Background The burden of disease, describing loss of health and death due to a disease, has not been fully studied for melanoma in the general population over time. Objectives To determine the burden of disease due to melanoma in the Netherlands. Methods Age- and sex-specific incidence data from all patients with melanoma in the Netherlands between 1991 and 2010 were obtained from the Netherlands Cancer Registry. Melanoma-specific mortality and life expectancy data were obtained from Statistics Netherlands. Melanoma duration was calculated using the DISMOD software from the World Health Organization. The years of life lived with disability (YLD) and years of life lost (YLL) due to melanoma were calculated using Dutch disability weights, incidence and mortality of melanoma, and the life expectancy from the general population. The number of disability-adjusted life-years (DALYs) was estimated by adding YLD and YLL. Results The world-standardized incidence rates of melanoma have more than doubled for both men (7·1 per 100 000 inhabitants in 1991 to 17·0 in 2010) and women (9·4 per 100 000 inhabitants in 1991 to 19·8 in 2010). Likewise, the burden of melanoma to society has increased rapidly. The YLD for men increased from 4795 (1991-4) to 12 441 (2007-10), and for women from 7513 (1991-4) to 16 544 (2007-10). In 2007-10 the total YLL due to melanoma was 30 651 for men and 26 244 for women compared with 17 238 and 16 900, respectively, in 1991-4. The DALYs increased by 96% for men, from 22 033 (1991-4) to 43 092 (2007-10), and by 75% for women, from 24 413 (1991-4) to 42 788 (2007-10). Conclusions Melanoma is becoming a great burden to Dutch society. What's already known about this topic? Melanoma leads to a loss of 20 years of life during a lifetime. What does this study add? Both the fatal and nonfatal burden of melanoma are important to describe the impact on society, because patients live on average 19-27 years with melanoma. The burden of melanoma has increased rapidly, now exceeding 21 000 disability-adjusted life-years annually. There is a general need for an empirical estimation of disability weights and duration of disease.

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Journal British Journal of Dermatology
Holterhues, C, Hollestein, L.M, Nijsten, T.E.C, Koomen, E.R, Nusselder, W.J, & de Vries, E. (2013). Burden of disease due to cutaneous melanoma has increased in the Netherlands since 1991. British Journal of Dermatology, 169(2), 389–397. doi:10.1111/bjd.12346