Age-standardized expected years of life lost: quantification of cancer severity

BackgroundThe critical implications of the expected years of life lost (EYLL) index of cancer for health policy assessments have been largely overlooked. We advocate to standardize life lost indices.MethodsUsing the Taiwan Cancer Registry database as an example, we calculated the EYLL and the age-standardized EYLL to facilitate comparisons among cancer types (a total of 903,935 patients from the database). The International Cancer Survival Standard was used for calculating age-standardized EYLL.ResultsPancreatic cancer is the most severe cancer in Taiwan, with the greatest age-standardized EYLL for the men (15.6years) and women (18.0years) as well as for the men and women combined (16.6years). Negative correlations were observed between unstandardized EYLL of cancer and mean age at diagnosis.ConclusionsThe unstandardized EYLL represents an overall assessment of disease burden, whereas the age-standardized EYLL is a suitable measure of disease severity. We suggest that both measures be incorporated into routine annual reports of cancer statistics alongside the usual incidence and mortality rates and their age-standardized counterparts.