title: Burden of disease due to cancer in England and Wales.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Public Health, Department of Public Health and Primary Care, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK. nj201@doctors.org.uk
authors.forename: N
authors.initials: N
authors.lastname: Jayatilleke
authors.forename: N
authors.initials: N
authors.lastname: Pashayan
authors.forename: J W
authors.initials: JW
authors.lastname: Powles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004185:Disability Evaluation; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000401:mortality; D019057:Quality-Adjusted Life Years; D014852:Wales / Q000453:epidemiology; D055815:Young Adult