Cervical cancer as a priority for prevention in different world regions: An evaluation using years of life lost

Abstract

The relative importance of cancer of the cervix among several important causes of mortality (from cancer and other diseases) has been evaluated by estimating the years of life lost (YLL) by young and middle-aged women (25-64 years old) in different regions of the world. The life years were weighted to reflect their importance to the individual and to society. On a global basis, cancer of the cervix is responsible for about 2% of the total (weighted) YLL, fewer than for other causes of mortality in this age group. However, it is the most important cause of YLL in Latin America and the Caribbean. It also makes the largest contribution to YLL from cancer in the populous regions of SubSaharan Africa and South-Central Asia where the actual risk of loss of life from this cause is higher, although overshadowed by noncancer deaths (from AIDS, TB and maternal conditions). The overall picture is not very sensitive to the age weighting function used. The fact that most of the loss of life is preventable, and that simple technologies have been developed that make this practicable, means that cervical cancer has an even higher profile from the perspective of resource allocation in low income settings. © 2004 Wiley-Liss, Inc. Key words: YLL; cervical neoplasm; disease burdenCervical cancer is the second most frequent cancer and the fifth most frequent cause of death from cancer among women in the world, with an estimated 471,000 new cases and 233,000 deaths in the year 2000. 1 The relative importance of cervical cancer is even greater for women in developing countries, where more than 80% of cases occur, and where it comprises about 15% of cancers in women, with a lifetime risk of about 2%. 2 In some countries of SubSaharan Africa, Latin America and Asia, incidence rates are very high, and the lifetime risk of cervical cancer may be as high as 6 -7%.However, the importance of cervical cancer as a cause of loss of life needs to be considered in relation to other diseases among populations that reside in developing countries in order to appreciate the time and resources that should be expended on control strategies. In this report, we examine years of life lost (YLL) as an indicator of disease burden for cervical cancer and for several other important causes of mortality. The YLL concept was introduced over 50 years ago 3 to refine the traditional mortality rates by providing a weighting for deaths at different ages. These methods became more widely used in the late 1970s in health services planning. There are many variations in the calculations used, depending upon the weights used (the value of years of life at different ages), 4 -6 the "normal" lifespan against which to compare premature death (fixed upper limit or life table expectations of life), 3,7-10 and the "discount rate" to apply to life-years (taking into consideration the life-years that would have been lived in the future). Discounting gives decreasing weights to the life-years saved over calendar time, admitting that life-years in the future are valued less highl...

Years of life lost as a measure of cancer burden in Colombia, 1997-2012

“…Together, these measures provide meaningful indicators for decisions regarding resource allocations and design of prevention programs (7)(8)(9). They are also a useful base for comparison with other countries, and show the relative importance of different causes of death, taking into account the life expectancies of each population (10). Previous national and local Colombian studies used external life expectancy data from Japan or the Global Burden of Disease reports, considered as the "potential" life expectancy for other countries (11)(12)(13).…”

Cervical Cancer Screening in Turkey: A Community-based Experience After 60 Years of Pap Smear Usage

“…In 2002, cervical cancer accounted for 239,000 deaths worldwide, around 2% of total weighted years of life lost in women aged 25-64 and around 9.4% of the burden of disease in females caused by malignant neoplasm (WHO, 2004;Yang et al, 2004). All these figures emphasize the extent of the possible effect of screening programs in decreasing the frequency of both the cervix cancer and death rates attributed.…”

“…Cervical cancer is the second most common cancer in females with around 500,000 new cases occurring annually. In 2002, cervical cancer accounted for 239,000 deaths (7.6% of female deaths due to malignant neoplasm) worldwide, around 2% of total weighted years of life lost in women aged between 25 and 64, and around 9.4% of the burden of disease in females caused by malignant neoplasms (WHO, 2004;Yang et al, 2004).…”

TLR9 Expression in Uterine Cervical Lesions of Uyghur Women Correlate with Cervical Cancer Progression and Selective Silencing of Human Papillomavirus 16 E6 and E7 Oncoproteins in Vitro

“…It takes of nearly 27 million women's lives everyyear and has been severely threatening the health and life of women (Yang et al, 2004;Cohen et al, 2005;Ferlay et al, 2007). In south Xinjiang Uyghur women prevalence rate of cervical cancer (590/10 million) is four times of China's women's average prevalence (138/10 million), therefore cervical cancer was listed as one of high-incidence endemic diseases in Xinjiang, China (Suzuke et al, 2006;Zhang et al, 2006;Liu et al, 2006;Zhang et al, 2009 ).…”