Institute of Public Health, Department of Public Health and Primary Care, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK.
J Public Health (Oxf). 2012 Jun;34(2):287-95. doi: 10.1093/pubmed/fdr093. Epub 2011 Dec 2.
This study aims to estimate the burden of cancer in England and Wales using disability-adjusted life years (DALYs) and to determine if the ranking of relative importance changes with metric used.
DALYs are the sum of years of life lost due to mortality and years lost due to disability. Annual DALYs due to cancer were calculated using cancer registration, mortality, disability weights and World Health Organization methodology.
There were 8 605 362 DALYs due to cancer (3242 DALYs/100 000 population/year). Of the total, 47% corresponded to lung, prostate and colorectal cancers in males and 56% to breast, lung, colorectal and ovarian cancers in females. Mortality (86% of DALYs) contributed predominantly to DALYs. Individuals of 65-75 years contributed to 28% of DALYs. Among females, lung cancer ranked highest by death rates, whereas the highest DALYs were from breast cancer.
Highest DALYs were due to lung, breast, prostate and colorectal cancers in England and Wales. The addition of the disability component changes the relative position of some of the top cancers. Although metrics based on deaths alone capture most effects of cancer on population health levels, important additional perspectives, relevant to the planning of services, can be gained from burden of disease analyses.
本研究旨在使用伤残调整生命年（DALYs）来估计英格兰和威尔士的癌症负担，并确定使用不同指标时相对重要性的排名是否会发生变化。
DALYs 是由死亡导致的生命损失年数和因残疾导致的生命损失年数之和。使用癌症登记、死亡率、残疾权重和世界卫生组织方法计算每年因癌症导致的 DALYs。
因癌症导致的 DALYs 为 8605362 个（3242 个 DALYs/100000 人/年）。其中，男性肺癌、前列腺癌和结直肠癌占 47%，女性乳腺癌、肺癌、结直肠癌和卵巢癌占 56%。死亡率（DALYs 的 86%）对 DALYs 的贡献最大。65-75 岁的人群占 DALYs 的 28%。在女性中，肺癌的死亡率最高，而乳腺癌导致的 DALYs 最高。
在英格兰和威尔士，肺癌、乳腺癌、前列腺癌和结直肠癌导致的 DALYs 最高。加入残疾部分会改变一些顶级癌症的相对位置。虽然仅基于死亡的指标能够捕捉癌症对人群健康水平的大部分影响，但疾病负担分析可以提供更重要的额外视角，这些视角与服务规划相关。
