Article Text
Abstract
Background The National Cancer Registry of Ireland states that “One in three people in Ireland will develop cancer during their lifetime”. Cancer accounts for more than one-quarter of the annual death toll in Ireland. It is the second most common cause of death in Ireland. Mortality estimates of cancer are not solely sufficient to understand the true magnitude and trends in cancer. Therefore, morbidity-related factors along with the mortality estimates are crucial.
Methods Data was abstracted from the Institute for Health Metrics and Evaluation (United States) website (www.healthdata.org) on all the cancers and five risk factors (smoking, alcohol consumption, low physical activity, high Body Mass Index (BMI) and dietary risks).
The following metrics were computed: Years-of-Life-Lost due to premature mortality (YLLs) – a product of total deaths at each age and the reference life expectancy at that age; Years-Lived-with-Disability (YLDs) – a product of prevalence and disability weight; Disability-Adjusted Life-Years (DALYs)-the sum of YLDs and YLLs, Health Adjusted Life Expectancy (HALE) – a summary measure of overall population health. These estimates were based on total disease conditions and risk factors, thus analysed on the GBD study.
Results The cancers with the largest DALYs in 1990 were: Lung cancer (males) −4.08% and breast cancer (females) −3.7%. In 2013 the cancers with the Largest DALYs were lung cancer 4.07% (males) and breast cancer (females) −3.6%.
The percentage contribution of the risk factors to the total DALYs from cancer in 1990 and 2013 were smoking (10.8% vs 11.4%), alcohol consumption (3.6% vs 4.3%), dietary risks (9.9% vs 10.4%), low physical activity (2.1% vs 2.4%), high BMI (4.8% vs 5.9%).
The DALYs per 100,000 for the highest ranking cancers in 1990 were lung (884.8), colorectal (553.3), breast (472.8), and stomach (269.3). The DALYs per 100,000 for the highest ranking cancers in 2013 were lung (777.1), colorectal (442.1), breast cancer (395.5), and stomach cancer (152.8) in 2013.
Males had proportionately higher DALYs compared to females for both the calendar years 1990 and 2013. YLDs attributable to cancers were 1% and 1.4% in 1990 and 2013, respectively. HALE for males increased from 72 to 78 years and for females from 78 to 83 years in 1990 and 2013, respectively.
Conclusion Overall health life expectancy has improved in Ireland but both productivity and the quality of life has declined between 1990 and 2013 in relation to cancer deaths and associated risk factors.