Abstract
BackgroundThe critical implications of the expected years of life lost (EYLL) index of cancer for health policy assessments have been largely overlooked. We advocate to standardize life lost indices.MethodsUsing the Taiwan Cancer Registry database as an example, we calculated the EYLL and the age-standardized EYLL to facilitate comparisons among cancer types (a total of 903,935 patients from the database). The International Cancer Survival Standard was used for calculating age-standardized EYLL.ResultsPancreatic cancer is the most severe cancer in Taiwan, with the greatest age-standardized EYLL for the men (15.6 years) and women (18.0 years) as well as for the men and women combined (16.6 years). Negative correlations were observed between unstandardized EYLL of cancer and mean age at diagnosis.ConclusionsThe unstandardized EYLL represents an overall assessment of disease burden, whereas the age-standardized EYLL is a suitable measure of disease severity. We suggest that both measures be incorporated into routine annual reports of cancer statistics alongside the usual incidence and mortality rates and their age-standardized counterparts.
Highlights
The critical implications of the expected years of life lost (EYLL) index of cancer for health policy assessments have been largely overlooked
The unstandardized and the age-standardized EYLLs for all cancers were presented in Table 1, Table 2, and Table 3, respectively
Negative correlations of moderate magnitudes were observed between the unstandardized EYLLs and the mean corresponding patient ages at the time of diagnosis among 20 cancers in the men and women combined (Fig. 1a, correlation coefficient = − 0.20), among 16 cancers in men (Fig. 1b, correlation coefficient = − 0.39), and among 19 cancers in women (Fig. 1c, correlation coefficient = − 0.02). These results indicated that a larger unstandardized EYLL for a cancer type may have been due to a younger mean age at diagnosis rather than greater severity
Summary
The critical implications of the expected years of life lost (EYLL) index of cancer for health policy assessments have been largely overlooked. The EYLL of a patient with cancer can be interpreted as the patient’s average deprivation of life due to cancer or the average life years that could be saved if the patient had not developed cancer [1, 15]. Economic effect such as lifetime cost can be derived via the EYLL and reimbursement database (for example, National Health Insurance Research Database in Taiwan) [15].
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