Boswell-Purdy Jane, Flanagan William M, Roberge Hélène, Le Petit Christel, White Kathleen J, Berthelot Jean-Marie
Policy Research Unit, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Chronic Dis Can. 2007;28(1-2):42-55.
Summary measures of population health that incorporate morbidity provide a new perspective for health policy and priority setting. Health-adjusted life years (HALYs) lost to a disease combine the impact of years of life lost to premature mortality and morbidity, measured as year-equivalents lost to reduced functioning. HALYs for 25 cancers were estimated from mortality and incidence in 2001 in Canada; population-attributable fractions were estimated for major risk factors contributing to these cancers. Results from this analysis indicate that Canadians would lose an estimated 905,000 health-adjusted years of life to cancer for 2001, including 771,000 to premature mortality and 134,000 to morbidity from incident cases (years discounted at 3 percent). Most of the estimated premature mortality was due to lung cancer; morbidity was largely due to breast, prostate and colorectal cancers. An estimated one quarter of HALYs lost to cancer were attributable to smoking and almost one quarter were attributable to alcohol consumption, lack of fruit and vegetables, obesity and physical inactivity combined. These results are a significant advance in measuring the population health impact of cancer in Canada because they incorporate morbidity as well as mortality.
纳入发病率的人群健康汇总指标为卫生政策制定和确定优先事项提供了新视角。因疾病损失的健康调整生命年（HALYs）综合了过早死亡导致的生命年损失和发病率的影响，发病率以因功能减退损失的等效年数来衡量。根据2001年加拿大的死亡率和发病率估算了25种癌症的健康调整生命年；对导致这些癌症的主要风险因素估算了人群归因分数。该分析结果表明，2001年加拿大人因癌症预计将损失90.5万个健康调整生命年，其中77.1万个归因于过早死亡，13.4万个归因于新发病例的发病（按3%的贴现率计算年数）。预计大部分过早死亡归因于肺癌；发病主要归因于乳腺癌、前列腺癌和结直肠癌。因癌症损失的健康调整生命年估计约四分之一归因于吸烟，近四分之一归因于饮酒、水果和蔬菜摄入不足、肥胖和身体活动不足的综合影响。这些结果在衡量加拿大癌症对人群健康的影响方面取得了重大进展，因为它们纳入了发病率和死亡率。
