Chie W C, Chen S Y, Chang K J
School of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2001 Jan;100(1):20-5.
The incidence and mortality of breast cancer in Taiwan have increased rapidly in the past several decades, but the societal impact of deaths and disabilities due to breast cancer has not been assessed. This study estimated the disability-adjusted life years (DALYs) for breast cancer patients during 1994, and compared the results with similar data from other areas of the world.
DALYs for breast cancer patients in Taiwan were calculated using the equation developed by Murray and Lopez. The incidence and mortality of breast cancer and the population structure were obtained from national statistics maintained by the Department of Health and the Ministry of the Interior. The age-specific mean survival time for breast cancer patients was estimated using the exponential distribution from incidence-mortality linkage of the incidence file at National Taiwan University Hospital and the National Mortality File maintained by the Department of Health.
There were 11,963 years of life lost (YLL) due to breast cancer during 1994, 2677 years lived with disability (YLD), and 14,640 DALYs. The YLL and DALYs per 1000 population (1.17 and 1.44) were in the middle of the world spectrum, while the YLD value per 1000 population (0.26) was closer to those of developed countries. The proportion of DALYs contributed by younger patients (< 45 years) was higher than in developed countries and similar to those in developing countries other than Sub-Saharan Africa. The DALYs per 1000 population of women younger than 45 years of age in Taiwan were also higher than those in India, China, other regions of Asia and Islands, Sub-Saharan Africa, and the Middle Eastern Crescent.
The disability portion (YLD) of the DALYs for breast cancer patients in Taiwan was higher than in other regions of the world. Moreover, patients younger than 45 years contributed a higher proportion of DALYs than in developed countries. The DALY value per 1000 population younger than 45 years of age was also higher than in developing countries. These results suggest that health professionals should focus more attention on programs for education, screening, and treatment of younger women.
在过去几十年中，台湾地区乳腺癌的发病率和死亡率迅速上升，但乳腺癌导致的死亡和残疾的社会影响尚未得到评估。本研究估算了1994年乳腺癌患者的伤残调整生命年（DALYs），并将结果与世界其他地区的类似数据进行了比较。
台湾地区乳腺癌患者的DALYs使用Murray和Lopez开发的公式进行计算。乳腺癌的发病率和死亡率以及人口结构数据来自卫生署和内政部维护的国家统计资料。台湾大学医院发病率文件与卫生署维护的国家死亡率文件通过发病-死亡关联，利用指数分布估算乳腺癌患者的年龄特异性平均生存时间。
1994年，乳腺癌导致11,963年生命损失（YLL），2677年带病生存（YLD），以及14,640个DALYs。每1000人口的YLL和DALYs（分别为1.17和1.44）处于世界范围的中间水平，而每1000人口的YLD值（0.26）更接近发达国家。年轻患者（<45岁）贡献的DALYs比例高于发达国家，与撒哈拉以南非洲以外的发展中国家相似。台湾地区45岁以下女性每1000人口的DALYs也高于印度、中国、亚洲其他地区和岛屿、撒哈拉以南非洲以及中东新月地区。
台湾地区乳腺癌患者DALYs中的残疾部分（YLD）高于世界其他地区。此外，45岁以下患者贡献的DALYs比例高于发达国家。45岁以下每1000人口的DALY值也高于发展中国家。这些结果表明，卫生专业人员应更加关注针对年轻女性的教育、筛查和治疗项目。
