Years of life lost (YLL) from cancer is an important measure of population burden--and should be considered when allocating research funds.
Years of life lost (YLL) from cancer is an important measure of population burden--and should be considered when allocating research funds.
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从癌症中丧生（YLL）是人口负担的重要衡量标准，在分配研究基金时应考虑。
DOI：
10.1038/sj.bjc.6602321
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发表时间：
2005-01-31
影响因子：
8.8
通讯作者：
Treasure, FP
中科院分区：
文献类型：
--
作者：
Burnet, NG;Jefferies, SJ;Benson, RJ;Hunt, DP;Treasure, FP
最近，癌症死亡率与国家癌症研究所（NCRI）的研究支出进行了比较，该研究所的研究预算约为2.5亿英镑。分析显示，死亡率和研究支出之间存在不匹配。除了粗死亡率，还应考虑其他癌症负担指标，因为它们提供了更多信息。在诊断出癌症后死亡的每个人的“寿命损失年数”（YLL）代表了该疾病对社会影响的基于人口的死亡率指标。每个癌症部位的寿命损失年数除以死亡人数产生了一个额外的统计数据，即平均寿命损失年数（AYLL），这是衡量癌症对个体患者负担的指标。对于17个有数据的癌症部位，将YLL与粗死亡率进行比较，四个肿瘤部位的死亡率差异相当大。寿命损失年数表明，尽管有宫颈癌筛查计划，但卵巢癌、宫颈癌和中枢神经系统癌的人口负担比粗死亡率所显示的要大。使用YLL，肺癌研究的资金不足与使用死亡率百分比报告的情况相似。乳腺癌和白血病的研究支出相对高于这些癌症的人口负担，而白血病的研究支出相当极端。前列腺癌的YLL百分比较低，但吸引了适度的研究支出。使用AYLL作为个人癌症负担的指标，大大改变了不同肿瘤死亡率的排名。平均AYLL为12.5年。前列腺癌的AYLL最低，只有6.1年;脑肿瘤患者的AYLL最高，只有20多年。将AYLL与研究支出进行比较，发现有四个“灰姑娘”癌症位点的个体癌症负担高，但研究支出低：中枢神经系统肿瘤、宫颈癌和肾癌以及黑色素瘤。乳腺癌和白血病的AYLL大致处于平均水平，但研究支出相当多。YLL强调研究支出和死亡率之间的差异，并可能有助于有关研究支持的决策。平均寿命损失年数衡量个体患者的负担，在个体需求相关的情况下可能有所帮助，例如姑息治疗。除了粗略的死亡率外，对死亡率统计数据进行更精细和更全面的计算将有助于关于研究资金和公共卫生问题的辩论。
Recently, cancer mortality has been compared to research spending by the National Cancer Research Institute (NCRI), whose research budget is approximately £250 million. The analysis shows a mis-match between mortality and research spending. As well as crude mortality rates, other measures of cancer burden should be considered because they contribute additional information. ‘Years of life lost’ (YLL) summed over each individual dying after a diagnosis of cancer represents a population-based mortality indicator of the impact of that disease on society. Years of life lost divided by the number of deaths for each cancer site produces an additional statistic, the average years of life lost (AYLL), which is a measure of the burden of cancer to the individual patient. For 17 cancer sites where data are available, four tumour sites have a rather large difference in mortality, comparing YLL to crude mortality. Years of life lost shows the population burden from cancers of the ovary, cervix, and CNS to be rather larger than suggested by crude mortality, despite screening programmes for cervix cancer. Using YLL, the underprovision of funding for lung cancer research is similar to that reported using percentage mortality. Breast cancer and leukaemia receive a relatively higher research spend than the population burden of these cancers, and the spending on leukaemia is quite extreme. Prostate cancer has a low per cent YLL but attracts a moderate amount of research spending. The use of AYLL as an indicator of individual cancer burden considerably changes the ranking of the mortality from different tumours. The mean AYLL is 12.5 years. Prostate cancer has the lowest AYLL, only 6.1 years; brain tumour patients have the highest, at just over 20 years. Comparing AYLL to research spending suggests four ‘Cinderella’ cancer sites with high individual cancer burden but low research spending: CNS tumours, cervix and kidney cancers, and melanoma. Breast cancer and leukaemia have roughly average AYLL but a considerable excess of research spending. YLL emphasises the discrepancy between research spending and mortality, and may be helpful for decisions concerning research support. Avearage years of life lost measures the burden to individual patients and may be helpful where individuals’ needs are relevant, such as palliative care. As well as crude mortality, more subtle and comprehensive calculations of mortality statistics would be useful in debates on research funding and public health issues.
影响因子：
7.7
作者：
ROMEDER, JM;MCWHINNIE, JR
通讯作者：
MCWHINNIE, JR