0.7	0.2	1.2	0.4	0.6	0.2
Dementia (F01, F03)	0.3	-	0.6	0.1	0.1	0.2
Alcohol abuse (including alcoholic psychosis) (F10)	0.1	0.2	-	0.0	0.1	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.3	-	0.6	0.2	0.4	-
Diseases of the nervous system and the sense organs (G00-H95)	14.7	16.8	12.8	11.0	11.5	10.6
Parkinson’s disease (G20)	1.1	1.3	0.8	1.4	1.4	1.4
Alzheimer’s disease (G30)	0.3	0.2	0.4	0.5	0.5	0.5
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	13.3	15.3	11.5	9.1	9.6	8.7
Diseases of the circulatory system (I00-I99)	949.6	950.7	948.6	797.7	802.5	793.3
Ischaemic heart diseases (I20-I25)	249.3	282.1	219.0	103.8	118.6	90.0
of which:
Acute myocardial infarction (I21-I22)	86.3	114.3	60.3	43.9	56.8	32.0
Other ischaemic heart diseases (I20, I23-I25)	163.1	167.8	158.7	59.8	61.8	58.0
Other heart diseases (I30-I51)	218.2	216.3	220.0	417.3	415.3	419.1
Cerebrovascular diseases (I60-I69)	323.1	302.6	342.0	192.4	178.4	205.4
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	159.0	149.7	167.6	84.3	90.2	78.8
Diseases of the respiratory system (J00-J99)	73.5	91.3	57.1	83.6	97.3	70.9
Influenza (J09-J11)	1.2	1.7	0.6	0.5	0.4	0.7
Pneumonia (J12-J18)	32.9	38.9	27.3	38.3	48.8	28.6
Chronic lower respiratory diseases (J40-J47)	14.4	17.9	11.1	17.7	20.1	15.4
of which:
Asthma (J45-J46)	0.2	0.2	0.2	0.0	0.1	-
Other chronic lower respiratory diseases (J40-J44, J47)	14.2	17.7	10.9	17.6	20.0	15.4
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	25.1	32.8	18.0	27.1	28.0	26.3
Diseases of the digestive system (K00-K92)	72.5	91.8	54.6	55.4	74.5	37.8
Ulcer of stomach, duodenum and jejunum (К25-К28)	3.8	3.5	4.0	0.7	0.8	0.7
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	28.1	45.9	11.5	25.7	41.3	11.3
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	40.7	42.4	39.1	28.9	32.3	25.8
Diseases of the skin and subcutaneous tissue (L00-L99)	1.5	0.7	2.2	0.6	0.3	0.9
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.4	0.4	0.4	0.2	0.3	0.2
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	0.0	-	0.1
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.4	0.4	0.4	0.2	0.3	0.1
Diseases of the genitourinary system (N00-N99)	24.8	26.2	23.5	38.1	42.2	34.3
Diseases of kidney and ureter (N00-N29)	24.4	25.6	23.3	37.8	41.9	33.9
Other diseases of the genitourinary system (N30-N99)	0.4	0.7	0.2	0.3	0.3	0.4
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.1	-	0.2	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.9	2.2	1.6	1.0	1.1	1.0
Congenital malformations and chromosomal abnormalities (Q00-Q99)	2.0	2.6	1.4	0.6	0.8	0.5
Symptoms, signs, ill-defined causes (R00-R99)	52.2	53.5	51.0	72.9	67.8	77.6
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	30.0	33.6	26.7	39.0	46.2	32.4
Other symptoms, signs, ill-defined causes (R00-R94)	22.2	19.9	24.3	33.8	21.5	45.2
External causes of morbidity and mortality (V01-Y98)	33.8	53.1	16.0	27.9	44.2	12.9
Accidents (V01-X59, Y85-Y86)	16.8	26.0	8.3	10.4	16.3	5.0
of which:
Transport accidents (V01-V99,Y85)	6.5	10.1	3.2	4.2	6.7	1.9
Accidental falls (W00-W19)	2.7	3.5	2.0	1.3	1.8	0.9
Drowning and accidental submersion '(W65-W74)	1.7	3.1	0.4	1.1	2.1	0.3
Accidental poisoning (W65-W74)	0.5	0.4	0.6	0.6	0.9	0.4
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.4	9.0	2.0	3.2	4.8	1.6
Suicide and intentional self-harm (X60-X84, Y87.0)	10.4	16.6	4.7	3.0	5.1	1.0
Homicide, assault (X85-Y09, Y87.1)	1.4	1.7	1.0	0.5	0.8	0.3
Events of undetermined intent (Y10-Y34, Y87.2)	3.2	5.2	1.2	13.1	20.4	6.4
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	2.1	3.5	0.8	0.8	1.5	0.2
Codes for special purposes (U00-U85)	6.3	7.0	5.7	5.5	6.9	4.3
of which COVID-19 (U07.1-U07.2)	6.3	7.0	5.7	5.5	6.9	4.3

(Continued and end)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Yuzhen tsentralen
ICD, X-th Revision, European Short List¹	Total	Male	Female
Total	1 550.1	1 665.5	1 442.8
Infectious and parasitic diseases (A00-B99)	6.4	8.6	4.4
Tuberculosis (A15-A19, B90)	1.1	1.9	0.3
AIDS (HIV-disease) (B20-B24)	0.3	0.5	0.1
Viral hepatitis (B15-B19, B94.2)	0.2	0.5	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	4.8	5.7	4.0
Neoplasms (C00-D48)	285.5	350.1	225.4
Malignant neoplasms (C00-C97)	284.0	349.0	223.7
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	7.1	10.2	4.3
Malignant neoplasm of oesophagus (C15)	2.9	5.4	0.6
Malignant neoplasm of stomach (C16)	17.4	23.7	11.5
Malignant neoplasm of colon, rectum and anus (C18-C21)	40.7	48.4	33.7
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	13.3	16.1	10.8
Malignant neoplasm of pancreas (C25)	17.6	20.7	14.8
Malignant neoplasm of larynx (C32)	5.1	9.9	0.6
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	57.9	89.9	28.2
Malignant melanoma of skin (C43)	2.8	3.7	1.9
Malignant neoplasm of breast (C50)	18.1	0.8	34.1
Malignant neoplasm of cervix uteri (C53)	4.4	-	8.4
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	4.5	-	8.7
Malignant neoplasm of ovary (C56)	7.6	-	14.6
Malignant neoplasm of prostate (C61)	20.0	41.5	-
Malignant neoplasm of kidney (C64)	7.6	11.3	4.1
Malignant neoplasm of bladder (C67)	9.3	14.3	4.6
Malignant neoplasm of brain and central nervous system (C70-C72)	9.7	10.7	8.7
Malignant neoplasm of thyroid (C73)	0.8	0.5	1.0
Hodgkin disease and lymphomas (C81-C86)	3.4	4.3	2.7
Leukaemia (C91-C95)	6.8	7.8	5.9
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.8	3.5	2.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	24.3	26.9	21.9
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.5	1.1	1.8
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	0.6	0.3	0.9
Endocrine, nutritional and metabolic diseases (E00-E89)	9.5	8.1	10.8
Diabetes mellitus (E10-E14)	9.3	8.0	10.6
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.2	0.2	0.1
Mental and behavioural disorders (F01-F99)	0.5	0.2	0.9
Dementia (F01, F03)	0.5	-	0.9
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.1	0.2	-
Diseases of the nervous system and the sense organs (G00-H95)	11.9	12.6	11.4
Parkinson’s disease (G20)	1.1	1.3	0.9
Alzheimer’s disease (G30)	0.3	-	0.6
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	10.6	11.3	9.9
Diseases of the circulatory system (I00-I99)	987.2	981.7	992.4
Ischaemic heart diseases (I20-I25)	325.1	340.1	311.3
of which:
Acute myocardial infarction (I21-I22)	109.9	138.7	83.2
Other ischaemic heart diseases (I20, I23-I25)	215.2	201.4	228.1
Other heart diseases (I30-I51)	171.8	182.3	162.1
Cerebrovascular diseases (I60-I69)	309.2	278.8	337.4
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	181.1	180.5	181.6
Diseases of the respiratory system (J00-J99)	46.3	60.9	32.8
Influenza (J09-J11)	1.2	1.6	0.9
Pneumonia (J12-J18)	20.1	25.0	15.7
Chronic lower respiratory diseases (J40-J47)	11.7	16.9	6.9
of which:
Asthma (J45-J46)	0.2	0.2	0.1
Other chronic lower respiratory diseases (J40-J44, J47)	11.6	16.7	6.8
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	13.3	17.5	9.3
Diseases of the digestive system (K00-K92)	56.1	74.9	38.6
Ulcer of stomach, duodenum and jejunum (К25-К28)	3.1	3.8	2.4
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	19.5	33.4	6.6
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	33.5	37.7	29.5
Diseases of the skin and subcutaneous tissue (L00-L99)	1.3	1.6	1.0
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.6	0.5	0.7
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.6	0.5	0.7
Diseases of the genitourinary system (N00-N99)	16.8	19.4	14.3
Diseases of kidney and ureter (N00-N29)	16.4	18.8	14.2
Other diseases of the genitourinary system (N30-N99)	0.4	0.6	0.1
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.2	-	0.4
Certain conditions originating in the perinatal period (P00-P96)	2.8	4.3	1.3
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.9	0.5	1.3
Symptoms, signs, ill-defined causes (R00-R99)	79.9	79.7	80.1
Sudden infant death syndrome (R95)	-	-	-
Unknown and unspecified causes (R96-R99)	50.5	60.8	40.9
Other symptoms, signs, ill-defined causes (R00-R94)	29.4	18.9	39.2
External causes of morbidity and mortality (V01-Y98)	36.1	52.2	21.1
Accidents (V01-X59, Y85-Y86)	24.9	34.4	16.1
of which:
Transport accidents (V01-V99,Y85)	7.7	11.1	4.6
Accidental falls (W00-W19)	10.3	12.6	8.3
Drowning and accidental submersion '(W65-W74)	0.8	1.4	0.3
Accidental poisoning (W65-W74)	1.7	3.0	0.4
Other accidents (W20-W64, W75- X39, X50-59, Y86)	4.3	6.2	2.5
Suicide and intentional self-harm (X60-X84, Y87.0)	8.0	13.4	3.0
Homicide, assault (X85-Y09, Y87.1)	0.5	0.6	0.4
Events of undetermined intent (Y10-Y34, Y87.2)	2.1	3.5	0.7
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	0.6	0.3	0.9
Codes for special purposes (U00-U85)	7.4	10.0	4.9
of which COVID-19 (U07.1-U07.2)	7.4	10.0	4.9
¹Elaborated by Eurostat harmonised list used for international comparisons. Since 2020 incl. Chapter XXII Codes for special purposes (U00-U85), COVID-19 (U07.1-U07.2).

MORTALITY BY CAUSES, SEX AND DISTRICTS IN 2024

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Bulgaria			Blagoevgrad
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 563.9	1 677.0	1 459.2	1 311.1	1 437.3	1 192.4
Infectious and parasitic diseases (A00-B99)	8.0	9.4	6.7	8.0	9.4	6.8
Tuberculosis (A15-A19, B90)	0.9	1.5	0.3	-	-	-
AIDS (HIV-disease) (B20-B24)	0.2	0.3	0.0	-	-	-
Viral hepatitis (B15-B19, B94.2)	0.3	0.5	0.1	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	6.6	7.1	6.2	8.0	9.4	6.8
Neoplasms (C00-D48)	265.8	313.7	221.5	216.9	271.3	165.8
Malignant neoplasms (C00-C97)	264.4	312.5	219.9	216.6	270.6	165.8
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	6.1	9.7	2.9	3.8	6.5	1.4
Malignant neoplasm of oesophagus (C15)	3.2	5.2	1.4	3.8	5.0	2.7
Malignant neoplasm of stomach (C16)	13.4	17.4	9.7	15.7	18.7	12.9
Malignant neoplasm of colon, rectum and anus (C18-C21)	39.7	49.2	30.9	34.2	46.1	23.0
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	10.5	13.2	8.0	11.5	15.8	7.4
Malignant neoplasm of pancreas (C25)	18.2	20.0	16.5	17.1	20.9	13.5
Malignant neoplasm of larynx (C32)	4.6	8.7	0.8	4.9	10.1	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	52.3	77.6	28.8	38.0	59.7	17.6
Malignant melanoma of skin (C43)	2.8	3.4	2.3	1.4	2.2	0.7
Malignant neoplasm of breast (C50)	18.9	0.7	35.8	12.6	0.7	23.7
Malignant neoplasm of cervix uteri (C53)	5.0	-	9.6	1.7	-	3.4
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	4.7	-	9.1	7.3	-	14.2
Malignant neoplasm of ovary (C56)	6.1	-	11.7	3.8	-	7.4
Malignant neoplasm of prostate (C61)	15.8	32.8	-	14.0	28.8	-
Malignant neoplasm of kidney (C64)	6.4	8.8	4.2	8.0	10.8	5.4
Malignant neoplasm of bladder (C67)	9.2	14.8	4.0	6.3	7.9	4.7
Malignant neoplasm of brain and central nervous system (C70-C72)	9.5	10.4	8.7	11.9	13.7	10.2
Malignant neoplasm of thyroid (C73)	0.7	0.5	0.7	-	-	-
Hodgkin disease and lymphomas (C81-C86)	3.5	4.1	2.9	2.1	2.9	1.4
Leukaemia (C91-C95)	6.0	6.8	5.3	7.0	8.6	5.4
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.1	2.3	2.0	0.7	0.7	0.7
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	25.6	27.1	24.3	10.8	12.2	9.5
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.4	1.2	1.6	0.3	0.7	-
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.4	1.5	1.3	-	-	-
Endocrine, nutritional and metabolic diseases (E00-E89)	22.8	21.8	23.7	10.5	6.5	14.2
Diabetes mellitus (E10-E14)	22.2	21.2	23.1	10.5	6.5	14.2
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.6	0.5	0.6	-	-	-
Mental and behavioural disorders (F01-F99)	1.2	1.4	1.0	-	-	-
Dementia (F01, F03)	0.5	0.2	0.7	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	0.4	0.7	0.0	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	0.0	0.1	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.3	0.4	0.2	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	13.9	15.6	12.3	4.5	4.3	4.7
Parkinson’s disease (G20)	2.0	1.9	2.0	0.3	-	0.7
Alzheimer’s disease (G30)	0.6	0.5	0.7	0.3	0.7	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	11.3	13.1	9.6	3.8	3.6	4.1
Diseases of the circulatory system (I00-I99)	948.5	948.8	948.3	757.9	763.6	752.6
Ischaemic heart diseases (I20-I25)	201.2	222.0	181.9	74.6	94.3	56.2
of which:
Acute myocardial infarction (I21-I22)	72.0	94.0	51.6	67.7	84.9	51.4
Other ischaemic heart diseases (I20, I23-I25)	129.2	128.0	130.3	7.0	9.4	4.7
Other heart diseases (I30-I51)	301.9	303.4	300.4	381.2	390.8	372.2
Cerebrovascular diseases (I60-I69)	272.2	253.1	289.9	207.9	190.7	224.0
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	173.3	170.3	176.1	94.2	87.8	100.2
Diseases of the respiratory system (J00-J99)	77.4	93.8	62.2	155.6	170.6	141.4
Influenza (J09-J11)	0.8	0.9	0.6	0.7	-	1.4
Pneumonia (J12-J18)	36.5	44.2	29.4	28.9	35.3	23.0
Chronic lower respiratory diseases (J40-J47)	18.5	23.3	14.1	31.4	40.3	23.0
of which:
Asthma (J45-J46)	0.4	0.3	0.4	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	18.2	23.0	13.7	31.4	40.3	23.0
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	21.6	25.3	18.1	94.5	95.0	94.1
Diseases of the digestive system (K00-K92)	66.6	88.5	46.4	44.6	69.8	21.0
Ulcer of stomach, duodenum and jejunum (К25-К28)	2.9	3.3	2.6	1.0	1.4	0.7
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	27.2	44.4	11.4	33.5	56.9	11.5
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	36.5	40.8	32.5	10.1	11.5	8.8
Diseases of the skin and subcutaneous tissue (L00-L99)	1.4	1.2	1.6	0.3	-	0.7
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.7	0.7	0.7	-	-	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.2	0.1	0.2	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.6	0.6	0.5	-	-	-
Diseases of the genitourinary system (N00-N99)	32.0	34.8	29.4	30.3	33.1	27.7
Diseases of kidney and ureter (N00-N29)	31.4	34.0	29.1	30.3	33.1	27.7
Other diseases of the genitourinary system (N30-N99)	0.6	0.9	0.4	-	-	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.1	-	0.2	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.9	2.5	1.3	0.7	0.7	0.7
Congenital malformations and chromosomal abnormalities (Q00-Q99)	1.0	1.2	0.8	0.3	0.7	-
Symptoms, signs, ill-defined causes (R00-R99)	78.7	79.7	77.8	60.0	74.1	46.7
Sudden infant death syndrome (R95)	0.0	0.1	-	-	-	-
Unknown and unspecified causes (R96-R99)	50.0	59.2	41.4	34.9	50.4	20.3
Other symptoms, signs, ill-defined causes (R00-R94)	28.7	20.4	36.4	25.1	23.8	26.4
External causes of morbidity and mortality (V01-Y98)	36.3	55.1	18.9	20.6	32.4	9.5
Accidents (V01-X59, Y85-Y86)	20.1	29.6	11.3	11.5	17.3	6.1
of which:
Transport accidents (V01-V99,Y85)	6.9	11.1	3.0	4.9	7.9	2.0
Accidental falls (W00-W19)	5.8	6.9	4.7	2.4	2.9	2.0
Drowning and accidental submersion '(W65-W74)	1.2	2.1	0.3	1.0	1.4	0.7
Accidental poisoning (W65-W74)	1.1	1.7	0.6	0.7	0.7	0.7
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.2	7.8	2.8	2.4	4.3	0.7
Suicide and intentional self-harm (X60-X84, Y87.0)	7.0	11.6	2.9	3.5	5.8	1.4
Homicide, assault (X85-Y09, Y87.1)	0.7	0.9	0.5	0.7	0.7	0.7
Events of undetermined intent (Y10-Y34, Y87.2)	7.3	11.3	3.6	4.9	8.6	1.4
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.1	1.7	0.6	-	-	-
Codes for special purposes (U00-U85)	6.1	7.5	4.8	0.7	0.7	0.7
of which COVID-19 (U07.1-U07.2)	6.1	7.5	4.8	0.7	0.7	0.7

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Burgas			Varna
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 332.4	1 449.5	1 224.5	1 353.0	1 484.7	1 231.3
Infectious and parasitic diseases (A00-B99)	17.3	19.4	15.4	14.9	20.5	9.7
Tuberculosis (A15-A19, B90)	1.0	1.6	0.5	0.5	1.0	-
AIDS (HIV-disease) (B20-B24)	0.3	0.5	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	0.8	1.6	-	0.2	-	0.4
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	15.3	15.6	14.9	14.2	19.6	9.3
Neoplasms (C00-D48)	243.4	287.0	203.2	246.9	299.6	198.2
Malignant neoplasms (C00-C97)	242.1	286.4	201.2	245.5	297.7	197.3
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	5.2	8.6	2.0	6.7	10.5	3.1
Malignant neoplasm of oesophagus (C15)	3.6	6.5	1.0	2.5	3.8	1.3
Malignant neoplasm of stomach (C16)	15.0	18.9	11.4	11.2	15.8	7.1
Malignant neoplasm of colon, rectum and anus (C18-C21)	38.5	46.9	30.8	36.9	48.3	26.5
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	9.3	11.9	7.0	7.3	9.6	5.3
Malignant neoplasm of pancreas (C25)	19.7	21.0	18.4	19.3	21.5	17.2
Malignant neoplasm of larynx (C32)	4.4	7.6	1.5	3.2	5.7	0.9
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	50.7	71.7	31.3	44.1	65.9	23.8
Malignant melanoma of skin (C43)	2.1	2.7	1.5	1.4	2.9	-
Malignant neoplasm of breast (C50)	15.0	-	28.8	17.0	-	32.7
Malignant neoplasm of cervix uteri (C53)	4.1	-	7.9	5.0	-	9.7
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	3.9	-	7.5	3.9	-	7.5
Malignant neoplasm of ovary (C56)	5.9	-	11.4	7.1	-	13.7
Malignant neoplasm of prostate (C61)	11.4	23.7	-	14.0	29.1	-
Malignant neoplasm of kidney (C64)	5.4	7.6	3.5	6.9	11.9	2.2
Malignant neoplasm of bladder (C67)	6.5	10.2	3.0	9.6	16.7	3.1
Malignant neoplasm of brain and central nervous system (C70-C72)	8.0	9.7	6.5	6.7	6.7	6.6
Malignant neoplasm of thyroid (C73)	0.5	1.1	-	0.5	-	0.9
Hodgkin disease and lymphomas (C81-C86)	2.1	2.7	1.5	2.8	4.3	1.3
Leukaemia (C91-C95)	5.2	7.6	3.0	4.8	3.8	5.7
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	0.5	1.1	-	1.4	0.5	2.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	25.1	26.4	23.8	33.3	40.6	26.5
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.3	0.5	2.0	1.4	1.9	0.9
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	2.6	4.3	1.0	0.2	0.5	-
Endocrine, nutritional and metabolic diseases (E00-E89)	2.1	1.6	2.5	2.5	2.4	2.6
Diabetes mellitus (E10-E14)	1.8	1.6	2.0	2.5	2.4	2.6
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.3	-	0.5	-	-	-
Mental and behavioural disorders (F01-F99)	0.3	-	0.5	0.7	1.4	-
Dementia (F01, F03)	-	-	-	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	0.5	1.0	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	0.2	0.5	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.3	-	0.5	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	6.5	10.2	3.0	16.5	16.7	16.3
Parkinson’s disease (G20)	-	-	-	-	-	-
Alzheimer’s disease (G30)	0.3	0.5	-	0.2	-	0.4
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	6.2	9.7	3.0	16.3	16.7	15.9
Diseases of the circulatory system (I00-I99)	798.3	815.1	782.9	852.6	866.8	839.4
Ischaemic heart diseases (I20-I25)	153.1	194.2	115.2	147.5	182.1	115.6
of which:
Acute myocardial infarction (I21-I22)	63.6	96.0	33.8	75.5	106.1	47.2
Other ischaemic heart diseases (I20, I23-I25)	89.5	98.2	81.5	72.0	76.0	68.4
Other heart diseases (I30-I51)	219.6	221.7	217.6	172.5	189.7	156.7
Cerebrovascular diseases (I60-I69)	337.7	311.3	362.1	178.7	185.4	172.6
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	87.9	87.9	87.9	353.8	309.7	394.5
Diseases of the respiratory system (J00-J99)	50.7	61.0	41.2	54.4	63.1	46.3
Influenza (J09-J11)	0.5	1.1	-	-	-	-
Pneumonia (J12-J18)	21.5	24.8	18.4	30.5	37.3	24.3
Chronic lower respiratory diseases (J40-J47)	5.9	5.4	6.5	1.6	1.4	1.8
of which:
Asthma (J45-J46)	0.3	0.5	-	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	5.7	4.9	6.5	1.6	1.4	1.8
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	22.8	29.7	16.4	22.3	24.4	20.3
Diseases of the digestive system (K00-K92)	67.5	85.8	50.7	62.4	89.4	37.5
Ulcer of stomach, duodenum and jejunum (К25-К28)	2.6	1.1	4.0	3.9	5.3	2.6
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	25.1	39.9	11.4	32.1	49.7	15.9
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	39.8	44.8	35.3	26.4	34.4	19.0
Diseases of the skin and subcutaneous tissue (L00-L99)	1.0	1.1	1.0	0.2	0.5	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.5	0.5	0.5	0.9	1.4	0.4
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.5	0.5	0.5	0.9	1.4	0.4
Diseases of the genitourinary system (N00-N99)	30.0	29.7	30.3	19.5	17.2	21.6
Diseases of kidney and ureter (N00-N29)	29.7	29.1	30.3	19.5	17.2	21.6
Other diseases of the genitourinary system (N30-N99)	0.3	0.5	-	-	-	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	0.5	-	0.9
Certain conditions originating in the perinatal period (P00-P96)	2.3	2.7	2.0	1.6	1.4	1.8
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.8	1.6	-	0.5	0.5	0.4
Symptoms, signs, ill-defined causes (R00-R99)	72.2	73.4	71.0	39.5	39.2	39.7
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	38.5	44.8	32.8	22.9	28.2	18.1
Other symptoms, signs, ill-defined causes (R00-R94)	33.6	28.6	38.3	16.5	11.0	21.6
External causes of morbidity and mortality (V01-Y98)	32.1	51.2	14.4	33.0	55.9	11.9
Accidents (V01-X59, Y85-Y86)	14.5	24.3	5.5	16.5	27.2	6.6
of which:
Transport accidents (V01-V99,Y85)	5.9	9.2	3.0	6.9	12.9	1.3
Accidental falls (W00-W19)	1.3	2.2	0.5	3.0	4.3	1.8
Drowning and accidental submersion '(W65-W74)	2.3	4.3	0.5	0.9	1.9	-
Accidental poisoning (W65-W74)	-	-	-	2.1	3.3	0.9
Other accidents (W20-W64, W75- X39, X50-59, Y86)	4.9	8.6	1.5	3.7	4.8	2.6
Suicide and intentional self-harm (X60-X84, Y87.0)	8.0	12.4	4.0	6.4	11.5	1.8
Homicide, assault (X85-Y09, Y87.1)	2.1	2.7	1.5	0.7	0.5	0.9
Events of undetermined intent (Y10-Y34, Y87.2)	3.4	5.4	1.5	9.2	16.7	2.2
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	4.1	6.5	2.0	0.2	-	0.4
Codes for special purposes (U00-U85)	4.9	4.9	5.0	6.2	8.1	4.4
of which COVID-19 (U07.1-U07.2)	4.9	4.9	5.0	6.2	8.1	4.4

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Veliko Tarnovo			Vidin
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 870.1	1 960.0	1 788.2	2 432.6	2 645.8	2 236.6
Infectious and parasitic diseases (A00-B99)	9.4	8.3	10.4	9.8	14.7	5.4
Tuberculosis (A15-A19, B90)	1.0	1.0	0.9	1.4	-	2.7
AIDS (HIV-disease) (B20-B24)	-	-	-	1.4	2.9	-
Viral hepatitis (B15-B19, B94.2)	0.5	-	0.9	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	7.9	7.3	8.5	7.0	11.7	2.7
Neoplasms (C00-D48)	387.4	438.4	340.9	397.7	481.1	321.1
Malignant neoplasms (C00-C97)	383.5	433.2	338.1	396.3	481.1	318.4
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	7.9	10.4	5.7	2.8	5.9	-
Malignant neoplasm of oesophagus (C15)	2.5	3.1	1.9	5.6	8.8	2.7
Malignant neoplasm of stomach (C16)	16.4	19.8	13.3	21.1	29.3	13.5
Malignant neoplasm of colon, rectum and anus (C18-C21)	57.1	63.5	51.3	67.5	102.7	35.1
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	13.9	20.8	7.6	18.3	17.6	18.9
Malignant neoplasm of pancreas (C25)	27.8	29.2	26.6	32.3	23.5	40.5
Malignant neoplasm of larynx (C32)	5.0	9.4	0.9	12.6	20.5	5.4
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	69.5	106.2	36.1	74.5	117.3	35.1
Malignant melanoma of skin (C43)	2.0	2.1	1.9	1.4	2.9	-
Malignant neoplasm of breast (C50)	31.8	-	60.8	30.9	-	59.4
Malignant neoplasm of cervix uteri (C53)	9.4	-	18.0	7.0	-	13.5
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	10.4	-	19.9	5.6	-	10.8
Malignant neoplasm of ovary (C56)	9.4	-	18.0	9.8	-	18.9
Malignant neoplasm of prostate (C61)	27.3	57.3	-	25.3	52.8	-
Malignant neoplasm of kidney (C64)	7.9	10.4	5.7	11.2	11.7	10.8
Malignant neoplasm of bladder (C67)	17.9	26.0	10.4	16.9	26.4	8.1
Malignant neoplasm of brain and central nervous system (C70-C72)	11.9	16.7	7.6	15.5	26.4	5.4
Malignant neoplasm of thyroid (C73)	0.5	-	0.9	-	-	-
Hodgkin disease and lymphomas (C81-C86)	7.0	5.2	8.5	5.6	5.9	5.4
Leukaemia (C91-C95)	5.5	8.3	2.8	9.8	11.7	8.1
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	4.0	4.2	3.8	2.8	2.9	2.7
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	38.2	39.6	37.0	19.7	8.8	29.7
Non-malignant neoplasms (benign and uncertain) (D00-D48)	4.0	5.2	2.8	1.4	-	2.7
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	2.5	2.1	2.8	4.2	8.8	-
Endocrine, nutritional and metabolic diseases (E00-E89)	4.5	5.2	3.8	22.5	26.4	18.9
Diabetes mellitus (E10-E14)	4.5	5.2	3.8	22.5	26.4	18.9
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	-	-	-	-	-	-
Mental and behavioural disorders (F01-F99)	0.5	1.0	-	2.8	2.9	2.7
Dementia (F01, F03)	-	-	-	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	0.5	1.0	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	2.8	2.9	2.7
Diseases of the nervous system and the sense organs (G00-H95)	24.3	27.1	21.8	22.5	26.4	18.9
Parkinson’s disease (G20)	7.5	8.3	6.6	7.0	-	13.5
Alzheimer’s disease (G30)	1.5	1.0	1.9	-	-	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	15.4	17.7	13.3	15.5	26.4	5.4
Diseases of the circulatory system (I00-I99)	992.9	958.1	1 024.7	1 531.8	1 537.0	1 527.0
Ischaemic heart diseases (I20-I25)	157.0	169.8	145.3	271.2	328.5	218.5
of which:
Acute myocardial infarction (I21-I22)	60.1	76.0	45.6	42.2	70.4	16.2
Other ischaemic heart diseases (I20, I23-I25)	96.9	93.7	99.7	229.1	258.1	202.3
Other heart diseases (I30-I51)	306.5	297.9	314.3	366.8	375.5	358.8
Cerebrovascular diseases (I60-I69)	284.6	265.6	302.0	564.9	484.0	639.4
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	244.9	225.0	263.1	328.8	349.1	310.3
Diseases of the respiratory system (J00-J99)	84.4	98.9	71.2	88.5	114.4	64.8
Influenza (J09-J11)	0.5	-	0.9	-	-	-
Pneumonia (J12-J18)	48.7	60.4	38.0	37.9	49.9	27.0
Chronic lower respiratory diseases (J40-J47)	13.9	13.5	14.2	40.8	46.9	35.1
of which:
Asthma (J45-J46)	-	-	-	1.4	-	2.7
Other chronic lower respiratory diseases (J40-J44, J47)	13.9	13.5	14.2	39.3	46.9	32.4
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	21.4	25.0	18.0	9.8	17.6	2.7
Diseases of the digestive system (K00-K92)	67.6	91.6	45.6	108.2	134.9	83.6
Ulcer of stomach, duodenum and jejunum (К25-К28)	3.5	5.2	1.9	8.4	5.9	10.8
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	21.9	36.5	8.5	32.3	58.7	8.1
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	42.2	50.0	35.1	67.5	70.4	64.8
Diseases of the skin and subcutaneous tissue (L00-L99)	3.0	3.1	2.8	2.8	5.9	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	1.5	2.1	0.9	1.4	-	2.7
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.5	-	0.9	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	1.0	2.1	-	1.4	-	2.7
Diseases of the genitourinary system (N00-N99)	37.3	29.2	44.6	70.3	76.3	64.8
Diseases of kidney and ureter (N00-N29)	35.8	28.1	42.7	67.5	73.3	62.1
Other diseases of the genitourinary system (N30-N99)	1.5	1.0	1.9	2.8	2.9	2.7
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.0	2.1	-	-	-	-
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.5	1.0	-	-	-	-
Symptoms, signs, ill-defined causes (R00-R99)	192.2	197.9	187.1	108.2	114.4	102.5
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	132.6	145.8	120.6	45.0	64.5	27.0
Other symptoms, signs, ill-defined causes (R00-R94)	59.6	52.1	66.5	63.2	49.9	75.5
External causes of morbidity and mortality (V01-Y98)	55.1	86.4	26.6	56.2	90.9	24.3
Accidents (V01-X59, Y85-Y86)	37.8	59.4	18.0	37.9	64.5	13.5
of which:
Transport accidents (V01-V99,Y85)	8.9	13.5	4.7	9.8	20.5	-
Accidental falls (W00-W19)	15.4	22.9	8.5	9.8	8.8	10.8
Drowning and accidental submersion '(W65-W74)	1.5	2.1	0.9	-	-	-
Accidental poisoning (W65-W74)	2.0	3.1	0.9	2.8	5.9	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	9.9	17.7	2.8	15.5	29.3	2.7
Suicide and intentional self-harm (X60-X84, Y87.0)	12.4	19.8	5.7	14.1	20.5	8.1
Homicide, assault (X85-Y09, Y87.1)	-	-	-	2.8	2.9	2.7
Events of undetermined intent (Y10-Y34, Y87.2)	2.5	3.1	1.9	1.4	2.9	-
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	2.5	4.2	0.9	-	-	-
Codes for special purposes (U00-U85)	6.0	7.3	4.7	5.6	11.7	-
of which COVID-19 (U07.1-U07.2)	6.0	7.3	4.7	5.6	11.7	-

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Vratsa			Gabrovo
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 902.5	2 030.1	1 782.8	2 085.0	2 196.6	1 984.3
Infectious and parasitic diseases (A00-B99)	6.1	8.4	4.0	6.4	4.5	8.1
Tuberculosis (A15-A19, B90)	0.7	1.4	-	2.1	2.2	2.0
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	1.1	-	2.0
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	5.4	7.0	4.0	3.2	2.2	4.0
Neoplasms (C00-D48)	339.2	384.3	296.9	396.4	455.9	342.8
Malignant neoplasms (C00-C97)	335.1	380.1	293.0	392.2	455.9	334.7
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	4.8	7.0	2.6	9.5	17.9	2.0
Malignant neoplasm of oesophagus (C15)	5.4	11.3	-	4.2	6.7	2.0
Malignant neoplasm of stomach (C16)	14.3	18.3	10.6	18.0	15.6	20.2
Malignant neoplasm of colon, rectum and anus (C18-C21)	42.9	56.3	30.4	80.6	100.6	62.5
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	13.6	16.9	10.6	11.7	13.4	10.1
Malignant neoplasm of pancreas (C25)	25.2	21.1	29.0	26.5	26.8	26.2
Malignant neoplasm of larynx (C32)	7.5	14.1	1.3	2.1	4.5	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	72.2	92.9	52.8	70.0	100.6	42.3
Malignant melanoma of skin (C43)	3.4	1.4	5.3	4.2	8.9	-
Malignant neoplasm of breast (C50)	31.3	2.8	58.1	27.6	-	52.4
Malignant neoplasm of cervix uteri (C53)	6.8	-	13.2	5.3	-	10.1
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	6.8	-	13.2	10.6	-	20.2
Malignant neoplasm of ovary (C56)	6.1	-	11.9	4.2	-	8.1
Malignant neoplasm of prostate (C61)	17.7	36.6	-	27.6	58.1	-
Malignant neoplasm of kidney (C64)	8.9	11.3	6.6	8.5	13.4	4.0
Malignant neoplasm of bladder (C67)	10.9	18.3	4.0	12.7	26.8	-
Malignant neoplasm of brain and central nervous system (C70-C72)	13.6	15.5	11.9	13.8	11.2	16.1
Malignant neoplasm of thyroid (C73)	1.4	1.4	1.3	-	-	-
Hodgkin disease and lymphomas (C81-C86)	6.8	12.7	1.3	6.4	4.5	8.1
Leukaemia (C91-C95)	8.9	12.7	5.3	10.6	8.9	12.1
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.7	4.2	1.3	3.2	2.2	4.0
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	23.8	23.9	23.8	35.0	33.5	36.3
Non-malignant neoplasms (benign and uncertain) (D00-D48)	4.1	4.2	4.0	4.2	-	8.1
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.4	1.4	1.3	2.1	4.5	-
Endocrine, nutritional and metabolic diseases (E00-E89)	121.2	133.7	109.5	56.2	55.9	56.5
Diabetes mellitus (E10-E14)	119.9	132.3	108.2	53.0	51.4	54.4
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	1.4	1.4	1.3	3.2	4.5	2.0
Mental and behavioural disorders (F01-F99)	3.4	5.6	1.3	6.4	8.9	4.0
Dementia (F01, F03)	1.4	1.4	1.3	2.1	-	4.0
Alcohol abuse (including alcoholic psychosis) (F10)	1.4	2.8	-	4.2	8.9	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.7	1.4	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	14.3	18.3	10.6	15.9	26.8	6.0
Parkinson’s disease (G20)	4.1	4.2	4.0	2.1	-	4.0
Alzheimer’s disease (G30)	2.7	1.4	4.0	-	-	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	7.5	12.7	2.6	13.8	26.8	2.0
Diseases of the circulatory system (I00-I99)	1 083.0	1 079.8	1 086.0	1 190.4	1 146.4	1 230.1
Ischaemic heart diseases (I20-I25)	116.5	146.4	88.4	327.5	333.0	322.6
of which:
Acute myocardial infarction (I21-I22)	40.2	53.5	27.7	62.5	78.2	48.4
Other ischaemic heart diseases (I20, I23-I25)	76.3	92.9	60.7	265.0	254.7	274.3
Other heart diseases (I30-I51)	559.9	558.9	560.8	177.0	176.5	177.5
Cerebrovascular diseases (I60-I69)	312.0	278.8	343.1	395.4	359.8	427.5
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	94.7	95.7	93.7	290.4	277.1	302.5
Diseases of the respiratory system (J00-J99)	111.7	125.3	99.0	154.8	167.6	143.2
Influenza (J09-J11)	-	-	-	-	-	-
Pneumonia (J12-J18)	16.3	15.5	17.2	104.9	100.6	108.9
Chronic lower respiratory diseases (J40-J47)	81.7	95.7	68.6	44.5	60.3	30.2
of which:
Asthma (J45-J46)	0.7	-	1.3	3.2	2.2	4.0
Other chronic lower respiratory diseases (J40-J44, J47)	81.1	95.7	67.3	41.3	58.1	26.2
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	13.6	14.1	13.2	5.3	6.7	4.0
Diseases of the digestive system (K00-K92)	77.0	90.1	64.7	107.1	129.6	86.7
Ulcer of stomach, duodenum and jejunum (К25-К28)	0.7	-	1.3	10.6	15.6	6.0
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	30.7	42.2	19.8	46.6	67.0	28.2
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	45.6	47.9	43.5	49.8	46.9	52.4
Diseases of the skin and subcutaneous tissue (L00-L99)	0.7	-	1.3	3.2	2.2	4.0
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.7	-	1.3	5.3	4.5	6.0
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	3.2	2.2	4.0
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.7	-	1.3	2.1	2.2	2.0
Diseases of the genitourinary system (N00-N99)	45.0	50.7	39.6	43.5	51.4	36.3
Diseases of kidney and ureter (N00-N29)	44.3	50.7	38.3	41.3	49.2	34.3
Other diseases of the genitourinary system (N30-N99)	0.7	-	1.3	2.1	2.2	2.0
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	2.0	2.8	1.3	1.1	-	2.0
Congenital malformations and chromosomal abnormalities (Q00-Q99)	2.0	2.8	1.3	2.1	2.2	2.0
Symptoms, signs, ill-defined causes (R00-R99)	47.0	52.1	42.2	36.0	44.7	28.2
Sudden infant death syndrome (R95)	0.7	1.4	-	-	-	-
Unknown and unspecified causes (R96-R99)	29.3	31.0	27.7	27.6	42.5	14.1
Other symptoms, signs, ill-defined causes (R00-R94)	17.0	19.7	14.5	8.5	2.2	14.1
External causes of morbidity and mortality (V01-Y98)	42.9	69.0	18.5	49.8	82.7	20.2
Accidents (V01-X59, Y85-Y86)	27.9	47.9	9.2	32.9	51.4	16.1
of which:
Transport accidents (V01-V99,Y85)	13.6	23.9	4.0	9.5	13.4	6.0
Accidental falls (W00-W19)	2.0	1.4	2.6	7.4	13.4	2.0
Drowning and accidental submersion '(W65-W74)	2.7	5.6	-	2.1	4.5	-
Accidental poisoning (W65-W74)	-	-	-	6.4	8.9	4.0
Other accidents (W20-W64, W75- X39, X50-59, Y86)	9.5	16.9	2.6	7.4	11.2	4.0
Suicide and intentional self-harm (X60-X84, Y87.0)	8.9	12.7	5.3	13.8	26.8	2.0
Homicide, assault (X85-Y09, Y87.1)	0.7	1.4	-	2.1	2.2	2.0
Events of undetermined intent (Y10-Y34, Y87.2)	4.8	5.6	4.0	1.1	2.2	-
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	0.7	1.4	-	-	-	-
Codes for special purposes (U00-U85)	4.8	5.6	4.0	8.5	8.9	8.1
of which COVID-19 (U07.1-U07.2)	4.8	5.6	4.0	8.5	8.9	8.1

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Dobrich			Kardzhali
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 992.2	2 175.3	1 824.8	1 520.1	1 666.7	1 378.7
Infectious and parasitic diseases (A00-B99)	14.4	14.3	14.4	2.7	5.5	-
Tuberculosis (A15-A19, B90)	0.7	1.4	-	0.7	1.4	-
AIDS (HIV-disease) (B20-B24)	0.7	1.4	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	13.0	11.5	14.4	2.0	4.1	-
Neoplasms (C00-D48)	391.3	424.7	360.8	183.8	251.9	118.1
Malignant neoplasms (C00-C97)	387.9	423.3	355.5	182.4	250.5	116.8
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	13.7	25.8	2.6	4.1	4.1	4.0
Malignant neoplasm of oesophagus (C15)	5.5	10.0	1.3	1.4	2.8	-
Malignant neoplasm of stomach (C16)	18.5	21.5	15.7	23.6	30.3	17.3
Malignant neoplasm of colon, rectum and anus (C18-C21)	57.6	73.2	43.3	23.0	31.7	14.6
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	11.0	12.9	9.2	11.5	12.4	10.6
Malignant neoplasm of pancreas (C25)	19.2	27.3	11.8	9.5	15.1	4.0
Malignant neoplasm of larynx (C32)	5.5	10.0	1.3	4.7	9.6	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	76.8	117.7	39.4	43.9	79.8	9.3
Malignant melanoma of skin (C43)	4.8	5.7	3.9	1.4	2.8	-
Malignant neoplasm of breast (C50)	39.1	-	74.8	4.7	-	9.3
Malignant neoplasm of cervix uteri (C53)	13.7	-	26.2	2.0	-	4.0
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	5.5	-	10.5	2.0	-	4.0
Malignant neoplasm of ovary (C56)	12.3	-	23.6	4.7	-	9.3
Malignant neoplasm of prostate (C61)	11.0	23.0	-	8.8	17.9	-
Malignant neoplasm of kidney (C64)	9.6	12.9	6.6	4.7	6.9	2.7
Malignant neoplasm of bladder (C67)	11.7	18.7	5.2	3.4	5.5	1.3
Malignant neoplasm of brain and central nervous system (C70-C72)	13.7	17.2	10.5	9.5	12.4	6.6
Malignant neoplasm of thyroid (C73)	0.7	-	1.3	-	-	-
Hodgkin disease and lymphomas (C81-C86)	5.5	5.7	5.2	1.4	2.8	-
Leukaemia (C91-C95)	12.3	11.5	13.1	4.1	4.1	4.0
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	-	-	-	2.7	1.4	4.0
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	40.4	34.4	45.9	11.5	12.4	10.6
Non-malignant neoplasms (benign and uncertain) (D00-D48)	3.4	1.4	5.2	1.4	1.4	1.3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.4	2.9	-	-	-	-
Endocrine, nutritional and metabolic diseases (E00-E89)	52.8	56.0	49.9	4.1	-	8.0
Diabetes mellitus (E10-E14)	50.0	53.1	47.2	3.4	-	6.6
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	2.7	2.9	2.6	0.7	-	1.3
Mental and behavioural disorders (F01-F99)	7.5	14.3	1.3	0.7	-	1.3
Dementia (F01, F03)	0.7	-	1.3	0.7	-	1.3
Alcohol abuse (including alcoholic psychosis) (F10)	6.2	12.9	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	0.7	1.4	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	15.8	20.1	11.8	14.9	15.1	14.6
Parkinson’s disease (G20)	4.8	4.3	5.2	2.0	1.4	2.7
Alzheimer’s disease (G30)	0.7	1.4	-	2.0	-	4.0
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	10.3	14.3	6.6	10.8	13.8	8.0
Diseases of the circulatory system (I00-I99)	1 112.9	1 152.2	1 077.0	846.5	825.8	866.5
Ischaemic heart diseases (I20-I25)	233.7	276.9	194.2	118.9	137.6	100.8
of which:
Acute myocardial infarction (I21-I22)	117.9	162.1	77.4	99.3	114.2	84.9
Other ischaemic heart diseases (I20, I23-I25)	115.8	114.8	116.8	19.6	23.4	15.9
Other heart diseases (I30-I51)	148.0	152.1	144.3	418.9	422.5	415.3
Cerebrovascular diseases (I60-I69)	465.3	449.1	480.1	272.3	238.1	305.2
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	265.9	274.1	258.4	36.5	27.5	45.1
Diseases of the respiratory system (J00-J99)	76.8	96.1	59.0	66.9	81.2	53.1
Influenza (J09-J11)	1.4	1.4	1.3	-	-	-
Pneumonia (J12-J18)	35.6	38.7	32.8	20.9	26.1	15.9
Chronic lower respiratory diseases (J40-J47)	34.3	47.4	22.3	6.1	8.3	4.0
of which:
Asthma (J45-J46)	2.1	1.4	2.6	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	32.2	45.9	19.7	6.1	8.3	4.0
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	5.5	8.6	2.6	39.9	46.8	33.2
Diseases of the digestive system (K00-K92)	117.2	147.8	89.2	40.5	56.4	25.2
Ulcer of stomach, duodenum and jejunum (К25-К28)	5.5	4.3	6.6	2.7	4.1	1.3
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	45.2	70.3	22.3	10.8	19.3	2.7
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	66.5	73.2	60.3	27.0	33.0	21.2
Diseases of the skin and subcutaneous tissue (L00-L99)	0.7	-	1.3	2.0	2.8	1.3
Diseases of the musculoskeletal system/connective tissue (M00-M99)	1.4	-	2.6	-	-	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.7	-	1.3	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.7	-	1.3	-	-	-
Diseases of the genitourinary system (N00-N99)	54.1	71.7	38.0	13.5	16.5	10.6
Diseases of kidney and ureter (N00-N29)	51.4	66.0	38.0	13.5	16.5	10.6
Other diseases of the genitourinary system (N30-N99)	2.7	5.7	-	-	-	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	1.4	-	2.7
Certain conditions originating in the perinatal period (P00-P96)	3.4	4.3	2.6	0.7	1.4	-
Congenital malformations and chromosomal abnormalities (Q00-Q99)	-	-	-	1.4	-	2.7
Symptoms, signs, ill-defined causes (R00-R99)	90.5	101.9	80.0	316.8	371.6	264.1
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	84.3	96.1	73.5	243.2	308.3	180.5
Other symptoms, signs, ill-defined causes (R00-R94)	6.2	5.7	6.6	73.6	63.3	83.6
External causes of morbidity and mortality (V01-Y98)	50.7	68.9	34.1	24.3	38.5	10.6
Accidents (V01-X59, Y85-Y86)	35.0	43.0	27.5	20.3	31.7	9.3
of which:
Transport accidents (V01-V99,Y85)	8.2	14.3	2.6	6.8	11.0	2.7
Accidental falls (W00-W19)	2.7	4.3	1.3	7.4	11.0	4.0
Drowning and accidental submersion '(W65-W74)	0.7	-	1.3	1.4	1.4	1.3
Accidental poisoning (W65-W74)	-	-	-	-	-	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	23.3	24.4	22.3	4.7	8.3	1.3
Suicide and intentional self-harm (X60-X84, Y87.0)	7.5	12.9	2.6	3.4	5.5	1.3
Homicide, assault (X85-Y09, Y87.1)	-	-	-	-	-	-
Events of undetermined intent (Y10-Y34, Y87.2)	8.2	12.9	3.9	0.7	1.4	-
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	-	-	-	-	-	-
Codes for special purposes (U00-U85)	1.4	-	2.6	-	-	-
of which COVID-19 (U07.1-U07.2)	1.4	-	2.6	-	-	-

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Kyustendil			Lovech
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	2 130.0	2 408.3	1 873.0	2 078.5	2 134.6	2 025.9
Infectious and parasitic diseases (A00-B99)	15.0	9.7	19.8	9.0	11.1	6.9
Tuberculosis (A15-A19, B90)	-	-	-	1.8	3.7	-
AIDS (HIV-disease) (B20-B24)	0.9	1.9	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	14.0	7.8	19.8	7.2	7.4	6.9
Neoplasms (C00-D48)	368.6	471.5	273.5	216.1	241.1	192.7
Malignant neoplasms (C00-C97)	368.6	471.5	273.5	211.6	235.5	189.2
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	9.4	15.6	3.6	8.1	14.8	1.7
Malignant neoplasm of oesophagus (C15)	4.7	7.8	1.8	1.8	1.9	1.7
Malignant neoplasm of stomach (C16)	15.9	25.3	7.2	9.9	9.3	10.4
Malignant neoplasm of colon, rectum and anus (C18-C21)	54.3	74.0	36.0	30.5	38.9	22.6
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	16.8	19.5	14.4	9.0	9.3	8.7
Malignant neoplasm of pancreas (C25)	25.3	15.6	34.2	16.1	14.8	17.4
Malignant neoplasm of larynx (C32)	9.4	15.6	3.6	2.7	3.7	1.7
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	78.6	120.8	39.6	38.6	66.8	12.2
Malignant melanoma of skin (C43)	5.6	9.7	1.8	1.8	-	3.5
Malignant neoplasm of breast (C50)	25.3	-	48.6	18.8	-	36.5
Malignant neoplasm of cervix uteri (C53)	5.6	-	10.8	7.2	-	13.9
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	6.5	-	12.6	3.6	-	6.9
Malignant neoplasm of ovary (C56)	4.7	-	9.0	7.2	-	13.9
Malignant neoplasm of prostate (C61)	31.8	66.2	-	9.9	20.4	-
Malignant neoplasm of kidney (C64)	7.5	13.6	1.8	6.3	7.4	5.2
Malignant neoplasm of bladder (C67)	11.2	17.5	5.4	4.5	5.6	3.5
Malignant neoplasm of brain and central nervous system (C70-C72)	11.2	11.7	10.8	6.3	7.4	5.2
Malignant neoplasm of thyroid (C73)	0.9	1.9	-	0.9	-	1.7
Hodgkin disease and lymphomas (C81-C86)	4.7	7.8	1.8	3.6	5.6	1.7
Leukaemia (C91-C95)	5.6	5.8	5.4	4.5	3.7	5.2
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	1.9	3.9	-	0.9	1.9	-
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	31.8	39.0	25.2	19.7	24.1	15.6
Non-malignant neoplasms (benign and uncertain) (D00-D48)	-	-	-	4.5	5.6	3.5
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	2.8	5.8	-	3.6	1.9	5.2
Endocrine, nutritional and metabolic diseases (E00-E89)	45.8	33.1	57.6	17.9	16.7	19.1
Diabetes mellitus (E10-E14)	44.9	33.1	55.8	16.1	14.8	17.4
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.9	-	1.8	1.8	1.9	1.7
Mental and behavioural disorders (F01-F99)	1.9	1.9	1.8	7.2	5.6	8.7
Dementia (F01, F03)	0.9	-	1.8	5.4	3.7	6.9
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	1.8	1.9	1.7
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.9	1.9	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	19.6	15.6	23.4	17.0	16.7	17.4
Parkinson’s disease (G20)	9.4	9.7	9.0	5.4	3.7	6.9
Alzheimer’s disease (G30)	-	-	-	1.8	1.9	1.7
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	10.3	5.8	14.4	9.9	11.1	8.7
Diseases of the circulatory system (I00-I99)	975.7	1 024.9	930.2	1 293.0	1 255.6	1 328.0
Ischaemic heart diseases (I20-I25)	154.3	159.8	149.3	92.4	98.3	86.8
of which:
Acute myocardial infarction (I21-I22)	50.5	58.5	43.2	35.9	35.2	36.5
Other ischaemic heart diseases (I20, I23-I25)	103.8	101.3	106.2	56.5	63.1	50.3
Other heart diseases (I30-I51)	407.9	424.8	392.2	852.7	825.3	878.4
Cerebrovascular diseases (I60-I69)	305.9	307.9	304.1	280.7	259.6	300.3
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	107.6	132.5	84.6	67.3	72.3	62.5
Diseases of the respiratory system (J00-J99)	150.6	208.5	97.2	99.5	116.8	83.3
Influenza (J09-J11)	-	-	-	-	-	-
Pneumonia (J12-J18)	82.3	120.8	46.8	21.5	22.3	20.8
Chronic lower respiratory diseases (J40-J47)	37.4	52.6	23.4	17.0	20.4	13.9
of which:
Asthma (J45-J46)	0.9	1.9	-	3.6	5.6	1.7
Other chronic lower respiratory diseases (J40-J44, J47)	36.5	50.7	23.4	13.5	14.8	12.2
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	30.9	35.1	27.0	61.0	74.2	48.6
Diseases of the digestive system (K00-K92)	72.0	89.6	55.8	62.8	77.9	48.6
Ulcer of stomach, duodenum and jejunum (К25-К28)	1.9	3.9	-	1.8	1.9	1.7
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	36.5	50.7	23.4	24.2	37.1	12.2
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	33.7	35.1	32.4	36.8	38.9	34.7
Diseases of the skin and subcutaneous tissue (L00-L99)	-	-	-	-	-	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.9	-	1.8	1.8	3.7	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	0.9	-	1.8	0.9	1.9	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	-	-	-	0.9	1.9	-
Diseases of the genitourinary system (N00-N99)	68.3	81.8	55.8	30.5	33.4	27.8
Diseases of kidney and ureter (N00-N29)	68.3	81.8	55.8	29.6	31.5	27.8
Other diseases of the genitourinary system (N30-N99)	-	-	-	0.9	1.9	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	0.9	-	1.8	1.8	1.9	1.7
Congenital malformations and chromosomal abnormalities (Q00-Q99)	-	-	-	-	-	-
Symptoms, signs, ill-defined causes (R00-R99)	365.8	411.1	323.9	253.8	268.9	239.6
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	297.5	368.3	232.1	196.4	226.3	168.4
Other symptoms, signs, ill-defined causes (R00-R94)	68.3	42.9	91.8	57.4	42.7	71.2
External causes of morbidity and mortality (V01-Y98)	35.5	46.8	25.2	60.1	79.7	41.7
Accidents (V01-X59, Y85-Y86)	18.7	21.4	16.2	25.1	35.2	15.6
of which:
Transport accidents (V01-V99,Y85)	9.4	9.7	9.0	9.0	14.8	3.5
Accidental falls (W00-W19)	5.6	7.8	3.6	10.8	13.0	8.7
Drowning and accidental submersion '(W65-W74)	0.9	1.9	-	1.8	1.9	1.7
Accidental poisoning (W65-W74)	-	-	-	0.9	1.9	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	2.8	1.9	3.6	2.7	3.7	1.7
Suicide and intentional self-harm (X60-X84, Y87.0)	5.6	7.8	3.6	11.7	13.0	10.4
Homicide, assault (X85-Y09, Y87.1)	0.9	1.9	-	0.9	1.9	-
Events of undetermined intent (Y10-Y34, Y87.2)	10.3	15.6	5.4	7.2	7.4	6.9
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	-	-	-	15.2	22.3	8.7
Codes for special purposes (U00-U85)	6.5	7.8	5.4	4.5	3.7	5.2
of which COVID-19 (U07.1-U07.2)	6.5	7.8	5.4	4.5	3.7	5.2

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Montana			Pazardzhik
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	2 147.3	2 303.4	2 001.1	1 714.1	1 840.9	1 594.0
Infectious and parasitic diseases (A00-B99)	6.2	7.3	5.1	5.8	7.3	4.3
Tuberculosis (A15-A19, B90)	2.6	1.8	3.4	0.9	1.8	-
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	0.4	0.9	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	3.5	5.5	1.7	4.5	4.6	4.3
Neoplasms (C00-D48)	312.4	358.4	269.3	279.4	345.5	216.9
Malignant neoplasms (C00-C97)	308.9	354.8	265.9	279.4	345.5	216.9
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	8.8	9.1	8.5	5.3	9.2	1.7
Malignant neoplasm of oesophagus (C15)	2.6	5.5	-	1.8	1.8	1.7
Malignant neoplasm of stomach (C16)	10.6	12.7	8.5	14.7	22.0	7.8
Malignant neoplasm of colon, rectum and anus (C18-C21)	40.5	50.9	30.7	39.7	46.7	33.0
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	12.3	14.6	10.2	16.0	19.2	13.0
Malignant neoplasm of pancreas (C25)	20.2	14.6	25.6	22.3	30.2	14.8
Malignant neoplasm of larynx (C32)	9.7	18.2	1.7	5.3	9.2	1.7
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	66.9	100.1	35.8	59.3	88.0	32.1
Malignant melanoma of skin (C43)	2.6	3.6	1.7	3.6	2.7	4.3
Malignant neoplasm of breast (C50)	23.8	1.8	44.3	21.4	0.9	40.8
Malignant neoplasm of cervix uteri (C53)	14.1	-	27.3	3.1	-	6.1
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	3.5	-	6.8	5.3	-	10.4
Malignant neoplasm of ovary (C56)	3.5	-	6.8	5.3	-	10.4
Malignant neoplasm of prostate (C61)	15.8	32.7	-	21.8	44.9	-
Malignant neoplasm of kidney (C64)	7.0	9.1	5.1	6.2	10.1	2.6
Malignant neoplasm of bladder (C67)	15.0	27.3	3.4	7.6	11.9	3.5
Malignant neoplasm of brain and central nervous system (C70-C72)	12.3	12.7	11.9	8.0	10.1	6.1
Malignant neoplasm of thyroid (C73)	-	-	-	0.4	0.9	-
Hodgkin disease and lymphomas (C81-C86)	5.3	7.3	3.4	4.9	7.3	2.6
Leukaemia (C91-C95)	4.4	5.5	3.4	4.5	2.7	6.1
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	-	-	-	0.9	-	1.7
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	29.9	32.7	27.3	21.8	26.6	17.4
Non-malignant neoplasms (benign and uncertain) (D00-D48)	3.5	3.6	3.4	-	-	-
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.8	1.8	1.7	0.4	0.9	-
Endocrine, nutritional and metabolic diseases (E00-E89)	72.2	60.0	83.5	24.1	21.1	26.9
Diabetes mellitus (E10-E14)	71.3	60.0	81.8	24.1	21.1	26.9
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.9	-	1.7	-	-	-
Mental and behavioural disorders (F01-F99)	1.8	3.6	-	0.4	-	0.9
Dementia (F01, F03)	0.9	1.8	-	0.4	-	0.9
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.9	1.8	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	20.2	21.8	18.7	1.3	1.8	0.9
Parkinson’s disease (G20)	2.6	3.6	1.7	-	-	-
Alzheimer’s disease (G30)	-	-	-	-	-	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	17.6	18.2	17.0	1.3	1.8	0.9
Diseases of the circulatory system (I00-I99)	1 317.4	1 330.0	1 305.6	1 236.8	1 263.6	1 211.3
Ischaemic heart diseases (I20-I25)	120.6	127.4	114.2	362.8	394.0	333.2
of which:
Acute myocardial infarction (I21-I22)	20.2	34.6	6.8	213.5	274.0	156.2
Other ischaemic heart diseases (I20, I23-I25)	100.3	92.8	107.4	149.3	120.0	177.0
Other heart diseases (I30-I51)	514.8	529.5	501.1	322.2	329.0	315.8
Cerebrovascular diseases (I60-I69)	482.3	462.1	501.1	373.0	336.3	407.8
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	199.8	211.1	189.2	178.7	204.3	154.5
Diseases of the respiratory system (J00-J99)	100.3	127.4	75.0	32.1	36.7	27.8
Influenza (J09-J11)	-	-	-	0.4	-	0.9
Pneumonia (J12-J18)	35.2	43.7	27.3	15.6	15.6	15.6
Chronic lower respiratory diseases (J40-J47)	23.8	27.3	20.5	3.1	4.6	1.7
of which:
Asthma (J45-J46)	-	-	-	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	23.8	27.3	20.5	3.1	4.6	1.7
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	41.4	56.4	27.3	12.9	16.5	9.5
Diseases of the digestive system (K00-K92)	105.6	149.2	64.8	24.5	36.7	13.0
Ulcer of stomach, duodenum and jejunum (К25-К28)	-	-	-	0.9	1.8	-
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	37.8	67.3	10.2	12.9	24.7	1.7
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	67.8	81.9	54.5	10.7	10.1	11.3
Diseases of the skin and subcutaneous tissue (L00-L99)	1.8	1.8	1.7	0.9	1.8	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.9	-	1.7	1.8	1.8	1.7
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.9	-	1.7	1.8	1.8	1.7
Diseases of the genitourinary system (N00-N99)	66.9	76.4	58.0	22.3	25.7	19.1
Diseases of kidney and ureter (N00-N29)	65.1	72.8	58.0	21.8	24.7	19.1
Other diseases of the genitourinary system (N30-N99)	1.8	3.6	-	0.4	0.9	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.9	-	1.7	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	2.6	5.5	-	4.5	6.4	2.6
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.9	1.8	-	0.9	-	1.7
Symptoms, signs, ill-defined causes (R00-R99)	89.8	91.0	88.6	45.0	38.5	51.2
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	38.7	50.9	27.3	19.6	22.9	16.5
Other symptoms, signs, ill-defined causes (R00-R94)	51.0	40.0	61.4	25.4	15.6	34.7
External causes of morbidity and mortality (V01-Y98)	38.7	63.7	15.3	28.1	46.7	10.4
Accidents (V01-X59, Y85-Y86)	26.4	43.7	10.2	15.2	22.9	7.8
of which:
Transport accidents (V01-V99,Y85)	11.4	21.8	1.7	4.9	8.2	1.7
Accidental falls (W00-W19)	3.5	7.3	-	4.5	6.4	2.6
Drowning and accidental submersion '(W65-W74)	0.9	1.8	-	0.4	-	0.9
Accidental poisoning (W65-W74)	0.9	-	1.7	0.9	0.9	0.9
Other accidents (W20-W64, W75- X39, X50-59, Y86)	9.7	12.7	6.8	4.5	7.3	1.7
Suicide and intentional self-harm (X60-X84, Y87.0)	5.3	9.1	1.7	8.9	16.5	1.7
Homicide, assault (X85-Y09, Y87.1)	0.9	-	1.7	-	-	-
Events of undetermined intent (Y10-Y34, Y87.2)	5.3	9.1	1.7	4.0	7.3	0.9
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	0.9	1.8	-	-	-	-
Codes for special purposes (U00-U85)	7.0	3.6	10.2	5.8	6.4	5.2
of which COVID-19 (U07.1-U07.2)	7.0	3.6	10.2	5.8	6.4	5.2

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Pernik			Pleven
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	2 087.7	2 261.1	1 929.0	1 890.1	2 067.6	1 726.3
Infectious and parasitic diseases (A00-B99)	1.8	3.8	-	10.2	17.3	3.6
Tuberculosis (A15-A19, B90)	0.9	1.9	-	1.8	3.8	-
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	2.8	5.8	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	0.9	1.9	-	5.5	7.7	3.6
Neoplasms (C00-D48)	382.9	473.8	299.8	396.6	487.8	312.4
Malignant neoplasms (C00-C97)	380.2	470.0	298.1	396.1	486.8	312.4
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	10.9	20.8	1.7	6.5	9.6	3.6
Malignant neoplasm of oesophagus (C15)	4.5	7.6	1.7	4.6	7.7	1.8
Malignant neoplasm of stomach (C16)	15.4	19.0	12.1	14.3	22.1	7.1
Malignant neoplasm of colon, rectum and anus (C18-C21)	68.8	89.1	50.3	59.6	76.0	44.4
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	14.5	19.0	10.4	16.6	21.2	12.4
Malignant neoplasm of pancreas (C25)	29.0	34.1	24.3	24.0	26.9	21.3
Malignant neoplasm of larynx (C32)	9.1	19.0	-	12.5	24.1	1.8
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	72.4	113.7	34.7	90.5	145.3	39.9
Malignant melanoma of skin (C43)	1.8	3.8	-	4.2	6.7	1.8
Malignant neoplasm of breast (C50)	22.6	-	43.3	24.5	1.0	46.2
Malignant neoplasm of cervix uteri (C53)	9.1	-	17.3	6.0	-	11.5
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	6.3	-	12.1	4.6	-	8.9
Malignant neoplasm of ovary (C56)	5.4	-	10.4	7.8	-	15.1
Malignant neoplasm of prostate (C61)	22.6	47.4	-	19.9	41.4	-
Malignant neoplasm of kidney (C64)	12.7	19.0	6.9	9.7	8.7	10.7
Malignant neoplasm of bladder (C67)	13.6	20.8	6.9	11.5	20.2	3.6
Malignant neoplasm of brain and central nervous system (C70-C72)	20.8	20.8	20.8	9.7	5.8	13.3
Malignant neoplasm of thyroid (C73)	-	-	-	0.5	1.0	-
Hodgkin disease and lymphomas (C81-C86)	2.7	5.7	-	2.8	3.8	1.8
Leukaemia (C91-C95)	7.2	7.6	6.9	7.8	7.7	8.0
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	1.8	1.9	1.7	4.2	1.9	6.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	29.0	26.5	31.2	54.5	55.8	53.3
Non-malignant neoplasms (benign and uncertain) (D00-D48)	2.7	3.8	1.7	0.5	1.0	-
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	0.9	-	1.7	0.5	1.0	-
Endocrine, nutritional and metabolic diseases (E00-E89)	105.0	89.1	119.6	53.1	54.8	51.5
Diabetes mellitus (E10-E14)	105.0	89.1	119.6	51.7	52.9	50.6
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	-	-	-	1.4	1.9	0.9
Mental and behavioural disorders (F01-F99)	-	-	-	2.3	3.8	0.9
Dementia (F01, F03)	-	-	-	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	1.4	2.9	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	0.9	1.0	0.9
Diseases of the nervous system and the sense organs (G00-H95)	17.2	22.7	12.1	21.2	29.8	13.3
Parkinson’s disease (G20)	1.8	-	3.5	6.9	7.7	6.2
Alzheimer’s disease (G30)	2.7	1.9	3.5	1.8	3.8	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	12.7	20.8	5.2	12.5	18.3	7.1
Diseases of the circulatory system (I00-I99)	1 188.7	1 171.3	1 204.5	1 015.7	967.9	1 059.8
Ischaemic heart diseases (I20-I25)	219.1	286.2	157.7	422.9	407.0	437.6
of which:
Acute myocardial infarction (I21-I22)	142.1	199.0	90.1	66.5	77.9	55.9
Other ischaemic heart diseases (I20, I23-I25)	77.0	87.2	67.6	356.4	329.0	381.7
Other heart diseases (I30-I51)	271.6	274.8	268.6	72.5	65.4	79.0
Cerebrovascular diseases (I60-I69)	470.8	407.5	528.6	331.0	306.9	353.3
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	227.2	202.8	249.6	189.3	188.6	189.9
Diseases of the respiratory system (J00-J99)	112.3	142.2	84.9	96.0	118.3	75.4
Influenza (J09-J11)	-	-	-	0.5	1.0	-
Pneumonia (J12-J18)	64.3	85.3	45.1	50.8	57.7	44.4
Chronic lower respiratory diseases (J40-J47)	21.7	26.5	17.3	39.2	52.0	27.5
of which:
Asthma (J45-J46)	-	-	-	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	21.7	26.5	17.3	39.2	52.0	27.5
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	26.3	30.3	22.5	5.5	7.7	3.6
Diseases of the digestive system (K00-K92)	97.8	125.1	72.8	81.3	117.4	47.9
Ulcer of stomach, duodenum and jejunum (К25-К28)	2.7	3.8	1.7	8.3	7.7	8.9
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	36.2	64.4	10.4	30.9	52.0	11.5
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	58.8	56.9	60.7	42.0	57.7	27.5
Diseases of the skin and subcutaneous tissue (L00-L99)	3.6	1.9	5.2	2.3	2.9	1.8
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.9	1.9	-	1.8	1.9	1.8
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.9	1.9	-	1.8	1.9	1.8
Diseases of the genitourinary system (N00-N99)	78.8	91.0	67.6	19.9	22.1	17.8
Diseases of kidney and ureter (N00-N29)	77.0	89.1	65.9	18.5	19.2	17.8
Other diseases of the genitourinary system (N30-N99)	1.8	1.9	1.7	1.4	2.9	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	0.5	-	0.9
Certain conditions originating in the perinatal period (P00-P96)	1.8	3.8	-	3.7	3.8	3.6
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.9	1.9	-	0.5	1.0	-
Symptoms, signs, ill-defined causes (R00-R99)	54.3	60.7	48.5	109.4	146.2	75.4
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	42.5	51.2	34.7	99.7	141.4	61.2
Other symptoms, signs, ill-defined causes (R00-R94)	11.8	9.5	13.9	9.7	4.8	14.2
External causes of morbidity and mortality (V01-Y98)	37.1	64.4	12.1	68.8	84.7	54.1
Accidents (V01-X59, Y85-Y86)	17.2	30.3	5.2	49.4	57.7	41.7
of which:
Transport accidents (V01-V99,Y85)	7.2	15.2	-	11.5	20.2	3.6
Accidental falls (W00-W19)	0.9	-	1.7	30.5	26.9	33.7
Drowning and accidental submersion '(W65-W74)	2.7	5.7	-	0.9	1.9	-
Accidental poisoning (W65-W74)	0.9	-	1.7	1.4	1.9	0.9
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.4	9.5	1.7	5.1	6.7	3.6
Suicide and intentional self-harm (X60-X84, Y87.0)	7.2	11.4	3.5	11.1	16.4	6.2
Homicide, assault (X85-Y09, Y87.1)	3.6	5.7	1.7	0.9	1.0	0.9
Events of undetermined intent (Y10-Y34, Y87.2)	7.2	13.3	1.7	6.9	8.7	5.3
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.8	3.8	-	0.5	1.0	-
Codes for special purposes (U00-U85)	3.6	7.6	-	6.5	6.7	6.2
of which COVID-19 (U07.1-U07.2)	3.6	7.6	-	6.5	6.7	6.2

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Plovdiv			Razgrad
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 440.9	1 523.1	1 365.9	1 793.6	1 907.1	1 689.1
Infectious and parasitic diseases (A00-B99)	4.9	6.6	3.3	7.0	10.4	3.8
Tuberculosis (A15-A19, B90)	0.8	1.7	-	-	-	-
AIDS (HIV-disease) (B20-B24)	0.5	0.7	0.3	-	-	-
Viral hepatitis (B15-B19, B94.2)	0.2	0.3	-	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	3.5	4.0	3.0	7.0	10.4	3.8
Neoplasms (C00-D48)	306.5	365.0	253.1	287.8	343.9	236.1
Malignant neoplasms (C00-C97)	304.6	363.7	250.7	286.8	343.9	234.2
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	8.0	11.9	4.5	9.0	14.6	3.8
Malignant neoplasm of oesophagus (C15)	3.8	7.3	0.6	2.0	4.2	-
Malignant neoplasm of stomach (C16)	15.6	21.1	10.5	20.0	25.0	15.4
Malignant neoplasm of colon, rectum and anus (C18-C21)	45.9	52.5	39.8	54.0	75.0	34.5
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	11.3	13.9	9.0	11.0	18.8	3.8
Malignant neoplasm of pancreas (C25)	17.8	19.2	16.6	12.0	12.5	11.5
Malignant neoplasm of larynx (C32)	4.6	8.9	0.6	6.0	12.5	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	57.0	86.2	30.4	56.0	85.5	28.8
Malignant melanoma of skin (C43)	3.0	4.6	1.5	1.0	2.1	-
Malignant neoplasm of breast (C50)	22.4	1.0	41.9	27.0	-	51.8
Malignant neoplasm of cervix uteri (C53)	4.7	-	9.0	6.0	-	11.5
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	5.0	-	9.6	6.0	-	11.5
Malignant neoplasm of ovary (C56)	7.2	-	13.9	3.0	-	5.8
Malignant neoplasm of prostate (C61)	22.7	47.6	-	14.0	29.2	-
Malignant neoplasm of kidney (C64)	9.5	14.5	4.8	8.0	10.4	5.8
Malignant neoplasm of bladder (C67)	11.8	17.2	6.9	7.0	14.6	-
Malignant neoplasm of brain and central nervous system (C70-C72)	10.7	9.6	11.8	11.0	8.3	13.4
Malignant neoplasm of thyroid (C73)	0.9	0.3	1.5	1.0	-	1.9
Hodgkin disease and lymphomas (C81-C86)	3.8	4.3	3.3	3.0	2.1	3.8
Leukaemia (C91-C95)	8.0	10.6	5.7	5.0	6.3	3.8
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	3.3	5.0	1.8	-	-	-
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	27.4	28.7	26.2	25.0	22.9	26.9
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.9	1.3	2.4	1.0	-	1.9
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	0.6	0.3	0.9	2.0	2.1	1.9
Endocrine, nutritional and metabolic diseases (E00-E89)	4.6	3.3	5.7	17.0	16.7	17.3
Diabetes mellitus (E10-E14)	4.6	3.3	5.7	16.0	14.6	17.3
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	-	-	-	1.0	2.1	-
Mental and behavioural disorders (F01-F99)	-	-	-	1.0	-	1.9
Dementia (F01, F03)	-	-	-	1.0	-	1.9
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	8.7	8.6	8.7	12.0	16.7	7.7
Parkinson’s disease (G20)	-	-	-	-	-	-
Alzheimer’s disease (G30)	-	-	-	-	-	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	8.7	8.6	8.7	12.0	16.7	7.7
Diseases of the circulatory system (I00-I99)	909.1	887.9	928.3	1 126.1	1 104.7	1 145.9
Ischaemic heart diseases (I20-I25)	418.1	423.8	412.8	292.8	308.5	278.3
of which:
Acute myocardial infarction (I21-I22)	93.0	117.6	70.5	124.9	158.4	94.1
Other ischaemic heart diseases (I20, I23-I25)	325.1	306.2	342.3	167.9	150.1	184.3
Other heart diseases (I30-I51)	29.2	32.0	26.5	216.8	218.9	215.0
Cerebrovascular diseases (I60-I69)	298.5	267.6	326.6	455.6	427.3	481.8
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	163.4	164.5	162.4	160.9	150.1	170.8
Diseases of the respiratory system (J00-J99)	32.3	45.3	20.5	107.9	156.3	63.3
Influenza (J09-J11)	1.6	2.0	1.2	-	-	-
Pneumonia (J12-J18)	15.0	19.8	10.5	53.0	64.6	42.2
Chronic lower respiratory diseases (J40-J47)	10.1	14.5	6.0	40.0	68.8	13.4
of which:
Asthma (J45-J46)	-	-	-	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	10.1	14.5	6.0	40.0	68.8	13.4
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	5.7	8.9	2.7	15.0	22.9	7.7
Diseases of the digestive system (K00-K92)	63.8	86.2	43.4	64.0	83.4	46.1
Ulcer of stomach, duodenum and jejunum (К25-К28)	4.6	5.6	3.6	1.0	-	1.9
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	21.1	35.3	8.1	26.0	50.0	3.8
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	38.1	45.3	31.6	37.0	33.3	40.3
Diseases of the skin and subcutaneous tissue (L00-L99)	1.1	1.3	0.9	1.0	2.1	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.6	0.3	0.9	-	-	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.6	0.3	0.9	-	-	-
Diseases of the genitourinary system (N00-N99)	9.3	9.6	9.0	53.0	43.8	61.4
Diseases of kidney and ureter (N00-N29)	9.0	8.9	9.0	53.0	43.8	61.4
Other diseases of the genitourinary system (N30-N99)	0.3	0.7	-	-	-	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.2	-	0.3	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	2.5	3.6	1.5	4.0	4.2	3.8
Congenital malformations and chromosomal abnormalities (Q00-Q99)	1.1	0.7	1.5	2.0	2.1	1.9
Symptoms, signs, ill-defined causes (R00-R99)	45.9	37.3	53.6	73.9	68.8	78.7
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	25.1	26.8	23.5	68.9	64.6	72.9
Other symptoms, signs, ill-defined causes (R00-R94)	20.8	10.6	30.1	5.0	4.2	5.8
External causes of morbidity and mortality (V01-Y98)	40.5	54.2	28.0	33.0	50.0	17.3
Accidents (V01-X59, Y85-Y86)	30.7	40.3	22.0	19.0	27.1	11.5
of which:
Transport accidents (V01-V99,Y85)	9.8	12.9	6.9	6.0	10.4	1.9
Accidental falls (W00-W19)	13.7	16.2	11.4	3.0	2.1	3.8
Drowning and accidental submersion '(W65-W74)	0.5	1.0	-	-	-	-
Accidental poisoning (W65-W74)	2.8	5.6	0.3	1.0	-	1.9
Other accidents (W20-W64, W75- X39, X50-59, Y86)	3.9	4.6	3.3	9.0	14.6	3.8
Suicide and intentional self-harm (X60-X84, Y87.0)	7.1	11.6	3.0	8.0	14.6	1.9
Homicide, assault (X85-Y09, Y87.1)	0.8	0.7	0.9	-	-	-
Events of undetermined intent (Y10-Y34, Y87.2)	1.1	1.3	0.9	6.0	8.3	3.8
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	0.8	0.3	1.2	-	-	-
Codes for special purposes (U00-U85)	9.3	12.9	6.0	2.0	2.1	1.9
of which COVID-19 (U07.1-U07.2)	9.3	12.9	6.0	2.0	2.1	1.9

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Ruse			Silistra
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 848.0	1 984.1	1 723.2	1 992.7	2 156.4	1 840.5
Infectious and parasitic diseases (A00-B99)	10.7	10.1	11.3	13.8	15.4	12.3
Tuberculosis (A15-A19, B90)	1.1	2.2	-	2.1	2.2	2.0
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	9.6	7.8	11.3	11.7	13.2	10.2
Neoplasms (C00-D48)	268.5	309.8	230.6	254.9	310.9	202.9
Malignant neoplasms (C00-C97)	268.5	309.8	230.6	250.7	310.9	194.7
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	5.3	7.8	3.1	7.4	11.0	4.1
Malignant neoplasm of oesophagus (C15)	1.6	2.2	1.0	1.1	2.2	-
Malignant neoplasm of stomach (C16)	16.6	16.8	16.4	17.0	28.7	6.1
Malignant neoplasm of colon, rectum and anus (C18-C21)	43.9	54.8	33.8	35.1	39.7	30.7
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	10.2	11.2	9.2	12.7	15.4	10.2
Malignant neoplasm of pancreas (C25)	16.0	20.1	12.3	12.7	11.0	14.3
Malignant neoplasm of larynx (C32)	4.3	8.9	-	7.4	15.4	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	62.0	87.2	39.0	59.5	108.0	14.3
Malignant melanoma of skin (C43)	1.6	2.2	1.0	2.1	2.2	2.0
Malignant neoplasm of breast (C50)	22.5	-	43.1	12.7	-	24.6
Malignant neoplasm of cervix uteri (C53)	3.7	-	7.2	7.4	-	14.3
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	0.5	-	1.0	6.4	-	12.3
Malignant neoplasm of ovary (C56)	5.9	-	11.3	4.2	-	8.2
Malignant neoplasm of prostate (C61)	14.4	30.2	-	8.5	17.6	-
Malignant neoplasm of kidney (C64)	3.7	4.5	3.1	3.2	4.4	2.0
Malignant neoplasm of bladder (C67)	11.2	17.9	5.1	5.3	4.4	6.1
Malignant neoplasm of brain and central nervous system (C70-C72)	7.0	7.8	6.2	9.6	8.8	10.2
Malignant neoplasm of thyroid (C73)	2.1	1.1	3.1	-	-	-
Hodgkin disease and lymphomas (C81-C86)	3.2	2.2	4.1	2.1	4.4	-
Leukaemia (C91-C95)	5.3	4.5	6.2	-	-	-
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	1.6	1.1	2.1	5.3	2.2	8.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	25.7	30.2	21.5	30.8	37.5	24.6
Non-malignant neoplasms (benign and uncertain) (D00-D48)	-	-	-	4.2	-	8.2
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	5.9	5.6	6.2	1.1	-	2.0
Endocrine, nutritional and metabolic diseases (E00-E89)	18.7	20.1	17.4	30.8	24.3	36.9
Diabetes mellitus (E10-E14)	17.7	20.1	15.4	30.8	24.3	36.9
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	1.1	-	2.1	-	-	-
Mental and behavioural disorders (F01-F99)	-	-	-	4.2	2.2	6.1
Dementia (F01, F03)	-	-	-	4.2	2.2	6.1
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	13.9	16.8	11.3	13.8	15.4	12.3
Parkinson’s disease (G20)	1.1	-	2.1	1.1	-	2.0
Alzheimer’s disease (G30)	0.5	-	1.0	1.1	-	2.0
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	12.3	16.8	8.2	11.7	15.4	8.2
Diseases of the circulatory system (I00-I99)	1 130.2	1 153.1	1 109.2	1 308.6	1 318.5	1 299.4
Ischaemic heart diseases (I20-I25)	141.2	186.8	99.4	145.5	180.8	112.7
of which:
Acute myocardial infarction (I21-I22)	70.1	98.4	44.1	81.8	110.2	55.3
Other ischaemic heart diseases (I20, I23-I25)	71.1	88.4	55.4	63.7	70.6	57.4
Other heart diseases (I30-I51)	563.8	549.2	577.1	493.9	458.6	526.7
Cerebrovascular diseases (I60-I69)	174.4	164.4	183.5	348.4	346.2	350.5
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	250.9	252.8	249.1	320.8	332.9	309.5
Diseases of the respiratory system (J00-J99)	136.9	162.2	113.8	108.3	134.5	84.0
Influenza (J09-J11)	1.6	2.2	1.0	4.2	6.6	2.0
Pneumonia (J12-J18)	102.7	123.0	84.1	45.7	50.7	41.0
Chronic lower respiratory diseases (J40-J47)	14.4	19.0	10.3	10.6	13.2	8.2
of which:
Asthma (J45-J46)	-	-	-	2.1	-	4.1
Other chronic lower respiratory diseases (J40-J44, J47)	14.4	19.0	10.3	8.5	13.2	4.1
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	18.2	17.9	18.5	47.8	63.9	32.8
Diseases of the digestive system (K00-K92)	87.2	120.8	56.4	88.2	132.3	47.1
Ulcer of stomach, duodenum and jejunum (К25-К28)	5.9	8.9	3.1	2.1	4.4	-
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	26.7	44.7	10.3	55.2	90.4	22.5
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	54.6	67.1	43.1	30.8	37.5	24.6
Diseases of the skin and subcutaneous tissue (L00-L99)	5.9	1.1	10.3	4.2	4.4	4.1
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.5	-	1.0	1.1	-	2.0
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	1.1	-	2.0
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.5	-	1.0	-	-	-
Diseases of the genitourinary system (N00-N99)	40.1	45.9	34.9	31.9	22.0	41.0
Diseases of kidney and ureter (N00-N29)	39.6	44.7	34.9	31.9	22.0	41.0
Other diseases of the genitourinary system (N30-N99)	0.5	1.1	-	-	-	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.6	3.4	-	3.2	4.4	2.0
Congenital malformations and chromosomal abnormalities (Q00-Q99)	1.1	1.1	1.0	1.1	2.2	-
Symptoms, signs, ill-defined causes (R00-R99)	81.3	69.3	92.3	78.6	88.2	69.7
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	47.1	47.0	47.2	70.1	77.2	63.5
Other symptoms, signs, ill-defined causes (R00-R94)	34.2	22.4	45.1	8.5	11.0	6.1
External causes of morbidity and mortality (V01-Y98)	36.4	54.8	19.5	44.6	77.2	14.3
Accidents (V01-X59, Y85-Y86)	23.0	33.6	13.3	28.7	48.5	10.2
of which:
Transport accidents (V01-V99,Y85)	9.1	15.7	3.1	4.2	6.6	2.0
Accidental falls (W00-W19)	8.6	8.9	8.2	8.5	13.2	4.1
Drowning and accidental submersion '(W65-W74)	0.5	1.1	-	2.1	4.4	-
Accidental poisoning (W65-W74)	1.6	2.2	1.0	1.1	2.2	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	3.2	5.6	1.0	12.7	22.0	4.1
Suicide and intentional self-harm (X60-X84, Y87.0)	1.1	2.2	-	12.7	22.0	4.1
Homicide, assault (X85-Y09, Y87.1)	0.5	1.1	-	1.1	2.2	-
Events of undetermined intent (Y10-Y34, Y87.2)	10.7	16.8	5.1	2.1	4.4	-
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.1	1.1	1.0	-	-	-
Codes for special purposes (U00-U85)	9.1	10.1	8.2	4.2	4.4	4.1
of which COVID-19 (U07.1-U07.2)	9.1	10.1	8.2	4.2	4.4	4.1

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Sliven			Smolyan
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 526.4	1 651.7	1 409.7	1 751.0	1 987.7	1 534.0
Infectious and parasitic diseases (A00-B99)	7.1	6.1	8.0	21.9	29.8	14.7
Tuberculosis (A15-A19, B90)	1.2	2.4	-	2.2	2.3	2.1
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	1.1	2.3	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	5.9	3.7	8.0	18.6	25.2	12.6
Neoplasms (C00-D48)	191.5	238.2	148.0	343.8	458.0	239.2
Malignant neoplasms (C00-C97)	189.8	235.8	146.9	341.7	455.7	237.1
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	3.5	6.1	1.1	11.0	16.0	6.3
Malignant neoplasm of oesophagus (C15)	3.5	6.1	1.1	3.3	6.9	-
Malignant neoplasm of stomach (C16)	10.0	12.2	8.0	28.5	41.2	16.8
Malignant neoplasm of colon, rectum and anus (C18-C21)	21.2	24.4	18.2	42.7	64.1	23.1
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	6.5	12.2	1.1	17.5	25.2	10.5
Malignant neoplasm of pancreas (C25)	8.3	13.4	3.4	17.5	22.9	12.6
Malignant neoplasm of larynx (C32)	3.5	7.3	-	5.5	11.5	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	47.1	77.0	19.4	85.4	148.9	27.3
Malignant melanoma of skin (C43)	0.6	1.2	-	3.3	2.3	4.2
Malignant neoplasm of breast (C50)	15.9	-	30.7	12.0	-	23.1
Malignant neoplasm of cervix uteri (C53)	5.3	-	10.2	1.1	-	2.1
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	3.5	-	6.8	7.7	-	14.7
Malignant neoplasm of ovary (C56)	2.9	-	5.7	25.2	-	48.3
Malignant neoplasm of prostate (C61)	11.8	24.4	-	11.0	22.9	-
Malignant neoplasm of kidney (C64)	2.9	3.7	2.3	4.4	6.9	2.1
Malignant neoplasm of bladder (C67)	7.1	14.7	-	11.0	18.3	4.2
Malignant neoplasm of brain and central nervous system (C70-C72)	7.1	6.1	8.0	6.6	9.2	4.2
Malignant neoplasm of thyroid (C73)	1.2	-	2.3	1.1	2.3	-
Hodgkin disease and lymphomas (C81-C86)	3.5	4.9	2.3	1.1	2.3	-
Leukaemia (C91-C95)	1.8	2.4	1.1	7.7	11.5	4.2
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	0.6	-	1.1	6.6	6.9	6.3
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	21.8	18.3	25.1	31.8	36.6	27.3
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.8	2.4	1.1	2.2	2.3	2.1
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	0.6	-	1.1	-	-	-
Endocrine, nutritional and metabolic diseases (E00-E89)	11.8	15.9	8.0	15.3	16.0	14.7
Diabetes mellitus (E10-E14)	10.6	14.7	6.8	15.3	16.0	14.7
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	1.2	1.2	1.1	-	-	-
Mental and behavioural disorders (F01-F99)	1.8	-	3.4	-	-	-
Dementia (F01, F03)	1.8	-	3.4	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	44.2	41.5	46.7	11.0	16.0	6.3
Parkinson’s disease (G20)	2.4	3.7	1.1	-	-	-
Alzheimer’s disease (G30)	-	-	-	1.1	-	2.1
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	41.8	37.9	45.5	9.9	16.0	4.2
Diseases of the circulatory system (I00-I99)	971.3	978.5	964.5	1 016.2	1 032.8	1 001.0
Ischaemic heart diseases (I20-I25)	168.6	183.2	154.9	236.5	270.2	205.7
of which:
Acute myocardial infarction (I21-I22)	60.1	73.3	47.8	125.9	151.1	102.8
Other ischaemic heart diseases (I20, I23-I25)	108.4	109.9	107.0	110.6	119.1	102.8
Other heart diseases (I30-I51)	493.3	477.7	507.9	164.3	162.6	165.8
Cerebrovascular diseases (I60-I69)	220.4	221.1	219.8	226.7	208.4	243.4
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	89.0	96.5	82.0	388.7	391.6	386.1
Diseases of the respiratory system (J00-J99)	113.7	139.3	90.0	96.4	121.4	73.4
Influenza (J09-J11)	2.4	3.7	1.1	-	-	-
Pneumonia (J12-J18)	21.8	24.4	19.4	48.2	57.3	39.9
Chronic lower respiratory diseases (J40-J47)	18.3	22.0	14.8	32.9	43.5	23.1
of which:
Asthma (J45-J46)	0.6	-	1.1	1.1	-	2.1
Other chronic lower respiratory diseases (J40-J44, J47)	17.7	22.0	13.7	31.8	43.5	21.0
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	71.3	89.2	54.7	15.3	20.6	10.5
Diseases of the digestive system (K00-K92)	72.5	91.6	54.7	107.3	158.0	60.9
Ulcer of stomach, duodenum and jejunum (К25-К28)	1.8	-	3.4	2.2	2.3	2.1
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	28.3	46.4	11.4	46.0	84.7	10.5
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	42.4	45.2	39.9	59.1	71.0	48.3
Diseases of the skin and subcutaneous tissue (L00-L99)	1.8	-	3.4	1.1	2.3	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.6	-	1.1	-	-	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.6	-	1.1	-	-	-
Diseases of the genitourinary system (N00-N99)	25.9	30.5	21.6	32.9	32.1	33.6
Diseases of kidney and ureter (N00-N29)	25.3	29.3	21.6	31.8	32.1	31.5
Other diseases of the genitourinary system (N30-N99)	0.6	1.2	-	1.1	-	2.1
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	2.4	2.4	2.3	1.1	2.3	-
Congenital malformations and chromosomal abnormalities (Q00-Q99)	3.5	4.9	2.3	-	-	-
Symptoms, signs, ill-defined causes (R00-R99)	31.2	34.2	28.5	56.9	52.7	60.9
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	26.5	28.1	25.1	28.5	36.6	21.0
Other symptoms, signs, ill-defined causes (R00-R94)	4.7	6.1	3.4	28.5	16.0	39.9
External causes of morbidity and mortality (V01-Y98)	36.5	58.6	15.9	40.5	57.3	25.2
Accidents (V01-X59, Y85-Y86)	15.3	22.0	9.1	17.5	25.2	10.5
of which:
Transport accidents (V01-V99,Y85)	5.9	7.3	4.6	4.4	9.2	-
Accidental falls (W00-W19)	1.2	2.4	-	8.8	9.2	8.4
Drowning and accidental submersion '(W65-W74)	2.4	3.7	1.1	-	-	-
Accidental poisoning (W65-W74)	-	-	-	1.1	2.3	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.9	8.6	3.4	3.3	4.6	2.1
Suicide and intentional self-harm (X60-X84, Y87.0)	15.9	28.1	4.6	18.6	27.5	10.5
Homicide, assault (X85-Y09, Y87.1)	0.6	-	1.1	2.2	4.6	-
Events of undetermined intent (Y10-Y34, Y87.2)	4.7	8.6	1.1	1.1	-	2.1
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	-	-	-	1.1	-	2.1
Codes for special purposes (U00-U85)	10.0	9.8	10.2	6.6	9.2	4.2
of which COVID-19 (U07.1-U07.2)	10.0	9.8	10.2	6.6	9.2	4.2

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Sofia			Sofia (stolitsa)
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 748.5	1 925.0	1 579.9	1 127.7	1 157.4	1 100.5
Infectious and parasitic diseases (A00-B99)	2.7	2.7	2.6	2.6	2.6	2.7
Tuberculosis (A15-A19, B90)	1.3	1.8	0.9	0.2	0.5	-
AIDS (HIV-disease) (B20-B24)	-	-	-	0.1	0.2	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	1.3	0.9	1.7	2.3	1.9	2.7
Neoplasms (C00-D48)	206.6	222.3	191.6	183.1	194.7	172.3
Malignant neoplasms (C00-C97)	204.8	220.4	189.9	182.9	194.7	172.0
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	4.9	7.3	2.6	3.6	5.7	1.6
Malignant neoplasm of oesophagus (C15)	2.2	3.6	0.9	2.9	3.7	2.1
Malignant neoplasm of stomach (C16)	8.4	10.0	6.9	7.0	8.3	5.8
Malignant neoplasm of colon, rectum and anus (C18-C21)	29.7	33.6	26.0	26.0	29.9	22.4
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	9.3	11.8	6.9	6.0	7.1	4.9
Malignant neoplasm of pancreas (C25)	16.0	20.0	12.1	15.2	17.0	13.5
Malignant neoplasm of larynx (C32)	2.2	2.7	1.7	2.1	3.6	0.7
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	31.5	44.5	19.1	31.2	37.9	25.1
Malignant melanoma of skin (C43)	2.7	1.8	3.5	4.5	4.5	4.5
Malignant neoplasm of breast (C50)	17.3	2.7	31.2	15.3	1.0	28.5
Malignant neoplasm of cervix uteri (C53)	3.5	-	6.9	3.5	-	6.7
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	6.2	-	12.1	3.2	-	6.1
Malignant neoplasm of ovary (C56)	2.7	-	5.2	5.3	-	10.1
Malignant neoplasm of prostate (C61)	9.8	20.0	-	10.8	22.7	-
Malignant neoplasm of kidney (C64)	4.4	7.3	1.7	3.6	4.9	2.4
Malignant neoplasm of bladder (C67)	8.0	12.7	3.5	6.7	11.0	2.8
Malignant neoplasm of brain and central nervous system (C70-C72)	8.4	9.1	7.8	7.7	8.1	7.4
Malignant neoplasm of thyroid (C73)	0.9	0.9	0.9	0.6	0.5	0.7
Hodgkin disease and lymphomas (C81-C86)	4.0	1.8	6.1	2.5	2.6	2.4
Leukaemia (C91-C95)	5.8	4.5	6.9	5.7	6.5	5.0
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	1.8	-	3.5	1.7	2.3	1.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	25.3	26.3	24.3	17.9	17.8	18.0
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.8	1.8	1.7	0.2	-	0.3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.3	0.9	1.7	0.4	0.6	0.1
Endocrine, nutritional and metabolic diseases (E00-E89)	21.3	28.1	14.7	8.6	10.0	7.3
Diabetes mellitus (E10-E14)	20.8	27.2	14.7	8.3	9.6	7.1
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.4	0.9	-	0.3	0.5	0.1
Mental and behavioural disorders (F01-F99)	0.4	0.9	-	0.4	0.6	0.1
Dementia (F01, F03)	-	-	-	0.2	0.2	0.1
Alcohol abuse (including alcoholic psychosis) (F10)	0.4	0.9	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-	0.2	0.5	-
Diseases of the nervous system and the sense organs (G00-H95)	11.5	11.8	11.3	11.2	11.8	10.5
Parkinson’s disease (G20)	0.9	0.9	0.9	1.1	1.3	0.9
Alzheimer’s disease (G30)	0.4	-	0.9	0.4	0.5	0.3
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	10.2	10.9	9.5	9.7	10.0	9.4
Diseases of the circulatory system (I00-I99)	1 141.6	1 232.8	1 054.4	698.4	684.6	711.0
Ischaemic heart diseases (I20-I25)	351.6	371.9	332.1	52.9	61.2	45.3
of which:
Acute myocardial infarction (I21-I22)	58.1	71.7	45.1	27.3	35.6	19.6
Other ischaemic heart diseases (I20, I23-I25)	293.5	300.3	287.0	25.6	25.6	25.7
Other heart diseases (I30-I51)	313.0	349.3	278.3	456.8	443.9	468.6
Cerebrovascular diseases (I60-I69)	218.6	217.7	219.4	151.2	138.2	163.1
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	258.5	293.9	224.6	37.5	41.3	34.0
Diseases of the respiratory system (J00-J99)	142.3	164.2	121.4	49.4	55.8	43.5
Influenza (J09-J11)	0.4	0.9	-	0.6	0.5	0.7
Pneumonia (J12-J18)	46.6	63.5	30.3	33.1	40.1	26.6
Chronic lower respiratory diseases (J40-J47)	28.8	33.6	24.3	10.7	9.9	11.4
of which:
Asthma (J45-J46)	-	-	-	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	28.8	33.6	24.3	10.7	9.9	11.4
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	66.5	66.2	66.8	5.0	5.3	4.8
Diseases of the digestive system (K00-K92)	59.0	86.2	33.0	52.2	67.8	37.9
Ulcer of stomach, duodenum and jejunum (К25-К28)	0.9	0.9	0.9	0.4	0.2	0.6
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	26.6	47.2	6.9	22.1	34.0	11.1
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	31.5	38.1	25.1	29.7	33.7	26.1
Diseases of the skin and subcutaneous tissue (L00-L99)	-	-	-	0.5	0.3	0.7
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.4	0.9	-	0.2	0.2	0.1
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.4	0.9	-	0.2	0.2	0.1
Diseases of the genitourinary system (N00-N99)	41.2	42.6	39.9	33.3	36.7	30.1
Diseases of kidney and ureter (N00-N29)	41.2	42.6	39.9	32.9	36.4	29.7
Other diseases of the genitourinary system (N30-N99)	-	-	-	0.4	0.3	0.4
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	0.9	0.9	0.9	1.1	1.1	1.0
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.4	0.9	-	0.8	0.8	0.7
Symptoms, signs, ill-defined causes (R00-R99)	78.5	66.2	90.2	52.1	38.7	64.4
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	16.8	21.8	12.1	22.1	22.5	21.8
Other symptoms, signs, ill-defined causes (R00-R94)	61.6	44.5	78.0	30.0	16.2	42.6
External causes of morbidity and mortality (V01-Y98)	34.1	56.2	13.0	27.0	42.7	12.6
Accidents (V01-X59, Y85-Y86)	12.9	21.8	4.3	8.5	13.4	4.0
of which:
Transport accidents (V01-V99,Y85)	7.1	11.8	2.6	2.9	4.5	1.3
Accidental falls (W00-W19)	0.9	1.8	-	0.8	1.1	0.4
Drowning and accidental submersion '(W65-W74)	0.9	1.8	-	1.1	1.9	0.3
Accidental poisoning (W65-W74)	0.4	0.9	-	0.7	1.1	0.3
Other accidents (W20-W64, W75- X39, X50-59, Y86)	3.5	5.4	1.7	3.1	4.7	1.6
Suicide and intentional self-harm (X60-X84, Y87.0)	6.7	12.7	0.9	1.6	2.9	0.4
Homicide, assault (X85-Y09, Y87.1)	0.4	0.9	-	0.2	0.3	0.1
Events of undetermined intent (Y10-Y34, Y87.2)	12.9	19.1	6.9	15.7	24.3	7.9
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.3	1.8	0.9	0.9	1.8	0.1
Codes for special purposes (U00-U85)	6.2	7.3	5.2	6.6	8.1	5.2
of which COVID-19 (U07.1-U07.2)	6.2	7.3	5.2	6.6	8.1	5.2

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Stara Zagora			Targovishte
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 629.8	1 704.1	1 561.1	1 816.7	2 026.4	1 619.0
Infectious and parasitic diseases (A00-B99)	6.6	7.9	5.3	17.9	13.0	22.5
Tuberculosis (A15-A19, B90)	1.0	2.2	-	1.1	-	2.0
AIDS (HIV-disease) (B20-B24)	-	-	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	1.4	2.2	0.7	-	-	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	4.1	3.6	4.7	16.8	13.0	20.4
Neoplasms (C00-D48)	275.6	340.0	216.1	285.8	376.7	200.1
Malignant neoplasms (C00-C97)	275.3	339.2	216.1	284.7	376.7	198.0
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	6.6	10.8	2.7	10.5	21.6	-
Malignant neoplasm of oesophagus (C15)	4.8	7.9	2.0	3.2	6.5	-
Malignant neoplasm of stomach (C16)	15.2	22.3	8.6	16.8	26.0	8.2
Malignant neoplasm of colon, rectum and anus (C18-C21)	40.1	56.8	24.6	43.1	56.3	30.6
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	10.7	16.5	5.3	10.5	15.2	6.1
Malignant neoplasm of pancreas (C25)	19.3	21.6	17.3	12.6	8.7	16.3
Malignant neoplasm of larynx (C32)	4.8	10.1	-	6.3	13.0	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	57.3	78.3	37.9	67.2	110.4	26.5
Malignant melanoma of skin (C43)	3.5	2.2	4.7	1.1	-	2.0
Malignant neoplasm of breast (C50)	16.6	0.7	31.2	13.7	2.2	24.5
Malignant neoplasm of cervix uteri (C53)	4.5	-	8.6	1.1	-	2.0
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	4.8	-	9.3	4.2	-	8.2
Malignant neoplasm of ovary (C56)	5.9	-	11.3	8.4	-	16.3
Malignant neoplasm of prostate (C61)	15.2	31.6	-	20.0	41.1	-
Malignant neoplasm of kidney (C64)	6.9	6.5	7.3	6.3	10.8	2.0
Malignant neoplasm of bladder (C67)	10.4	17.2	4.0	10.5	17.3	4.1
Malignant neoplasm of brain and central nervous system (C70-C72)	9.3	12.9	6.0	9.5	6.5	12.2
Malignant neoplasm of thyroid (C73)	0.7	1.4	-	1.1	2.2	-
Hodgkin disease and lymphomas (C81-C86)	4.5	4.3	4.7	5.3	2.2	8.2
Leukaemia (C91-C95)	5.2	9.3	1.3	5.3	4.3	6.1
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	4.5	6.5	2.7	3.2	2.2	4.1
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	24.5	20.8	27.9	25.2	34.6	16.3
Non-malignant neoplasms (benign and uncertain) (D00-D48)	0.3	0.7	-	1.1	-	2.0
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.7	1.4	2.0	5.3	2.2	8.2
Endocrine, nutritional and metabolic diseases (E00-E89)	30.0	23.0	36.6	125.0	116.9	132.7
Diabetes mellitus (E10-E14)	28.7	22.3	34.6	125.0	116.9	132.7
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	1.4	0.7	2.0	-	-	-
Mental and behavioural disorders (F01-F99)	1.0	0.7	1.3	2.1	-	4.1
Dementia (F01, F03)	-	-	-	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	0.3	0.7	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.7	-	1.3	2.1	-	4.1
Diseases of the nervous system and the sense organs (G00-H95)	11.1	12.9	9.3	15.8	19.5	12.2
Parkinson’s disease (G20)	2.1	2.2	2.0	3.2	2.2	4.1
Alzheimer’s disease (G30)	0.7	-	1.3	5.3	4.3	6.1
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	8.3	10.8	6.0	7.4	13.0	2.0
Diseases of the circulatory system (I00-I99)	1 042.0	991.8	1 088.4	945.7	1 002.4	892.2
Ischaemic heart diseases (I20-I25)	324.6	340.0	310.5	216.5	246.8	187.8
of which:
Acute myocardial infarction (I21-I22)	104.3	121.5	88.4	56.7	88.8	26.5
Other ischaemic heart diseases (I20, I23-I25)	220.3	218.5	222.1	159.7	158.0	161.3
Other heart diseases (I30-I51)	92.2	89.8	94.4	173.4	216.5	132.7
Cerebrovascular diseases (I60-I69)	320.9	296.1	343.7	231.2	212.2	249.1
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	304.3	265.9	339.7	324.7	326.9	322.6
Diseases of the respiratory system (J00-J99)	88.1	111.4	66.5	101.9	136.4	69.4
Influenza (J09-J11)	1.7	2.2	1.3	1.1	-	2.0
Pneumonia (J12-J18)	57.3	69.7	45.9	48.3	67.1	30.6
Chronic lower respiratory diseases (J40-J47)	23.8	30.9	17.3	30.5	41.1	20.4
of which:
Asthma (J45-J46)	-	-	-	3.2	2.2	4.1
Other chronic lower respiratory diseases (J40-J44, J47)	23.8	30.9	17.3	27.3	39.0	16.3
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	5.2	8.6	2.0	22.1	28.1	16.3
Diseases of the digestive system (K00-K92)	76.3	92.7	61.2	85.1	112.6	59.2
Ulcer of stomach, duodenum and jejunum (К25-К28)	6.9	7.9	6.0	2.1	2.2	2.0
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	26.2	44.6	9.3	38.9	62.8	16.3
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	43.2	40.2	45.9	44.1	47.6	40.8
Diseases of the skin and subcutaneous tissue (L00-L99)	2.4	0.7	4.0	-	-	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	0.3	0.7	-	1.1	2.2	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	1.1	2.2	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	0.3	0.7	-	-	-	-
Diseases of the genitourinary system (N00-N99)	18.7	21.6	16.0	43.1	36.8	49.0
Diseases of kidney and ureter (N00-N29)	18.7	21.6	16.0	39.9	32.5	47.0
Other diseases of the genitourinary system (N30-N99)	-	-	-	3.2	4.3	2.0
Complications of pregnancy, childbirth and puerperium (O00-O99)	0.3	-	0.7	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.0	0.7	1.3	-	-	-
Congenital malformations and chromosomal abnormalities (Q00-Q99)	3.5	3.6	3.3	3.2	4.3	2.0
Symptoms, signs, ill-defined causes (R00-R99)	31.1	34.5	27.9	134.5	127.7	140.9
Sudden infant death syndrome (R95)	-	-	-	1.1	2.2	-
Unknown and unspecified causes (R96-R99)	24.2	26.6	21.9	69.3	80.1	59.2
Other symptoms, signs, ill-defined causes (R00-R94)	6.9	7.9	6.0	64.1	45.5	81.7
External causes of morbidity and mortality (V01-Y98)	33.8	51.0	18.0	46.2	71.4	22.5
Accidents (V01-X59, Y85-Y86)	20.4	29.5	12.0	20.0	30.3	10.2
of which:
Transport accidents (V01-V99,Y85)	7.6	12.2	3.3	11.6	19.5	4.1
Accidental falls (W00-W19)	4.5	5.0	4.0	3.2	4.3	2.0
Drowning and accidental submersion '(W65-W74)	0.7	1.4	-	1.1	2.2	-
Accidental poisoning (W65-W74)	1.7	1.4	2.0	-	-	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.9	9.3	2.7	4.2	4.3	4.1
Suicide and intentional self-harm (X60-X84, Y87.0)	9.3	13.7	5.3	15.8	23.8	8.2
Homicide, assault (X85-Y09, Y87.1)	1.0	2.2	-	1.1	2.2	-
Events of undetermined intent (Y10-Y34, Y87.2)	1.7	2.9	0.7	9.5	15.2	4.1
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.4	2.9	-	-	-	-
Codes for special purposes (U00-U85)	6.2	9.3	3.3	4.2	4.3	4.1
of which COVID-19 (U07.1-U07.2)	6.2	9.3	3.3	4.2	4.3	4.1

(Continued)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Haskovo			Shumen
ICD, X-th Revision, European Short List¹	Total	Male	Female	Total	Male	Female
Total	1 639.7	1 763.2	1 523.4	1 664.3	1 808.6	1 528.7
Infectious and parasitic diseases (A00-B99)	7.7	9.0	6.6	7.4	9.7	5.2
Tuberculosis (A15-A19, B90)	1.9	3.0	0.9	0.7	1.4	-
AIDS (HIV-disease) (B20-B24)	0.5	1.0	-	-	-	-
Viral hepatitis (B15-B19, B94.2)	-	-	-	0.7	1.4	-
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	5.3	5.0	5.6	6.0	6.9	5.2
Neoplasms (C00-D48)	274.6	334.3	218.3	271.6	328.6	218.0
Malignant neoplasms (C00-C97)	273.1	333.3	216.4	268.2	325.8	214.1
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	6.8	8.0	5.6	8.0	12.4	3.9
Malignant neoplasm of oesophagus (C15)	2.4	5.0	-	4.0	5.5	2.6
Malignant neoplasm of stomach (C16)	16.4	20.9	12.2	11.4	13.8	9.1
Malignant neoplasm of colon, rectum and anus (C18-C21)	38.1	42.8	33.7	41.5	49.7	33.7
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	15.9	17.9	14.1	10.0	11.0	9.1
Malignant neoplasm of pancreas (C25)	17.9	17.9	17.8	18.1	23.5	13.0
Malignant neoplasm of larynx (C32)	6.3	12.9	-	3.3	5.5	1.3
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	56.9	84.6	30.9	52.2	80.1	26.0
Malignant melanoma of skin (C43)	1.9	3.0	0.9	0.7	-	1.3
Malignant neoplasm of breast (C50)	13.5	1.0	25.3	13.4	-	26.0
Malignant neoplasm of cervix uteri (C53)	7.7	-	15.0	6.0	-	11.7
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	2.4	-	4.7	4.0	-	7.8
Malignant neoplasm of ovary (C56)	5.3	-	10.3	2.0	-	3.9
Malignant neoplasm of prostate (C61)	21.7	44.8	-	20.1	41.4	-
Malignant neoplasm of kidney (C64)	6.8	8.0	5.6	7.4	6.9	7.8
Malignant neoplasm of bladder (C67)	6.8	12.9	0.9	12.7	17.9	7.8
Malignant neoplasm of brain and central nervous system (C70-C72)	9.7	13.9	5.6	8.0	6.9	9.1
Malignant neoplasm of thyroid (C73)	1.0	-	1.9	-	-	-
Hodgkin disease and lymphomas (C81-C86)	3.4	3.0	3.7	5.4	6.9	3.9
Leukaemia (C91-C95)	7.2	6.0	8.4	2.0	-	3.9
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	1.9	3.0	0.9	4.0	2.8	5.2
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	23.2	27.9	18.7	34.1	40.0	28.6
Non-malignant neoplasms (benign and uncertain) (D00-D48)	1.4	1.0	1.9	3.3	2.8	3.9
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	1.4	-	2.8	7.4	5.5	9.1
Endocrine, nutritional and metabolic diseases (E00-E89)	10.1	10.9	9.4	62.2	41.4	81.8
Diabetes mellitus (E10-E14)	9.7	10.0	9.4	60.9	40.0	80.5
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.5	1.0	-	1.3	1.4	1.3
Mental and behavioural disorders (F01-F99)	2.4	1.0	3.7	2.0	2.8	1.3
Dementia (F01, F03)	1.9	-	3.7	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	0.5	1.0	-	2.0	2.8	1.3
Diseases of the nervous system and the sense organs (G00-H95)	31.8	32.8	30.9	17.4	19.3	15.6
Parkinson’s disease (G20)	5.3	7.0	3.7	6.0	5.5	6.5
Alzheimer’s disease (G30)	-	-	-	1.3	1.4	1.3
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	26.5	25.9	27.2	10.0	12.4	7.8
Diseases of the circulatory system (I00-I99)	1 044.2	1 048.8	1 039.9	934.5	947.1	922.7
Ischaemic heart diseases (I20-I25)	186.3	206.0	167.7	143.2	183.6	105.1
of which:
Acute myocardial infarction (I21-I22)	50.2	67.7	33.7	85.6	116.0	57.1
Other ischaemic heart diseases (I20, I23-I25)	136.1	138.3	134.0	57.5	67.6	48.0
Other heart diseases (I30-I51)	272.6	310.5	237.0	174.6	174.0	175.2
Cerebrovascular diseases (I60-I69)	335.9	310.5	359.8	242.2	230.6	253.1
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	249.5	221.9	275.4	374.6	359.0	389.3
Diseases of the respiratory system (J00-J99)	68.0	93.5	44.0	68.9	84.2	54.5
Influenza (J09-J11)	2.4	4.0	0.9	-	-	-
Pneumonia (J12-J18)	28.0	35.8	20.6	40.8	45.6	36.3
Chronic lower respiratory diseases (J40-J47)	20.7	31.8	10.3	22.1	33.1	11.7
of which:
Asthma (J45-J46)	0.5	1.0	-	0.7	-	1.3
Other chronic lower respiratory diseases (J40-J44, J47)	20.3	30.8	10.3	21.4	33.1	10.4
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	16.9	21.9	12.2	6.0	5.5	6.5
Diseases of the digestive system (K00-K92)	55.0	59.7	50.6	82.3	100.8	64.9
Ulcer of stomach, duodenum and jejunum (К25-К28)	1.4	1.0	1.9	8.0	6.9	9.1
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	16.4	24.9	8.4	32.1	55.2	10.4
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	37.2	33.8	40.3	42.1	38.7	45.4
Diseases of the skin and subcutaneous tissue (L00-L99)	1.9	1.0	2.8	6.7	8.3	5.2
Diseases of the musculoskeletal system/connective tissue (M00-M99)	-	-	-	2.0	1.4	2.6
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-	0.7	-	1.3
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	-	-	-	1.3	1.4	1.3
Diseases of the genitourinary system (N00-N99)	29.0	38.8	19.7	60.9	77.3	45.4
Diseases of kidney and ureter (N00-N29)	28.5	37.8	19.7	60.2	75.9	45.4
Other diseases of the genitourinary system (N30-N99)	0.5	1.0	-	0.7	1.4	-
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	3.9	7.0	0.9	2.7	4.1	1.3
Congenital malformations and chromosomal abnormalities (Q00-Q99)	0.5	1.0	-	1.3	2.8	-
Symptoms, signs, ill-defined causes (R00-R99)	62.7	52.7	72.1	91.0	114.6	68.8
Sudden infant death syndrome (R95)	-	-	-	-	-	-
Unknown and unspecified causes (R96-R99)	33.8	35.8	31.9	84.3	106.3	63.6
Other symptoms, signs, ill-defined causes (R00-R94)	29.0	16.9	40.3	6.7	8.3	5.2
External causes of morbidity and mortality (V01-Y98)	37.6	59.7	16.9	38.1	48.3	28.6
Accidents (V01-X59, Y85-Y86)	24.1	34.8	14.1	19.4	26.2	13.0
of which:
Transport accidents (V01-V99,Y85)	6.8	10.0	3.7	8.0	13.8	2.6
Accidental falls (W00-W19)	9.2	10.9	7.5	5.4	4.1	6.5
Drowning and accidental submersion '(W65-W74)	2.4	5.0	-	1.3	2.8	-
Accidental poisoning (W65-W74)	0.5	-	0.9	0.7	1.4	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	5.3	9.0	1.9	4.0	4.1	3.9
Suicide and intentional self-harm (X60-X84, Y87.0)	8.2	14.9	1.9	7.4	12.4	2.6
Homicide, assault (X85-Y09, Y87.1)	-	-	-	0.7	-	1.3
Events of undetermined intent (Y10-Y34, Y87.2)	4.3	9.0	-	10.7	9.7	11.7
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	1.0	1.0	0.9	-	-	-
Codes for special purposes (U00-U85)	8.7	12.9	4.7	8.0	12.4	3.9
of which COVID-19 (U07.1-U07.2)	8.7	12.9	4.7	8.0	12.4	3.9

(Continued and end)

(Per 100 000 of population)
ICD, X-th Revision, European Short List¹	Yambol
ICD, X-th Revision, European Short List¹	Total	Male	Female
Total	1 825.7	2 022.1	1 641.3
Infectious and parasitic diseases (A00-B99)	17.0	21.4	12.8
Tuberculosis (A15-A19, B90)	2.8	5.8	-
AIDS (HIV-disease) (B20-B24)	0.9	1.9	-
Viral hepatitis (B15-B19, B94.2)	0.9	-	1.8
Other infectious and parasitic diseases (A00-A09, A20-B09, B25-B89, B91-B94.1, B94.8-B99)	12.3	13.6	11.0
Neoplasms (C00-D48)	299.4	352.9	249.1
Malignant neoplasms (C00-C97)	299.4	352.9	249.1
of which:
Malignant neoplasm of lip, oral cavity, pharynx (C00-C14)	3.8	5.8	1.8
Malignant neoplasm of oesophagus (C15)	0.9	-	1.8
Malignant neoplasm of stomach (C16)	13.2	17.5	9.2
Malignant neoplasm of colon, rectum and anus (C18-C21)	58.6	72.1	45.8
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	12.3	9.7	14.7
Malignant neoplasm of pancreas (C25)	17.0	13.6	20.2
Malignant neoplasm of larynx (C32)	1.9	3.9	-
Malignant neoplasm of trachea, bronchus, lung (C33-C34)	63.3	103.3	25.6
Malignant melanoma of skin (C43)	0.9	1.9	-
Malignant neoplasm of breast (C50)	19.8	-	38.5
Malignant neoplasm of cervix uteri (C53)	2.8	-	5.5
Malignant neoplasm of other and unspecified parts of uterus (С54-С55)	7.6	-	14.7
Malignant neoplasm of ovary (C56)	6.6	-	12.8
Malignant neoplasm of prostate (C61)	14.2	29.2	-
Malignant neoplasm of kidney (C64)	6.6	5.8	7.3
Malignant neoplasm of bladder (C67)	8.5	13.6	3.7
Malignant neoplasm of brain and central nervous system (C70-C72)	14.2	19.5	9.2
Malignant neoplasm of thyroid (C73)	0.9	1.9	-
Hodgkin disease and lymphomas (C81-C86)	4.7	7.8	1.8
Leukaemia (C91-C95)	9.4	13.6	5.5
Other malignant neoplasm of lymphoid and haematopoietic tissue (C88, C90, C96)	2.8	3.9	1.8
Other malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44-C49, C51-C52, C57-C60, C62-C63, C65-C66, C68-C69, C74-C80, C97)	29.3	29.2	29.3
Non-malignant neoplasms (benign and uncertain) (D00-D48)	-	-	-
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	0.9	-	1.8
Endocrine, nutritional and metabolic diseases (E00-E89)	17.9	21.4	14.7
Diabetes mellitus (E10-E14)	17.0	21.4	12.8
Other endocrine, nutritional and metabolic diseases (E00-E07, E15-E89)	0.9	-	1.8
Mental and behavioural disorders (F01-F99)	-	-	-
Dementia (F01, F03)	-	-	-
Alcohol abuse (including alcoholic psychosis) (F10)	-	-	-
Drug dependence, toxicomania (F11-F16, F18-F19)	-	-	-
Other mental and behavioural disorders (F04-F09, F17, F20-F99)	-	-	-
Diseases of the nervous system and the sense organs (G00-H95)	7.6	11.7	3.7
Parkinson’s disease (G20)	-	-	-
Alzheimer’s disease (G30)	-	-	-
Other diseases of the nervous system and the sense organs (G00-G12, G14, G21-G25, G31-H95)	7.6	11.7	3.7
Diseases of the circulatory system (I00-I99)	1 214.6	1 285.0	1 148.6
Ischaemic heart diseases (I20-I25)	524.2	600.6	452.5
of which:
Acute myocardial infarction (I21-I22)	161.5	226.2	100.8
Other ischaemic heart diseases (I20, I23-I25)	362.7	374.4	351.7
Other heart diseases (I30-I51)	117.1	122.8	111.7
Cerebrovascular diseases (I60-I69)	440.1	419.2	459.8
Other diseases of the circulatory system (I00-I15, I26-I28, I70-I99)	133.2	142.3	124.6
Diseases of the respiratory system (J00-J99)	52.9	70.2	36.6
Influenza (J09-J11)	-	-	-
Pneumonia (J12-J18)	25.5	29.2	22.0
Chronic lower respiratory diseases (J40-J47)	13.2	21.4	5.5
of which:
Asthma (J45-J46)	-	-	-
Other chronic lower respiratory diseases (J40-J44, J47)	13.2	21.4	5.5
Other diseases of the respiratory system (J00-J06, J20-J39, J60-J99)	14.2	19.5	9.2
Diseases of the digestive system (K00-K92)	80.3	111.1	51.3
Ulcer of stomach, duodenum and jejunum (К25-К28)	2.8	5.8	-
Cirrhosis, fibrosis and chronic hepatitis (К70, К73-К74)	43.4	70.2	18.3
Other diseases of the digestive system (K00-K22, K29-K66, K71-K72, K75-K92)	34.0	35.1	33.0
Diseases of the skin and subcutaneous tissue (L00-L99)	-	-	-
Diseases of the musculoskeletal system/connective tissue (M00-M99)	-	-	-
Rheumatoid arthritis and osteoarthrosis (М05-М06, М15-М19)	-	-	-
Other diseases of the musculoskeletal system/connective tissue (M00-M02, M08-M13, M20-M99)	-	-	-
Diseases of the genitourinary system (N00-N99)	20.8	19.5	22.0
Diseases of kidney and ureter (N00-N29)	18.9	17.5	20.2
Other diseases of the genitourinary system (N30-N99)	1.9	1.9	1.8
Complications of pregnancy, childbirth and puerperium (O00-O99)	-	-	-
Certain conditions originating in the perinatal period (P00-P96)	1.9	3.9	-
Congenital malformations and chromosomal abnormalities (Q00-Q99)	-	-	-
Symptoms, signs, ill-defined causes (R00-R99)	70.8	64.3	76.9
Sudden infant death syndrome (R95)	-	-	-
Unknown and unspecified causes (R96-R99)	20.8	21.4	20.2
Other symptoms, signs, ill-defined causes (R00-R94)	50.1	42.9	56.8
External causes of morbidity and mortality (V01-Y98)	35.9	56.5	16.5
Accidents (V01-X59, Y85-Y86)	17.9	29.2	7.3
of which:
Transport accidents (V01-V99,Y85)	6.6	11.7	1.8
Accidental falls (W00-W19)	5.7	5.8	5.5
Drowning and accidental submersion '(W65-W74)	0.9	1.9	-
Accidental poisoning (W65-W74)	-	-	-
Other accidents (W20-W64, W75- X39, X50-59, Y86)	4.7	9.7	-
Suicide and intentional self-harm (X60-X84, Y87.0)	13.2	21.4	5.5
Homicide, assault (X85-Y09, Y87.1)	0.9	-	1.8
Events of undetermined intent (Y10-Y34, Y87.2)	3.8	5.8	1.8
Other external causes of injury and poisoning (Y35-Y84, Y88-Y89)	-	-	-
Codes for special purposes (U00-U85)	5.7	3.9	7.3
of which COVID-19 (U07.1-U07.2)	5.7	3.9	7.3
¹Elaborated by Eurostat harmonised list used for international comparisons. Since 2020 incl. Chapter XXII Codes for special purposes (U00-U85), COVID-19 (U07.1-U07.2).

26.06.2025

Time series

Zdr_6.1.4_Umr_EN.xlsx

Metadata

Methodology

Euro-SDMX Metadata Structure (ESMS)

Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Contact

Contact organisation

National Statistical Institute

Contact organisation unit

"Health and Justice Statistics" Department

Contact name

Evelin Yordanova

Contact person function

Head of department

Contact mail address

2, P. Volov Str.; 1038 Sofia, Bulgaria

Contact email address

[email protected]

Contact phone number

+359 2 9857 459

Contact fax number

Metadata update

Metadata last certified

26 June 2025

Metadata last posted

26 June 2025

Metadata last update

26 June 2025

Statistical presentation

Data description

Causes of death statistics is widely used as a basic source of information for health status international comparisons as well as for national analyses. The one-type data collection procedures, unified death certificate and WHO International Classification of Diseases are used in all European countries. Since 2005 the International Classification of Diseases - X Revision is used in Bulgaria. The requirements of ICD X are elaborated in COD statistical work in Bulgaria. According to Eurostat requirements since 2014 the harmonised 86 causes list is used for development of statistical tables as well as for analysis.

Data source on causes of death statistics is the medical death certificate. The form and the content of the document are determined by Ordinance № 42 of 8 December 2004 the Minister of Health, as part of the cause of death and other medical information is standardized in accordance with the recommendations of the World Health Organization (WHO).

The death certificate is filled in by the physician who recognized the death.

The coding of causes of death and stillbirth are carried out on a paper document by physicians working in Regional health inspections, specially trained to implement the requirements of the International Classification of Diseases - X revision and the Methodological instructions to Ordinance № 42 of 08.12.2004 of the Ministry of Health.

Data are broken down by sex, age groups, type of the settlement and cause of death (by chapters of ICD-10 or in accordance with the harmonized European Short List of 86 causes) at national level and by statistical regions and districts in accordance with the Nomenclature of territorial units for statistics in Bulgaria (NUTS 2 and NUTS 2).

Annual data are presented in numbers and per 100 000 of population.

Classification system

International Statistical Classification of Diseases and Related Health Problems, X rev.;
Classification of Territorial Units for Statistical Purposes in Bulgaria (NUTS);
Unified Classification of Administrative-Territorial and Territorial Units (UCATTU);
European Shortlist - Harmonised 86 causes list, created by Eurostat in accordance with the standards of the World Health Organization and the International Statistical Classification of Diseases and Related Health Problems (ICD).

Sector coverage

The deceased persons who have the present address in the Republic of Bulgaria are included.

Statistical concepts and definitions

In accordance with the requirements of WHO, statistical tables are elaborated based on the underlying cause of death, i.e. "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury".

Four-digit code of ICD - X rev. is used.

The cause of death frequency is the ratio between number of deaths by certain cause and annual average of the respective population. It is calculated per 100 000 of population.

Infant mortality rate is calculated per 1000 live born.

Statistical unit

The statistical unit is the deceased person. The reporting unit is the physician who filled in the death certificate (certifier). The events are registered by following document:

Death Certificate for deaths and
Birth Certificate - for stillbirths.

Statistical population

The deceased persons who have a present address in the Republic of Bulgaria are included.

Reference area

Covered by the territory of the Republic of Bulgaria. The regional data is according to the administrative-territorial division of the country as of 31.12. of the reference year.

Time coverage

By 1994 - only published data.

1995 - 2004 - the data are available on request.

2005 - 2024 - the data are available on the website www.nsi.bg

Base period

Not applicable.

Unit of measure

Number, per 100 000 of population.

Reference period

Annually

Institutional mandate

Legal acts and other agreements

Regulation (ЕU) №1338/2008 of th European Parliament and of the Council on Community Statistics on public health and safety at work;
Commission Regulation (EU) No 328/2011 of 5 April 2011 implementing Regulation (EU) No 1338/2008 as regards statistics on causes of death;
Commission Decision of 5 April 2011 granting derogations to certain Member States with respect to the transmission of statistics pursuant to Regulation (EU) No 1338/2008 as regards statistics on causes of death (notified under document C(2011) 2057);
Law on statistics;
Amendment and supplement of Ordinance № 14/2004 of the Ministry of Health on medical criteria and procedures for the establishment of death, publ., SG 41 of 21.05.2019;

Ordinance No 42 of 8 December 2004 on the Introduction of Classification Statistical Systems for Coding of Diseases and Health Problems and Medical Procedures, SG. Issue 111 of December 21, 2004, am. SG. No. 88 of 20 October 2023;
Ministry of Health instructions and guidelines.

Data sharing

Until 2010 data are provided to Eurostat and the World Health Organization in framework of joint data collection by single cause, sex, age, and statistical regions (NUTS 2).

Since 2011 the data are provided pursuant to Regulation (EC) № 328/2011.

Confidentiality

Confidentiality - policy

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society;
Law on Statistics;
Law on Personal Data Protection.

Confidentiality - data treatment

The level of detailing of the causes of death and preparation of statistics table data are in accordance with the recommendations of the World Health Organization.

Release policy

Release calendar

The date of the statistical information release is shown in the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute.

Release calendar access

The calendar is available on the NSI website: http://www.nsi.bg/en/node/480

User access

Data on Deaths by causes and mortality by causes is published on the NSI website, section Health in accordance with the Law on Statistics and the European Statistics Code of Practice respecting the professional independence and aimed at objectivity, transparency and equal treatment of all consumers.

Frequency of dissemination

Annually

Accessibility and clarity

News release

Not applicable.

Publications

Health Services;
Statistical yearbook;
Population and Demographic Processes.

On-line database

Data on Deaths by causes and mortality by causes are available to all users of the NSI website under the heading Health - Deaths by causes and mortality by causes: http://www.nsi.bg/en/node/5614;

Online database of Eurostat.

Micro-data access

Anonymised individual data can be provide for scientific and research purposes, and for individual request according to the Rules for the provision of anonymised individual data for scientific and research purposes.

All data on causes of deaths are stored in a database "Demography". Access is strictly regulated in accordance with the rules on protection of personal data and protection of statistical secrecy.

Other

Information service on request, according to the Rules for the dissemination of statistical products and services in NSI.

Documentation on methodology

Methodological notes: http://www.nsi.bg/sites/default/files/files/metadata/Zdr_6_Methodology_EN.pdf;
International Statistical Classification of Diseases and Related Health Problems (ICD) - X rev.
WHO and Ministry of Health instructions and guidelines.

Quality documentation

The quality of information on causes of deaths and mortality by causes are mainly determined by the information filled in by the physician as well as by the implemented rules for the selection and coding of the underlying cause of death.

Quality management

Quality assurance

Strict implementation of the WHO requirements and the rules and instructions for certification and coding according to ICD - X rev.

Annual logical control of data quality in accordance with ICD - X rev.

Implementation of the recommendations of Eurostat for quality control of the data.

Integrated quality and security management system has been implemented in accordance with the requirements of BDS EN ISO 9001: 2015 and BDS EN ISO 27001: 2017. The certificate fully meets all international requirements and guarantees the quality of the processes and information security of the entire statistical and information infrastructure of the NSI, both at national and regional levels.

Quality assessment

Relevance

User needs

Data on causes of death are provided annually to Eurostat and World Health Organization (WHO) in strict compliance with the prescribed terms and forms of presentation of the data. In the framework of regular annual questionnaires data are also provided to other European and international organizations - UNESCO, UNICEF, etc. Users of health information at national and regional level are the National Assembly of the Republic of Bulgaria, the executive and local authorities, National Health Insurance Fund. The data are provided annually to the National Centre for Public Health and Analysis at the Ministry of Health, Ministry of Health and its territorial units - Regional Health Inspections, whose functions are to implement and organize the government health policy at national and regional level.

Upon request data is provided to research institutes, universities, NGOs and other users.

User satisfaction

Not applicable.

Completeness

For the public dissemination (the website) data on causes of death are presented by chapters of ICD-10 and according to the Eurostat harmonised 86 causes list and in accordance with the standards of the World Health Organization and the International Statistical Classification of Diseases and Related Health Problems (ICD). Since 2020 in accordance with the WHO updates as well as Ministry of Health instructions and guidelines Chapter 22 Codes for special purposes (U00-U85), of which COVID-19 (U07.1-U07.2) is included in the tables. Detailed tables on COVID-19 (U07.1-U07.2) deaths in Bulgaria have been also published.

In accordance with the ICD definitions:

U07.1 COVID-19, virus identified - confirmed by laboratory testing irrespective of severity of clinical signs or symptoms;

U07.2 COVID-19, virus not identified - diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available.

Data are presented by sex, 5-year age groups, type of the settlement and cause of death at national level and by statistical regions and districts in accordance with the Nomenclature of territorial units for statistics in Bulgaria (NUTS 2 and NUTS 2).

Accuracy and reliability

Overall accuracy

Exhaustive survey.

Sampling error

Not applicable.

Non-sampling error

Not applicable.

Timeliness and punctuality

Timeliness

T+6 months

Punctuality

Data are disseminated according to the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute.

Coherence and comparability

Comparability - geographical

The data are comparable for all territorial regions in the country.

For international comparison the following has to be taken into account - The comparability of the data across different countries is limited by the fact that the revision of classification used to collect information on underlying cause of death may be different. Furthermore, not all countries apply the recommended WHO's updates.

The coverage of residents dying abroad or non-residents dying in the reporting country can also affect the comparability among countries.

Comparability - over time

The time series for deaths by causes are comparable since 2005 (according to ICD - X rev).

Until 2004 ICD - IX rev. was used.

Coherence - cross domain

The total number of cause of death (stillbirths by cause) are equal to the number of deaths (stillbirths) in the theme "Population".

Coherence - internal

Not applicable.

Cost and burden

Not applicable.

Data revision

Data revision - policy

The revision of data is possible after validation procedure in accordance with the Regulation (EU) 328/2011 requirements. In addition, revision is possible when have a change in statistical regions (NUTS 2).

Data revision - practice

See pervious position.

Statistical processing

Source data

Data source for deaths and stillbirths are forms of National Civil Registration System (NCRS). The events are registered by following document:

Death Certificate for death events;
Birth Certificate - for stillbirths.

Frequency of data collection

Annually

Data collection

1. Certification

Description of the certification process and the validation process

Data source on causes of death statistics is the medical certificate of death. The form and content of the document are determined by the Ordinance № 42 of 8 December 2004 the Minister of Health, as the part of the causes of death and other medical information is standardized in accordance with the recommendations of the World Health Organization (WHO).

The death certificate is filled in by the physician who recognized the death in accordance with the Amendment and supplement of Ordinance № 14/2004 of the Ministry of Health on medical criteria and procedures for the identifying death, publ., SG 41 of 21.05.2019. The national legislation determines in details all the procedures and medical criteria needed in order to identify the person as deceased

How are the certification errors assessed?

Supervision and control of the certification process is carried out by experts in Regional health inspections occasionally or ad hoc on a specific issue.

Is training in certification obligatory in your country?

The training in certification is part of the medical education.

2. Coding

Did you use any form of automated coding? No

Underlying cause of death selection and modification - only manual selection of underlying cause is applied.

Information available in the national COD database - only information on the underlying cause is stored in the national COD database. Multiple cases are not available.

Stillbirths and Neonates: Do you have a different death certificate or do you code these data differently from other deaths? If yes, how?

Stillbirths - Data source for stillbirths is the certificate of birth. The certificate is completed in health establishment and in case of stillbirth one copy is submitted to the Regional health inspections. Coding of causes of stillbirth (as well as deaths) is performed by doctors working in Regional health inspections, specially trained for this purpose.

Neonates - The neonatal deaths are coded as all other deaths.

Data validation

1. Coding

The coding of underlying cause of death is carried out by physicians working in Regional Health Inspections, specially trained to implement the requirements of the International Classification of Diseases - X revision.

Physician who codes the cause of death must review the medical information in the death certificate, and in cases it is not filled in correctly, he is obliged to contact with the physician, who has issued a death certificate for further specifications.

After coding the documents are submitted to the Regional Statistical Offices for entering the information. The data is processed and stored in IS "Demography".

Data validation is performed:

At data transmission – preliminary checking and processing, the proper application of the criterion for length of stay of 12 months.
At the data processing stage - criteria for doubling, correctness, validation rules for each record’s characteristic incl. potential inconsistency in the death certificate or error due to mistake when filling the deaths certificates. In case of inconsistencies or errors, the physician who codes and/ or certifier should be contacted.

Description of the outcome of the error detection procedures in place
In case of inconsistencies or errors, the certifier should be contacted.

Is coding carried out at a central level?
The coding is carried out in the Regional Health Inspections. The Regional Health Inspections implement and organize the government health policy within the territory of administrative regions. There are 28 Regional Healthcare Inspections in the country.

Is coding performed by a certifier?

No. The coding of underlying cause of death is carried out by physicians working in Regional Health Inspections, specially trained to implement the requirements of the International Classification of Diseases - X revision.

Are double coding exercises performed (if yes, please indicate the rate of codification errors for uderlying cause of death/if not give an estimate of the rate of codification errors)?

No.

Percentage of ICD codes

	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024


Unspecified COD (for ICD10: R00-R99 codes)	3,3	3,1	3,5	3,5	3,6	3,1	3,3	4,5	4,7	5,0
Unknown COD (for ICD10: R98-R99 codes)	1,3	1,5	1,6	1,7	1,8	1,7	2	2,6	2,5	2,8
Deaths due to senility (for ICD10: R54 code)	1,3	1,0	1,3	1,1	1,1	0,8	0,8	1,2	1,4	1,3
Deaths due to exposure to unspecified factor (for ICD10: X59 code)	0,1	0,1	0,0	0,0	0,0	0,0	0,0	0,0	0,0	0,0

2. Validation process

Data validation is performed at three stages:

At data transmission – preliminary checking and processing, the proper application of the criterion for length of stay of 12 months.
At the data processing stage - criteria for doubling, correctness, validation rules for each record’s characteristic.
Before data release - checking the frequencies of separate variables, consistency of table and cross-tabulations.

What are the criteria (external source, local registers, …) used for the validation of the coverage?

Data source for all demographic events is the National civil registration system. Events information is obtained as an electronic file. Causes of death and stillbirth are coded on a paper documents, a copy of which is also obtained. In case of stillbirth as well as death of a child up to 168 hours of his/her birth a certificate for perinatal death is filled in and send to the Regional health inspections. The last is used to verify data on perinatal mortality.

Data compilation

The data is processed and stored in IS "Demography".

Adjustment

Not applicable.

Comment

Download in SDMX 2.1 file format: Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Metadata Structure Definition in SDMX 2.1: ESMS_MSD+BNSI+2.0+SDMX.2.1.xml

Download in SDMX 2.0 file format: Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Metadata Structure Definition in SDMX 2.0: ESMS_MSD+BNSI+2.0+SDMX.2.0.xml

Quality reports

ESS Standard for Quality Reports Structure (ESQRS)

Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Contact

Contact organisation

National Statistical Institute

Contact organisation unit

"Health and Justice Statistics" Department

Contact name

Evelin Yordanova

Contact person function

Head of department

Contact mail address

2, P. Volov Str.; 1038 Sofia, Bulgaria

Contact email address

[email protected]

Contact phone number

+359 2 9857 459

Contact fax number

Statistical presentation

Data description

The death certificate is filled in by the physician who recognized the death.

Annual data are presented in numbers and per 100 000 of population.

Classification system

International Statistical Classification of Diseases and Related Health Problems, X rev.;
Classification of Territorial Units for Statistical Purposes in Bulgaria (NUTS);
Unified Classification of Administrative-Territorial and Territorial Units (UCATTU);
European Shortlist - Harmonised 86 causes list, created by Eurostat in accordance with the standards of the World Health Organization and the International Statistical Classification of Diseases and Related Health Problems (ICD).

Sector coverage

The deceased persons who have the present address in the Republic of Bulgaria are included.

Statistical concepts and definitions

Four-digit code of ICD - X rev. is used.

The cause of death frequency is the ratio between number of deaths by certain cause and annual average of the respective population. It is calculated per 100 000 of population.

Infant mortality rate is calculated per 1000 live born.

Statistical unit

The statistical unit is the deceased person. The reporting unit is the physician who filled in the death certificate (certifier). The events are registered by following document:

Death Certificate for deaths and
Birth Certificate - for stillbirths.

Statistical population

The deceased persons who have a present address in the Republic of Bulgaria are included.

Reference area

Covered by the territory of the Republic of Bulgaria. The regional data is according to the administrative-territorial division of the country as of 31.12. of the reference year.

Time coverage

By 1994 - only published data.

1995 - 2004 - the data are available on request.

2005 - 2024 - the data are available on the website www.nsi.bg

Base period

Not applicable.

Statistical processing

Source data

Data source for deaths and stillbirths are forms of National Civil Registration System (NCRS). The events are registered by following document:

Death Certificate for death events;
Birth Certificate - for stillbirths.

Frequency of data collection

Annually

Data collection

1. Certification

Description of the certification process and the validation process

How are the certification errors assessed?

Supervision and control of the certification process is carried out by experts in Regional health inspections occasionally or ad hoc on a specific issue.

Is training in certification obligatory in your country?

The training in certification is part of the medical education.

2. Coding

Did you use any form of automated coding? No

Underlying cause of death selection and modification - only manual selection of underlying cause is applied.

Information available in the national COD database - only information on the underlying cause is stored in the national COD database. Multiple cases are not available.

Stillbirths and Neonates: Do you have a different death certificate or do you code these data differently from other deaths? If yes, how?

Neonates - The neonatal deaths are coded as all other deaths.

Data validation

1. Coding

After coding the documents are submitted to the Regional Statistical Offices for entering the information. The data is processed and stored in IS "Demography".

Data validation is performed:

At data transmission – preliminary checking and processing, the proper application of the criterion for length of stay of 12 months.
At the data processing stage - criteria for doubling, correctness, validation rules for each record’s characteristic incl. potential inconsistency in the death certificate or error due to mistake when filling the deaths certificates. In case of inconsistencies or errors, the physician who codes and/ or certifier should be contacted.

Description of the outcome of the error detection procedures in place
In case of inconsistencies or errors, the certifier should be contacted.

Is coding performed by a certifier?

Are double coding exercises performed (if yes, please indicate the rate of codification errors for uderlying cause of death/if not give an estimate of the rate of codification errors)?

No.

Percentage of ICD codes

	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024


Unspecified COD (for ICD10: R00-R99 codes)	3,3	3,1	3,5	3,5	3,6	3,1	3,3	4,5	4,7	5,0
Unknown COD (for ICD10: R98-R99 codes)	1,3	1,5	1,6	1,7	1,8	1,7	2	2,6	2,5	2,8
Deaths due to senility (for ICD10: R54 code)	1,3	1,0	1,3	1,1	1,1	0,8	0,8	1,2	1,4	1,3
Deaths due to exposure to unspecified factor (for ICD10: X59 code)	0,1	0,1	0,0	0,0	0,0	0,0	0,0	0,0	0,0	0,0

2. Validation process

Data validation is performed at three stages:

At data transmission – preliminary checking and processing, the proper application of the criterion for length of stay of 12 months.
At the data processing stage - criteria for doubling, correctness, validation rules for each record’s characteristic.
Before data release - checking the frequencies of separate variables, consistency of table and cross-tabulations.

What are the criteria (external source, local registers, …) used for the validation of the coverage?

Data compilation

The data is processed and stored in IS "Demography".

Adjustment

Not applicable.

Quality management

Quality assurance

Strict implementation of the WHO requirements and the rules and instructions for certification and coding according to ICD - X rev.

Annual logical control of data quality in accordance with ICD - X rev.

Implementation of the recommendations of Eurostat for quality control of the data.

Quality assessment

Relevance

User needs

Upon request data is provided to research institutes, universities, NGOs and other users.

User satisfaction

Not applicable.

Completeness

In accordance with the ICD definitions:

U07.1 COVID-19, virus identified - confirmed by laboratory testing irrespective of severity of clinical signs or symptoms;

U07.2 COVID-19, virus not identified - diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available.

Data completeness - rate

Not applicable.

Accuracy and reliability

Overall accuracy

Exhaustive survey.

Sampling error

Not applicable.

Sampling errors - indicators

Not applicable.

Non-sampling error

Not applicable.

Coverage error

Administrative data sources are used for production of official statistics. Data files are provided to NSI containing information on demographic events - births, deaths, marriages, divorces, change of address in the country, international migration. Computer files are received from the Unified System for Civil registration and Administrative Service of Population.

Registration is done at the moment of death/ birth and the number is calculated as of 31.12 of the reference year. Data collection is exhaustively for all deaths/ stillbirths registered during the year.

The events are registered at their occurrence according to the usual residence of the person and they form the respective periodical aggregate for a fixed time. This specific time for the current demographic statistics as well as for health statistics is a calendar year.

Data are processed, edited and validated through the Information System Demography, respecting the settled in advance system and logic criteria. Data on demographic events is checked and controlled before to be loaded in the IS "Demography".

For successful processing, the initial notification should meet the system rules on validation and control. The processed results are validated in respect the consistency of a single table and between the tables.

Records linkage is done based on Identification Number of the persons subject of a demographic event.

Data validation is performed at three stages:

At data transmission – preliminary checking and processing, the proper application of the criterion for length of stay of 12 months.
At the data processing stage - criteria for doubling, correctness, validation rules for each record’s characteristic.
Before data release - checking the frequencies of separate variables, consistency of table and cross-tabulations.

Over-coverage - rate

Not applicable.

Common units - proportion

Not applicable.

Measurement error

Not applicable.

Non response error

Not applicable.

Unit non-response - rate

Not applicable.

Item non-response - rate

Not applicable.

Processing error

Not applicable.

Imputation - rate

Not applicable.

Model assumption error

Not applicable.

Seasonal adjustment

Not applicable.

Data revision - policy

Data revision - practice

See pervious position.

Data revision - average size

Not applicable.

Timeliness and punctuality

Timeliness

T+6 months

Time lag - first results

Time lag - final results

Punctuality

Data are disseminated according to the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute.

Punctuality - delivery and publication

Coherence and comparability

Comparability - geographical

The data are comparable for all territorial regions in the country.

The coverage of residents dying abroad or non-residents dying in the reporting country can also affect the comparability among countries.

Asymmetry for mirror flows statistics - coefficient

Not applicable.

Comparability - over time

The time series for deaths by causes are comparable since 2005 (according to ICD - X rev).

Until 2004 ICD - IX rev. was used.

Length of comparable time series

Coherence - cross domain

The total number of cause of death (stillbirths by cause) are equal to the number of deaths (stillbirths) in the theme "Population".

Coherence - sub annual and annual statistics

Not applicable.

Coherence - National Accounts

Not applicable.

Coherence - internal

Not applicable.

Accessibility and clarity

News release

Not applicable.

Publications

Health Services;
Statistical yearbook;
Population and Demographic Processes.

On-line database

Data on Deaths by causes and mortality by causes are available to all users of the NSI website under the heading Health - Deaths by causes and mortality by causes: http://www.nsi.bg/en/node/5614;

Online database of Eurostat.

Data tables - consultations

Not applicable.

Micro-data access

All data on causes of deaths are stored in a database "Demography". Access is strictly regulated in accordance with the rules on protection of personal data and protection of statistical secrecy.

Other

Information service on request, according to the Rules for the dissemination of statistical products and services in NSI.

Metadata - consultations

Not applicable.

Documentation on methodology

Methodological notes: http://www.nsi.bg/sites/default/files/files/metadata/Zdr_6_Methodology_EN.pdf;
International Statistical Classification of Diseases and Related Health Problems (ICD) - X rev.
WHO and Ministry of Health instructions and guidelines.

Metadata completeness – rate

100%

Quality documentation

Cost and burden

Not applicable.

Confidentiality

Confidentiality - policy

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society;
Law on Statistics;
Law on Personal Data Protection.

Confidentiality – data treatment

The level of detailing of the causes of death and preparation of statistics table data are in accordance with the recommendations of the World Health Organization.

Comment

Download in SDMX 2.1 file format: Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Metadata Structure Definition in SDMX 2.1: ESQRS_MSD+BNSI+2.0+SDMX.2.1.xml

Download in SDMX 2.0 file format: Deaths by causes and mortality by causes - Deaths by causes, Mortality by causes, Still-births and Still-births per 1 000 live births

Metadata Structure Definition in SDMX 2.0: ESQRS_MSD+BNSI+2.0+SDMX.2.0.xml

Press releases

Date	Name	File
17.06.2025	In-patient, out-patient and other health care establishments as of 31.12.2024	322.55 kb
25.04.2025	Creches - 2024	240.44 kb
17.06.2024	In-patient, Out-patient and Other Health Care Establishments as of 31.12.2023	240.39 kb
25.04.2024	Crèches in 2023	752.75 kb
16.06.2023	In-patient, Out-patient and Other Health Care Establishments as of 31.12.2022	590.12 kb
25.04.2023	Creches in 2022	758.95 kb

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Publications

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