Disability-adjusted life years for breast cancer patients in Taiwan.
OBJECTIVE
The incidence and mortality of breast cancer in Taiwan have increased rapidly in the past several decades, but the societal impact of deaths and disabilities due to breast cancer has not been assessed. This study estimated the disability-adjusted life years (DALYs) for breast cancer patients during 1994, and compared the results with similar data from other areas of the world.


METHODS
DALYs for breast cancer patients in Taiwan were calculated using the equation developed by Murray and Lopez. The incidence and mortality of breast cancer and the population structure were obtained from national statistics maintained by the Department of Health and the Ministry of the Interior. The age-specific mean survival time for breast cancer patients was estimated using the exponential distribution from incidence-mortality linkage of the incidence file at National Taiwan University Hospital and the National Mortality File maintained by the Department of Health.


RESULTS
There were 11,963 years of life lost (YLL) due to breast cancer during 1994, 2677 years lived with disability (YLD), and 14,640 DALYs. The YLL and DALYs per 1000 population (1.17 and 1.44) were in the middle of the world spectrum, while the YLD value per 1000 population (0.26) was closer to those of developed countries. The proportion of DALYs contributed by younger patients (< 45 years) was higher than in developed countries and similar to those in developing countries other than Sub-Saharan Africa. The DALYs per 1000 population of women younger than 45 years of age in Taiwan were also higher than those in India, China, other regions of Asia and Islands, Sub-Saharan Africa, and the Middle Eastern Crescent.


CONCLUSIONS
The disability portion (YLD) of the DALYs for breast cancer patients in Taiwan was higher than in other regions of the world. Moreover, patients younger than 45 years contributed a higher proportion of DALYs than in developed countries. The DALY value per 1000 population younger than 45 years of age was also higher than in developing countries. These results suggest that health professionals should focus more attention on programs for education, screening, and treatment of younger women.
School of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
W C
WC
Chie
S Y
SY
Chen
K J
KJ
Chang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology