Leukemia and Non-Hodgkin Lymphoma Among Cancers With Greatest Burden for U.S. Patients

A study published in the American Journal of Preventive Medicine suggests that leukemia and non-Hodgkin lymphoma (NHL) are among the 10 cancers with the greatest burden (in terms of disability-adjusted life years [DALYs], or “healthy” years lost due to living with a cancer diagnosis) for patients in the United States.

“In the United States, people of different races/ethnicities have differences in cancer incidence, mortality, survival, stage at diagnosis, and receipt of treatment, resulting in variances in cancer burden,” lead author Joannie Lortet-Tieulent, MSc, of the American Cancer Society in Atlanta, Georgia, and colleagues wrote. To quantify the burden of cancer in 2011, the authors assessed DALYs (calculated as years of life lost and years lived with disability) for patients with 24 types of cancers, using data from a population-based cancer registry and literature reviews.

The burden of cancer was more than 9.8 million DALYs lost, which affected men and women equally. DALYs lost to cancer were mostly related to premature death (91%), while the remaining 9 percent were related to impaired quality of life due to the disease or its treatment.

Lung, breast, colorectal, and pancreatic cancers had the highest burden, with half of DALYs lost due to these cancer types.

The top 10 cancers related to loss of healthy years were:

  1. lung cancer (24% of total DALYs)
  2. breast cancer (10%)
  3. colorectal cancer (9%)
  4. pancreatic cancer (6%)
  5. prostate cancer (5%)
  6. leukemia (4%)
  7. liver cancer (4%)
  8. brain cancer (3%)
  9. NHL (3%)
  10. ovarian cancer (3%)

The cancer burden was highest among African-American patients (according to age-standardized DALYs rate), followed by non-Hispanic white patients, Hispanic patients, and Asian patients.

Age-standardized DALYs lost (per 100,000 individuals) were the following for hematologic malignancies:

  • Leukemia
    • 115 for non-Hispanic African-American patients
    • 115 for non-Hispanic white patients
    • 98 for Hispanic patients
    • 82 for Asian patients
  • NHL
    • 93 for non-Hispanic white patients
    • 86 for non-Hispanic African-American patients
    • 78 for Hispanic patients
    • 60 for Asian patients
  • Hodgkin lymphoma
    • 11 for non-Hispanic African-American patients
    • 10 for non-Hispanic white patients
    • 10 for Hispanic patients
    • 3 for Asian patients
  • Myeloma
    • 93 for non-Hispanic African-American patients
    • 43 for non-Hispanic white patients
    • 42 for Hispanic patients
    • 26 for Asian patients

“In all races/ethnicities, the cancer burden was largely driven by years of life lost, highlighting the need to prevent death at middle age through broad implementation of structural and behavioral measures of primary prevention, early detection, and treatment,” the authors concluded.

Source: Lortet-Tieulent J, Soerjomataram I, Lin CC, et al. U.S. burden of cancer by race and ethnicity according to disability-adjusted life years. Am J Prev Med. 2016;51:673-81.