The breast cancer related burden of morbidity and mortality in six European countries: the European Disability Weights project

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.