National Burden of Cancers Attributable to Secondhand Smoking in Indonesia

BACKGROUND: The high prevalence of smokers in Indonesia is also increase the number of people as secondhand smokers. Secondhand smoke causes many health problems, including cancer. Thus, Indonesia will bear large number cancer burden of disease, but research on cancer related to secondhand smoking in Indonesia still does not exist. Therefore, this study aimed to determine the number of secondhand smoke attributable fractions (SAFs) of six cancers (lung, bladder, colorectal, stomach, pancreas and larynx) and burden of cancer caused by secondhand smoking in Indonesia using Disability Adjusted Life Years (DALYs) indicator. MATERIAL AND METHODS: This research was using descriptive epidemiological prevalence-based research design, with cancers prevalence data gained from Indonesian health assurance system database in 2016. The SAFs is calculated by combining both data of secondhand smoking prevalence and relative risk and the DALY indicator is calculated as the sum of years of life lost due to premature mortality (YLL) and the equivalent healthy years lost due to disability (YLD). RESULTS: Based on SAFs proportion, the highest SAFs among men were in pancreas cancer (80.20%), stomach cancer (79.54%) and laryngeal cancer (69.61%), whereas in women, pancreas cancer (78.95%), stomach cancer (78.26%) and bladder cancer (63.30%). Meanwhile, burden priorities for Indonesian men and woman were lung cancer (110,491), colorectal (68,131), and bladder cancer (39,140). CONCLUSIONS: In total, DALYs 6 cancer diseases due to secondhand smoke analyzed in this study were 283,360 DALYs. Thus, the results of the research can be used as a basis for further policies making on national cigarette prevention and control in Indonesia.