Total Burden of Esophageal Cancer Disability Adjusted Life Years in Golestan Province during 1387

Abstract

Background:

 Maintenance of health and its fair and just promotion in any society is the responsibility and duty of its respective government. Appropriate financial allocations and prudent decisions in the health sector requires the definition of an index that would reveal the loss resulting from early deaths of any cause and originate from disabilities due to nonfatal outcomes. The disability adjusted life years (DALY) index has such a characteristic. Esophageal cancer is the third prevalent cancer of the gastrointestinal tract. In Golestan Province, among the variety of cancers, it is the third leading cause of death and its incidence rate in the province is the highest in the country. In this study we try to compute the burden of this cancer. In this manner, while estimating the importance of this disease in Golestan Province, we aim to pave the way for scientific and effective assessments of this disease and determine an action plan for its containment.

Materials and Methods:

In this cross-sectional study, we used Dismod II software that has been designed for cancer modeling in populations. With this software, we computed the burden of cancer for the year 1387 in Golestan Province. The data needed as input for Dismod II included the population of the province, mortality and incidence rates that originated from esophageal cancer, all which were obtained from the 1385 census, Mortality Registry System, Cancer Registry System and expert panel views.

Results:

Total burden of esophageal cancer according to DALY in Golestan Province during 1387 was 2992/48 years in the total population. Amongst males, it was 1533/65 years and 1408/46 years in females due to years of lost life (YLL). As a result of years lived with disability (YLD), it was 25/54 years in males and 24/84 years in females. The burden of esophageal cancer per 1000 population of Golestan Province equaled 1/76 years for females and 1/88 years for males. The peak age of esophageal cancer burden was in the age groups of 60 to 80 years and above 80 years.

Conclusion:

The relative high burden of esophageal cancer in Golestan Province compared to other parts of the country is justifiable due to the existence of the highest incidence rate in this province. Therefore, we believe that esophageal cancer should be one of the highest priorities of the health system of the province. However, the final and definitive judgment is contingent upon computations of the burden of other cancers and diseases at the provincial level and its respective rankings