Abstract
BackgroundThe importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data.MethodsWe estimated the Belgian cancer burden from 2004 to 2019 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment.ResultsThe age-standardized non-fatal burden of cancer increased from 2004 to 2019 by 6 and 3% respectively for incidence- and prevalence-based YLDs. In 2019, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2019, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 49 to 111 for men and from 15 to 44 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 105 to 84 for men and from 66 to 58 for women.ConclusionsBreast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.
Highlights
The importance of assessing and monitoring the health status of a population has grown in the last decades
Central to the framework of the global and national burden of disease studies, the Disability-Adjusted Life Year (DALY) metric quantifies the healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL) [9]
Similar trends are observed for the total number of cancer-associated YLDs, which have increased from 44,774 YLDs to 57,317 YLD (+ 25%), over a period of 15 years, and a slight increase in the age-standardized YLD rates, from 472 per 100,000 to 501 per 100,000 (+ 6%)
Summary
The importance of assessing and monitoring the health status of a population has grown in the last decades. An evidence-based answer to this question involves an evaluation of the health status of the population, ideally based on coherent and comparable measures of morbidity and Gorasso et al BMC Cancer (2022) 22:58 mortality. Confronted with this need, there has been an increased interest in the establishment of burden of disease studies [2,3,4]. Central to the framework of the global and national burden of disease studies, the Disability-Adjusted Life Year (DALY) metric quantifies the healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL) [9]
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