OBJECTIVES : We aimed to estimate the burden of liver disease in Colombia for 2009-2016, and its economic impact for 2016.

METHODS

: We used the Warehouse-Cube of SISPRO as the main source of prevalence data, and individual and anonymized registries from death certificates (vital statistics) of the National Administrative Department of Statistics. Disease categories and disability weights were established by a two-round consensus of experts with Delphi methodology. The outcomes were: disability-adjusted life years (DALYs), years of life lost due to premature death (YLL), and years lived with disability (YLD). The burden of disease was calculated based on life expectancy at birth: men: 80 years, women: 82.5. DALYs were the sum of YLLs and YLDs. From human capital approach, we estimated the economic burden associated with premature deaths due to cirrhosis and hepatocarcinoma through the economic valuation of productive YLL (PYLL) (productive time of 18-57 years in women and up to 62 in men). We discounted the results using a 3% of annual discount rate.

RESULTS

: Between 2009-2016 the total burden of liver disease represented 687,861 DALYs, 67% associated to mortality and 33% to disability. Liver cirrhosis accounted 307,412 DALYs, 109,280 metabolic diseases, 202,300 liver tumors, and 26,102 viral infections. In 2016, deaths in productive ages due to cirrhosis and hepatocarcinoma caused 9,064 and 4,103 PYLLs, respectively. These PYLLs generated an economic burden that ranged between 68.4-124.1 billion pesos for cirrhosis and 29.7-54 billion for hepatocarcinoma.

CONCLUSIONS

: These numbers highlight a challenging opportunity to enhance public health because most causes of liver diseases are avoidable. Cirrhosis and hepatocarcinoma represented the highest Colombian burden of liver disease. Despite public health interventions like immunization, healthy lifestyle habits and measures to control alcohol consumption, the burden of liver disease in Colombia reflects the need to strengthen promotion and prevention strategies.