National Burden of Cancers in Tunisia: A Disability Adjusted Life–year Approach

Abstract

Cancer places a considerable burden on society that is reflected in both economic and humanitarian costs. We aimed to estimate the disease burden of cancers in Tunisia using the Disability Adjusted Life Years (DALYs) as a health measure. We performed the methodology suggested in the Global Burden of Disease. The DALYs were calculated as the arithmetic addition of Years of Life Lost (YLLs) and years lived with disability. National cancer data for all cancers were extracted from the GLOBOCAN database 2012. The overall age-standardized incidence rate was 127/100,000 males and 96/100,000 females. The total number of DALYs was 60,678.33 and 47,326.36 in males and females, respectively. Ranked by the age-standardized DALY rate, the top three cancers were lung (463.6/100,000 population), prostate (128/100,000 population), and colorectum (117.5/100,000 population) in males and breast (241/100,000 population), colorectum (111.7/100,000 population), and ovary cancer (86.5/100,000 population) in females. Among males, cancers with the highest YLL/DALY ratio were pancreas (93.95%), stomach (94%), and leukemia (93.5%). For females, ovary (96%), esophagus (94.4%), and stomach (94.4%) had the highest proportion of YLL toward DALY. According to age groups, brain and nervous system cancer, leukemia, and non-Hodgkin lymphoma were ranked first, second, or third in both sexes until the age of 30 years. Our study provides an insight into the magnitude of the disease burden of cancers in Tunisia. There is an urgent need to emphasize on cancer prevention, screening, early diagnosis, and curative care, notably for breast and lung cancers.

Keywords

• Burden of diseases
• cancer
• disability adjusted life years
• years lived with disability
• years of life lost