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The European Journal of Public Health 2004 14(2):141-146; doi:10.1093/eurpub/14.2.141
© 2004 by European Journal of Public Health
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European perspectives

The breast cancer related burden of morbidity and mortality in six European countries

The European Disability Weights project

Michelle E. Kruijshaar1,2, Jan J. Barendregt1 and European Disability Weights Group3

1 Department of Public Health, Erasmus University Rotterdam, Rotterdam, the Netherlands 2 Department for Public Health Forecasting, National Institute of Public Health and the Environment, Bilthoven, the Netherlands 3 Members listed at the end of this article

Background: The burden of breast cancer expressed in Disability Adjusted Life Years (DALYs) was compared for six European countries and its sensitivity to different sources of variation examined. Methods: DALYs were calculated using country-specific epidemiological data and European Disability Weights. Epidemiological data for 1996 were obtained for Denmark, England and Wales, France, the Netherlands, Spain and Sweden. Disability weights were empirically derived. Results: Denmark and the Netherlands lost the largest number of DALYs (approximately 1100 DALYs per 100,000 women). They were followed by England (87% of the Danish burden), France (72%), Sweden (68%) and Spain (67%). 70 to 80% of the burden was caused by mortality. Cross-national variation in disease epidemiology was the largest source of variation in the burden of breast cancer. Variation in disability weights and uncertainty in epidemiological data had smaller effects. Conclusion: To compare the burden of breast cancer and most other types of cancer mortality rates provide sufficient information.

Keywords: breast cancer, burden of disease, DALY, disability weights, health status values

Received 15 November 2002. Accepted 10 March 2003.

* Correspondence: Michelle E. Kruijshaar, PhD, Department of Public Health, Erasmus Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, the Netherlands, tel. +31 10 4087732, fax +31 10 4089449, e-mail: m.kruijshaar{at}erasmusmc.nl


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