TY - JOUR
T1 - Comparison of expected health impacts for major cancers
T2 - Integration of incidence rate and loss of quality-adjusted life expectancy
AU - Hung, Mei Chuan
AU - Lai, Wu Wei
AU - Chen, Helen H.W.
AU - Su, Wu Chou
AU - Wang, Jung Der
N1 - Funding Information:
This work was supported by grants from the National Science Council of Taiwan (Grant Nos. NSC 102-2314-B-006-029-MY2 , NSC 102-2811-B-006-018 and NSC 101-314-Y-006-001 ), Ministry of Health and Welfare of Taiwan ( DOH 102-TD-C-111-003 ) and the Top University Project to the National Cheng Kung University from the Ministry of Education of Taiwan . The funding bodies had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. We are grateful to all the patients who participated in this study, and to Drs. Jenq-Chang Lee, Yih-Jyh Lin, Jenn-Ren Hsiao, Ya-Min Cheng and Yan-Shen Shan for helping us in the collection of QOL data from their clinics.
Publisher Copyright:
© 2014 The Authors.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Purpose: The study aims to quantify the expected impacts of different cancers through multiplying the incidence rate by loss-of-QALE (quality-adjusted life expectancy), with QALY (quality-adjusted life year) as the common unit, to aid prevention policy decisions. Methods: 464,722 patients with pathologically verified cancer registered in the Taiwan Cancer Registry during 1998-2009 were used to estimate lifetime survival through Kaplan-Meier estimation combined with a semi-parametric method. A convenience sample for measuring the utility value with EQ-5D was conducted with 11,453 cancer patients, with the results then multiplied by the survival functions to estimate QALE. The loss-of-QALE was calculated by subtracting the QALE of each cancer cohort from the life expectancy of the corresponding age- and gender-matched reference population. The cumulative incidence rates from age 20 to 79 (CIR20-79) were calculated to estimate the lifetime risk of cancer for each organ-system. Results: Liver and lung cancer were found the highest expected lifetime health impacts in males and females, or expected lifetime losses of 0.97 and 0.41 QALYs that could be averted, respectively. While the priority changes for prevention based on expected health impacts were slightly different for females based on standardized mortality rates, those of males involve a broader spectrum, including oral, colorectal, esophageal and stomach cancer. Conclusion: The integration of incidence rate with loss-of-QALE could be used to represent the expected losses that could be averted by prevention, which may be useful in prioritizing strategies for cancer control.
AB - Purpose: The study aims to quantify the expected impacts of different cancers through multiplying the incidence rate by loss-of-QALE (quality-adjusted life expectancy), with QALY (quality-adjusted life year) as the common unit, to aid prevention policy decisions. Methods: 464,722 patients with pathologically verified cancer registered in the Taiwan Cancer Registry during 1998-2009 were used to estimate lifetime survival through Kaplan-Meier estimation combined with a semi-parametric method. A convenience sample for measuring the utility value with EQ-5D was conducted with 11,453 cancer patients, with the results then multiplied by the survival functions to estimate QALE. The loss-of-QALE was calculated by subtracting the QALE of each cancer cohort from the life expectancy of the corresponding age- and gender-matched reference population. The cumulative incidence rates from age 20 to 79 (CIR20-79) were calculated to estimate the lifetime risk of cancer for each organ-system. Results: Liver and lung cancer were found the highest expected lifetime health impacts in males and females, or expected lifetime losses of 0.97 and 0.41 QALYs that could be averted, respectively. While the priority changes for prevention based on expected health impacts were slightly different for females based on standardized mortality rates, those of males involve a broader spectrum, including oral, colorectal, esophageal and stomach cancer. Conclusion: The integration of incidence rate with loss-of-QALE could be used to represent the expected losses that could be averted by prevention, which may be useful in prioritizing strategies for cancer control.
UR - http://www.scopus.com/inward/record.url?scp=84924954095&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924954095&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2014.12.004
DO - 10.1016/j.canep.2014.12.004
M3 - Article
C2 - 25553846
AN - SCOPUS:84924954095
SN - 1877-7821
VL - 39
SP - 126
EP - 132
JO - Cancer Epidemiology
JF - Cancer Epidemiology
IS - 1
ER -