Disability adjusted life years for cancer patients in India

The disability adjusted life year (DALY) has been employed to quantify the burden of diseases. This measure allows for combining in a single indicator "years of life lived with disabilities (YLD)" and "years of life lost from premature death (YLL)" . The present communication attempts to estimate the burden of cancers in-terms of YLL, YLD and DALY for "all sites" and leading sites of cancer in India for the years 2001, 2006, 2011 and 2016. The YLL, YLD and DALY were estimated by employing Global Burden of Disease (GBD) methodology using the DISMOD procedure. The published data on age, gender and site specific cancer incidence and mortality for the years 2001-2003 relating to six population-based cancer registries viz. Bangalore, Barshi, Bhopal, Chennai, Delhi and Mumbai, expectation of life by gender for urban areas of the country for 1999-2003 and the projected population during years 2001, 2006, 2011 and 2016 were utilized for the computations. DALYs were found to be lower for males (2,038,553, 2,313,843, 2,656,693 and 3,021,708 for 2001, 2006, 2011 and 2016 respectively) as compared to females (2,560,423, 2,961,218, 3,403,176 and 3,882,649). Amongst males, highest DALYs were contributed by cancer of the lung and esophagus while in females they were for cancers of breast and cervix uteri. It is estimated that total DALYs due to cancer in India combined for both genders would increase from 4,598,976 in 2001 to 6,904,358 by 2016. Premature mortality is a major contributor to disease burden. According to the present estimates, the YLL component of DALY is about 70.0%. The above described computations reveal an urgent need for initiating primary and secondary prevention measures for control of cancers.