Hsieh Cheng-Chieh, Chen Si-Yu, Lin Chun-Hui, Chen Szu-Chieh, Liao Chung-Min
Department of Public Health, Chung Shan Medical University, Taichung, Taiwan.
Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan.
Cancer Med. 2025 Jan;14(1):e70592. doi: 10.1002/cam4.70592.
Cancer is a leading cause of death globally, with significant variations in incidence and mortality rates among different cancer types and regions. In Taiwan, breast cancer (BC), cervical cancer (CxCa), colorectal cancer (CRC), and oral cancer (OC) are prevalent and have prompted government-led screening programs to mitigate their impact. This study aims to assess the burden of these cancers at the county scale using disability-adjusted life years (DALYs) as a metric, focusing on the years 2010, 2015, 2018, 2019, and 2020.
Data on cancer incidence, mortality, disability weights, and treatment outcomes were sourced from the Taiwan HPA, Ministry of Health and Welfare, and Taiwan Cancer Registry. Years of life lost (YLLs) and years lived with disability (YLDs) were calculated for each cancer, considering age, stage, and treatment. The correlation between cancer screening rates and disease burden also conducted.
The analysis highlights significant trends in cancer mortality, incidence, and disease burden in Taiwan from 2010 to 2020. BC and CRC showed rising ASMR and DALYs rates, while CxCa experienced consistent declines. OC had a fluctuating pattern, particularly in eastern regions. YLLs contributed significantly to DALYs for all cancers, emphasizing premature mortality's role in the disease burden. Screening rates, particularly for BC and CxCa, correlated with changes in burden, with BC rates increasing and CxCa decreasing, reflecting the impact of preventive measures on cancer outcomes.
The findings underscore the importance of targeted interventions and evidence-informed resource allocation to address regional differences in cancer burden in Taiwan.
癌症是全球主要的死亡原因之一，不同癌症类型和地区的发病率和死亡率存在显著差异。在台湾，乳腺癌（BC）、宫颈癌（CxCa）、结直肠癌（CRC）和口腔癌（OC）较为普遍，促使政府主导开展筛查项目以减轻其影响。本研究旨在以伤残调整生命年（DALYs）为指标，评估2010年、2015年、2018年、2019年和2020年这些癌症在县级层面的疾病负担。
癌症发病率、死亡率、伤残权重和治疗结果的数据来源于台湾卫生福利部疾病管制署和台湾癌症登记处。考虑到年龄、分期和治疗情况，计算每种癌症的寿命损失年数（YLLs）和伤残生命年数（YLDs）。还分析了癌症筛查率与疾病负担之间的相关性。
分析突出了2010年至2020年台湾癌症死亡率、发病率和疾病负担的显著趋势。乳腺癌和结直肠癌的年龄标准化死亡率（ASMR）和伤残调整生命年率呈上升趋势，而宫颈癌则持续下降。口腔癌呈现波动模式，特别是在东部地区。所有癌症的伤残调整生命年中，寿命损失年数占比显著，凸显过早死亡在疾病负担中的作用。筛查率，特别是乳腺癌和宫颈癌的筛查率，与负担变化相关，乳腺癌筛查率上升，宫颈癌筛查率下降，反映了预防措施对癌症结局的影响。
研究结果强调了针对性干预措施和基于证据的资源分配对于解决台湾癌症负担地区差异的重要性。
