Mortality, Morbidity, Survival, and Burden of Top 9 Cancers in a Developing Country


1 Department of Statistics Experts in Health, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

3 Medical Ethics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mashhad, Iran. Tel: +985138002388; Email:

4 Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranTel: +989155084676; Email:



Background: Cancer is one of the most important leading causes of morbidity and mortality worldwide. Objectives: This study aimed to calculate the burden of 9 common cancers in the population covered by Mashhad University of Medical Sciences in Iran in 2010-2011. Patients and Methods: We calculated disability adjusted life years (DALYs ) for each of nine cancers according to the sex and age groups of (0-4, 5-14, 15-29, 30-44, 45-59, 60-69, 70-79, and ≥ 80 years) using disease modeling (DisMod) version II software. The population-based data used in this study is mostly from cancer registries. The final estimates for the survival time were derived by combining several information sources. We applied r = 0.03 discounting and β = 0.04 age weighting. In our study, the standard life expectancy considered 80 years for men and 82.5 for women. Results: This study shows that the most years life lost (YLL) related to gastric, leukemia and lung cancers are 10116, 9564 and 7061 respectively. Cancers with the most years lost due to disability (YLD) were breast, brain and esophageal cancers (594, 506 and 460). The most DALY related to gastric, leukemia and lung cancers (10516, 9803 and 722). The maximum DALY was for breast cancer (1550) seen in women aged 30-44 years old. Conclusions: It can be concluded that the YLL (93%) has a major role in the burden of diseases in developing countries. Better strategies for improving the prevention and screening program are really needed in developing countries.


  1. 1.Abegunde D, Stanciole A. An estimation of the economic impact of chronic noncomunicable diseases in selected countries.Geneva: World Health Organization Department of Chronic Diseases and Health Promotion; 2006.

    1. World Health Organization.. The top 10 causes of death. 2012. Available from: index2.html.
    2. Wallace R. Public Health & Preventive Medicine.USA: McGrawHill; 2008.
    3. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008?2030): a population-based study. Lancet Oncol. 2012;13(8):790–801.
    4. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.
    5. World Health Organization.. The GlobalBurden of Disease: 2004 Update. 2008. Available from: global_burden_disease/GBD_report_2004update_full.pdf.
    6. Murray CJL, Lopez AD. Global and regional descriptive epidemiology of disability: incidence, prevalence, health expectancies and years lived with disability. In: Murray CJL, Lopez AD editors. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020.. Boston, MA: Harvard University Press; 1996. pp. 201–46.
    7. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.
    8. Polinder S, Haagsma JA, Stein C, Havelaar AH. Systematic review of general burden of disease studies using disability-adjusted life years. Popul Health Metr. 2012;10(1):21.
    9. Mathers CD, Vos T, Lopez AD, Salomon JA, Ezzati M. National Burden of Diseases Studies: A Practical Guide.Geneva: WHO Global Program on Evidence for Health Policy; 2001.
    10. Melse JM, Essink-Bot ML, Kramers PG, Hoeymans N. A national burden of disease calculation: Dutch disability-adjusted life-years. Dutch Burden of Disease Group. Am J Public Health. 2000;90(8):1241–7.
    11. Malekzadeh R, Derakhshan MH, Malekzadeh Z. Gastric cancer in Iran: epidemiology and risk factors. Arch Iran Med. 2009;12(6):576–83.
    12. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J. 2007;13(4):383–91.
    13. McDonald MP, Hertz RW, Pitman S. The Burden of Cancer in Asia. 2008. Available from: in_asia.pdf.
    14. Soerjomataram I, Lortet-Tieulent J, Ferlay J, Forman D, Mathers C, Parkin DM, et al. Estimating and validating disability-adjusted life years at the global level: a methodological framework for cancer. BMC Med Res Methodol. 2012;12:125.
    15. Victorian burden of disease study: Mortality and morbidity in 2001.Melbourne: The Public Health Group, Rural and Regional Health and Aged Care Services Division; 2005.
    16. Soerjomataram I, Lortet-Tieulent J, Parkin DM, Ferlay J, Mathers C, Forman D, et al. Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. Lancet. 2012;380(9856):1840–50.
    17. Mathers CD, Vos ET, Stevenson CE, Begg SJ. The burden of disease and injury in Australia. Bull World Health Organ. 2001; 79(11):1076–84.
    18. Anand P, Kunnumakkara AB, Sundaram C, Harikumar KB, Tharakan ST, Lai OS, et al. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008;25(9):2097–116.
    19. Kinzler KW, Vogelstein B. The genetic basis of human cancer.New York: McGraw-Hill, Medical Pub; 2002.
    20. Bonta M, Bud C. Malignant Skin Tumors and Solar Radiations. Int J Pharm Arch. 2014;3(1):273–84.
    21. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62(1):30–67.