QUANTIFYING THE DISEASE BURDEN OF LOCALLY ADVANCED OR METASTATIC UROTHELIAL CANCER (LA/MUC) USING A DISABILITY-ADJUSTED LIFE-YEARS (DALYS) ESTIMATION APPROACH: FINDINGS FROM A RETROSPECTIVE OBSERVATIONAL STUDY IN SWEDEN
Author(s)
Mairead Kearney, MB, BCh, MPH, MBA, MSc Econ1, Jakob Börsum, MSc2, Fraence Hardtstock, MSc3, Suzanne Bergman, MSc4, Petra Skare, PhD4, Markus Aly, MD, PhD5.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
OBJECTIVES: DALYs are a standardized population health metric combining mortality and morbidity into a single measure of disease burden. This study aimed to estimate DALYs attributable to la/mUC in Sweden.
METHODS: DALYs were calculated as the sum of 2 components: years of life lost (YLL) and years lived with disability (YLD), in accordance with Global Burden of Disease methodology. Incident and prevalent la/mUC cases were identified from the Swedish National Cancer Register. Individual-level data were linked across national registers using unique personal identity codes. Survival and life expectancy estimates were derived from Swedish standard life tables, stratified by age and sex. Expected survival was obtained by matching each patient to corresponding life table mortality rates. To calculate YLL, the number of deaths attributable to la/mUC was multiplied by the average remaining life expectancy at the age at death. Disability weights were assigned by cancer stage and used to estimate stage-specific YLD. Follow-up was defined from la/mUC diagnosis until death, censoring, or the end of the study period.
RESULTS: Between 2006 and 2021, a total of 1,114 UC-related deaths occurred among 2,026 incident cases. The overall burden of la/mUC totaled 23,921.2 DALYs, composed of 22,030.7 YLL and 1,890.6 YLD, driven heavily by premature mortality rather than disability. Those aged 70-79 years experienced the highest burden; men: YLL: 4,565.4 and YLD: 580.9, totaling 5,146.3 DALYs, and women: YLL: 2,628.5, YLD: 228.7, and DALYs: 2,857.2. This disease burden increased with age, predominantly affecting men ≥50 years. However, in the 30-49 age group, women exhibited greater YLL and DALYs.
CONCLUSIONS: This novel, patient-centric approach demonstrates that the disease burden from la/mUC constitutes a significant societal and public health impact in Sweden. These findings can inform public health decision-makers regarding la/mUC’s health impact and the possible gains from targeted early diagnostic efforts and adoption of modern therapeutic interventions.
METHODS: DALYs were calculated as the sum of 2 components: years of life lost (YLL) and years lived with disability (YLD), in accordance with Global Burden of Disease methodology. Incident and prevalent la/mUC cases were identified from the Swedish National Cancer Register. Individual-level data were linked across national registers using unique personal identity codes. Survival and life expectancy estimates were derived from Swedish standard life tables, stratified by age and sex. Expected survival was obtained by matching each patient to corresponding life table mortality rates. To calculate YLL, the number of deaths attributable to la/mUC was multiplied by the average remaining life expectancy at the age at death. Disability weights were assigned by cancer stage and used to estimate stage-specific YLD. Follow-up was defined from la/mUC diagnosis until death, censoring, or the end of the study period.
RESULTS: Between 2006 and 2021, a total of 1,114 UC-related deaths occurred among 2,026 incident cases. The overall burden of la/mUC totaled 23,921.2 DALYs, composed of 22,030.7 YLL and 1,890.6 YLD, driven heavily by premature mortality rather than disability. Those aged 70-79 years experienced the highest burden; men: YLL: 4,565.4 and YLD: 580.9, totaling 5,146.3 DALYs, and women: YLL: 2,628.5, YLD: 228.7, and DALYs: 2,857.2. This disease burden increased with age, predominantly affecting men ≥50 years. However, in the 30-49 age group, women exhibited greater YLL and DALYs.
CONCLUSIONS: This novel, patient-centric approach demonstrates that the disease burden from la/mUC constitutes a significant societal and public health impact in Sweden. These findings can inform public health decision-makers regarding la/mUC’s health impact and the possible gains from targeted early diagnostic efforts and adoption of modern therapeutic interventions.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH240
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology