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Fulltext Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review

Htwe O, Yuliawiratman BS, Tannor AY, Nor Asikin MZ, Soh E, DE Groote W, et al.

Eur J Phys Rehabil Med, 2024 Jun;60(3):514-522.
PMID: 38551518 DOI: 10.23736/S1973-9087.24.08154-1

INTRODUCTION: With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data.
EVIDENCE ACQUISITION: In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review.
EVIDENCE SYNTHESIS: Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators.
CONCLUSIONS: Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.

Matched MeSH terms: Disabled Persons/rehabilitation
Fulltext Trend of learning disability among lower primary school children in Malaysia from 2013 to 2018

Noorhaire Sumarlie Nordin, Abdul Shukor Salha, Don Ismail Mohamed,, Saidatul Norbaya Buang

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):96-96.
MyJurnal

Introduction: Learning disability (LD) is a neurologically related processing problem which can interfere with basic and higher learning skill. The prevalence of learning disability was estimated to be ranging from 5 and 9 percent in general population. The aim of this study was to describe the trend of LD among lower primary school children particularly among Year 3 school children from 2013 to 2018. Methods: Data were taken from the Ministry of Health database on LD among lower primary school children particularly among Year 3 school children in Malaysia from 2013 until 2018. These data were collected from the assessment of LD school children who were referred from schools nationwide to the government medical practitioners. Results: There were approximately 2.6 million Year 3 school children in Malaysia from 2013 until 2018. Of these, a total of 9,063 school children were diagnosed to have LD. There was an increase trend in the incidence of LD from 13 per 10,000 school children in 2013 to 77 per 10,000 school children in 2016. From 2017 onwards there was a reduction in the incidence which consistently remained at 35 per 10,000 school children. Of these, the highest incidence was seen in school children with Intellectual Disabil-ity (ranging from 18 to 36 per 10,000 school children) followed by those with Specific Learning Disability (ranging from 1 to 23 per 10,000 school children) from 2013 until 2018. Conclusion: Learning disability although not as common as other disabilities in general population is still an important issue that need to be tackled to improve the well-being of those affected.

Matched MeSH terms: Disabled Persons
A study on safe accessibility for wheelchair user in selected KTM commuter station in Kuala Lumpur

Abdul Halim Imaduddin, Abdul Hamid Nor Hanani

Journal of Occupational Safety and Health, 2011;8(1):51-59.
MyJurnal

The research is focus generally to identify and investigate the issue of accessible design for wheelchair users on selected Keretapi Tanah Melayu Berhad (KTM) commuter stations in the city of Kuala Lumpur. The objectives are to ensure that the design of accessibility is comply with the law, regulations, standard requirements and guidelines; to understand the recent condition and their needs in commuter stations and to allow their secure equal rights and opportunities as others. The research began by gaining reliable information through literature study and a checklist for building audit was prepared to evaluate the accessibility. A building access survey was carried out on selected stations which enclosed three main stages to show the pattern of passengers’ path. Stage 1: From the road to the ticket counter. Stage 2: From the ticket counter to the platform. Stage 3: From the platform to the train. A series of structured questionnaire was also constructed to study and get a feedback from selected target of users. Result of findings in this study had been analyzed to assist the management and the station concerned in upgrading their station facilities to a comfortable, accessible, friendly and safe environment in order to encourage more users, including disabled persons to benefit from it.

Matched MeSH terms: Disabled Persons
Fulltext Disabled people are left behind the information age: are the gap getting bigger?

Nur Ajrun Khalid, Rohana Yusof

Malaysian Journal of Social Sciences and Humanities, 2016;1(4):37-41.
MyJurnal

Rapid progress of Information Communication Technology (ICT) will accelerate the distribution of
information from government to the people; however the monopoly of technology ICT services will
lead to inequality of information distribution in between of normal people and disabled people.
Embrace with the inequality of ICT distribution directly make the group of disabled people left behind
at the information age, or the situation also known as digital divide. Hence, this article attempts to
identify and examine the issues facing by disabled people in order to catch up the fast diffusion of ICT.

Matched MeSH terms: Disabled Persons
Fulltext The use of verve app for the disabled in managing navigation sport facilities

Mazlina Mahdzar, Muhammad Anwar Haziq Mohd Yunus, Nurfarah Idayu Abdul Halim, Shamirra Zhulliana Zainal Abidin

Jurnal Inovasi Malaysia, 2018;1(2):83-92.
MyJurnal

Tourism industry is constantly changing. A strong and positive destination image is always desired especially from potential market segments. The disability market is the next big consumer market that is often overlooked. In sports tourism, most of the facilities developed for the disabled are limited, preventing them from experiencing the industry as a normal person would. People with disability have the rights to travel and live an active and healthy lifestyle. Promoting sports tourism and making it accessible to the disabled is seen as a problem as there is currently no easy access to information that is available for them. Verve App is an innovation to assist the disabled to navigate their ways to sport facilities such as the stadiums and many other disabled-friendly sporting facilities near them. This innovation is also designed to offer a wide-range of information to people with disabilities, to provide exposure to the disabled on disabled-friendly facilities, to provide a convenient and easy way to search for sport facilities within close proximity, to navigate the disabled, as well as to provide on facility accessibility.

Matched MeSH terms: Disabled Persons
Fulltext Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

BMC Public Health, 2010;10:492.
PMID: 20716377 DOI: 10.1186/1471-2458-10-492

The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.

Matched MeSH terms: Disabled Persons/classification*; Disabled Persons/statistics & numerical data
Mental health and wellbeing in the Sustainable Development Goals

Izutsu T, Tsutsumi A, Minas H, Thornicroft G, Patel V, Ito A

Lancet Psychiatry, 2015 Dec;2(12):1052-4.
PMID: 26613844 DOI: 10.1016/S2215-0366(15)00457-5
Matched MeSH terms: Disabled Persons
Fulltext Trends of disability among workers in Malaysia: case study on SOCSO’scontributors

Shamshimah Samsuddin, Noriszura Ismail

Jurnal Sains Kesihatan Malaysia, 2018;16(1):87-94.
MyJurnal

Occupational injury is an issue that needs to be considered in reducing the problems of disability and death in the
workplace. Healthy and high-productivity workers are one of the important factors that are important to the economic
growth of a country. This study aims to identify the trend of disability for employees covered by the Employment Injury
Scheme under the Social Security Organization Malaysia (SOCSO) for the years 2009-2013. Based on the descriptive
analysis, 80% of the total numbers of workers who suffer injury or death in the workplace are male employees. In
addition, workers aged 25 and above are more prone to injury and death associated with work. The results showed that
socio-demographic factors such as gender and age, as well as level of disability are several important factors that need
to be considered in identifying the trend of disability among employees.

Matched MeSH terms: Disabled Persons
Fulltext Mobile GIS applications for people with disabilities healthcare services

Abdul Rauf Abdul Rasam, Abdul Rauf Abdul Rasam, Azri Haziq Azlin, Noraqila Aiman Abu, Ahmad Norhisyam Idris, Nurmilah Romeyu

Jurnal Inovasi Malaysia, 2020;3(2):87-99.
MyJurnal

Disability is termed as both evolving concept and manifestation of interaction between persons with disabilities (PWDs) and physical and environmental barriers that holds them back from contributing actively in a society. People who fall in this category will find themselves trapped in a such vulnerable condition as they may not be able to cope with their daily problems without high surveillance from their guardian. Development of a mobile apps and web GIS-based healthcare system in Ampang is proposed in this study as this application has a bright potential to assist PWDs in terms of accessibilities to reach healthcare centres. The main objectives of this paper are i) to study the needs assessment on the proposed system, ii) to develop a mobile and web GIS-based healthcare information system and iii) to evaluate the performance of the proposed system. Selected respondents agreed on the development of the prototype system, namely the mobile apps and web system. The system was created with main menus such as doctor home visits, ambulance and medication delivery. Medical support team can also perform analyses in the system for PWD needs such as shortest path analysis, buffering and view of the main menus.

Matched MeSH terms: Disabled Persons
Fulltext IoT-based smart wheelchair system for physically impaired person

Muhammad Afiq Mohd Aizam, Nor Shahanim Mohamad Hadis, Samihah Abdullah

ESTEEM Academic Journal, 2020;16(1):59-73.
MyJurnal

Disabled persons usually require an assistant to help them in their daily routines especially for their mobility. The limitation of being physically impaired affects the quality of life in executing their daily routine especially the ones with a wheelchair. Pushing a wheelchair has its own side effects for the user especially the person with hands and arms impairments. This paper aims to develop a smart wheelchair system integrated with home automation. With the advent of the Internet of Things (IoT), a smart wheelchair can be operated using voice command through the Google assistant Software Development Kit (SDK). The smart wheelchair system and the home automation of this study were powered by Raspberry Pi 3 B+ and NodeMCU, respectively. Voice input commands were processed by the Google assistant Artificial Intelligence Yourself (AIY) to steer the movement of wheelchair. Users were able to speak to Google to discover any information from the website. For the safety of the user, a streaming camera was added on the wheelchair. An improvement to the wheelchair system that was added on the wheelchair is its combination with the home automation to help the impaired person to control their home appliances through Blynk application.
Observations on three voice tones (low, medium and high) of voice command show that the minimum voice intensity for this smart wheelchair system is 68.2 dB. Besides, the user is also required to produce a clear voice command to increase the system accuracy.

Matched MeSH terms: Disabled Persons
Fulltext A psychosocial study on the effects of employee characteristics and workplace ergonomics on chronic back pain related to work

Tam, Jenn Zhueng, Sharifa Ezat Wan Putih, Noor Hassim

Journal of Occupational Safety and Health, 2018;15(2):2-11.
MyJurnal

The study objective is to examine the effects of the identified attributes (i.e. employee characteristics and ergonomics) that influences the chronic back pain disabilities acquired and benefits awarded via the recognition of workplace relatedness. As these factors are considered in work- related chronic back pain, we hypothesized that the ascertainment of work relatedness would depend on employees’ workplace conditions (poor ergonomic practices) and innate personal conditions (excellent pre-existing medical health). Two set of data was collected from a registry owned by a social security organization in 2012. Factor analysis and structural equation modeling (SEM) was used to analyze the data. As predicted, workplace conditions and employees’ pre- existing medical health status mediated occupational back pain to develop disability and monetary benefit relationships. In conclusion, the results support the importance of obtaining workplace evidence and employees’ pre- existing medical health status that produces stronger relationship in terms of the amount of benefits to be given compared to the lesser effects on disability. Both models with different samples showed consistent SEM results. The proposed model would be applicable in the heterogenous Asian setting and that occupational back pain consensus is the key element in providing effective social security protection.

Matched MeSH terms: Disabled Persons
Dental students' perception on Disability Equality Training as part of the special care dentistry curriculum

Mohamed Rohani M, Mohd Nor NA

J Dent Educ, 2021 May;85(5):690-698.
PMID: 33476414 DOI: 10.1002/jdd.12528

INTRODUCTION: The Special Care Dentistry (SCD) undergraduate program increasingly aims to address student attitudes toward people with disabilities (PWD). One of the efforts made by the Faculty of Dentistry, University of Malaya (FODUM), is to introduce Disability Equality Training (DET) as part of the learning activity in the SCD curriculum. This study aimed to explore students' perception about the DET program.
METHODS: This was a qualitative research project exploring students' perception toward DET in 2 cohorts of third-year dental students from FODUM (n = 100). The reflection notes were analyzed using Luborsky's method of thematic analysis. Identification of themes was based on statements that were most frequently reported by students.
RESULTS: The majority of the students gave positive feedback for the training, which includes enhanced knowledge, attitudes, and skills about treating PWD. They also reflected that the DET improved their understanding of social and professional responsibility. In terms of learning experience, many reported that the training was useful and enjoyable. Students' suggestions for improvement included learning "sign language", visiting special needs centers, and providing simulation exercises involving real PWD.
CONCLUSION: Students' comments on the DET were positive and they enjoyed the learning experience. The findings support the continuation of DET as part of the undergraduate dental curriculum. Dental institutions seeking to implement or refine the SCD curriculum are encouraged to include DET based on its potential benefits for undergraduate students.

Matched MeSH terms: Disabled Persons
Fulltext The applictions of International Classification of Functioning, Disability and Health (ICF) by World Health Organization (WHO) in rehabilitation medicine practice

Lydia, A.L., Nazirah, H.

JUMMEC, 2007;10(2):16-21.
MyJurnal

Rehabilitation Medicine is dedicated to optimise patients function and health in the most comprehensive manner. ICF, the latest International Classification by World Health Organization (WHO) is a conceptual framework for the assessment of functioning, disability and health. The purpose of this paper is to describe the applications of ICF in Rehabilitation Medicine practice in the Medical Rehabilitation Unit, University of Malaya Medical Centre (UMMC), Kuala Lumpur. Issues: ICF consists of body function, structure, activity, participation and environmental factor. ICF categories are exhaustive, but are not practical to be used entirely and not applicable in clinical practice on their own. How is ICF used from the clinical perspective? It has to be adapted to make it usable. In Rehabilitation Medicine settings, the following are ways ICF is applied in clinical practice: research in terms of validating the use of available ICF Core Sets and development of new ICF Core Set; clinical practice based on the ICF-based sheet; and educational tools. Conclusion: The practice of Rehabilitation Medicine is in line and compatible with the concept of ICF and can serve as a new important language that can improve the practice of Rehabilitation Medicine. It can be a universal language in functioning, disability and health and can improve understanding in addressing issues on disability within the medical community, improve multi professionals’ communication among patients, healthcare providers and stakeholders.

Matched MeSH terms: Disabled Persons
Fulltext Common developmental disabilities in young children

Toh, Teck Hock

Int J Public Health Res, 2011;1(2):57-65.
MyJurnal

Developmental disabilities in young children are common, and the prevalence is estimated as high as 0.1-1.75% in the children population for each disabilities. With increasing awareness and health expectation, more children with Developmental disabilities are presenting to health care professionals, and at earlier age. Literatures also suggested the importance of early intervention programme in determining the outcome of this group of children. Therefore, it is vital for health professionals who have direct contact with young children are competent in detecting children with possible Developmental disabilities, and have the basic knowledge about some of the common disorders in order to discuss the issues with the parents. It is also important to work with the various resources available in the local community, such as non-governmental organisations for children with special needs, schools offering special education programmes and inclusive classes, and the allied health who provide cares to this group of young children and their family. A lot of information are also available online, and may be offered to help parents gaining more understanding regarding these Developmental disabilities.

Matched MeSH terms: Disabled Persons
Fulltext Interactions Between Psychiatric Disorder And Physical Illness

Nor Zuraida, Z.

Malaysian Journal of Psychiatry, 2009;18(2):1-2.
MyJurnal

The vital importance of the mental health of a nation for the overall well being of the population and socioeconomic development is increasingly recognized. In Malaysia, psychiatric disorders were responsible for 8.6% of the total Disability Adjusted Life Years and were ranked fourth as the leading cause of burden of disease by disease categories. More and more evidence shows that physical illnesses are strongly associated with psychiatric disorders. Those with physical illnesses have much higher risk of developing psychiatric disorders compared to that without. The mechanisms of co-morbidity of psychiatric and physical illness are complex. It is a two-way interaction and there are five different possible ways to describe this.

Matched MeSH terms: Disabled Persons
Fulltext Should parental decision override best interest of a handicapped child? A case illustration in a Malaysian child with Down Syndrome

Fashiham Taib, Nur Arzuar Abdul Rahim, Mohd Rizal Mohd Zain, Mohamad Ikram Ilias, Nik Mohd Rizal Mohd Fakri, Zabidi Azhar Hussin

Education in Medicine Journal, 2015;7(1):67-71.
MyJurnal

The paper discusses on the complexity of the issues surrounding a patient with subluxation of cervical spine in a Down syndrome child. Several relevant issues are discussed including consent in a minor, conflicting decision making between parents and doctors, end-of-life issues, supporting handicapped child with minimal co-morbidities, community ethics, neglect of care by the caregiver and decision making after allowing zonal of parental discretion. Despite the difficulties surrounding parental actions, there are still ethical priorities which have to be considered individually to alleviate the suffering of the patients and the family members. Dealing with patients with chronic illnesses is a challenge for any medical doctors. The case warrants sensitive approach to allow appropriate respect for parental decision despite in disagreement with the clinical team. The term ‘zone of parental discretion’ refers to a controversial area of decision making; and has still many potential conflicts on day to day clinical cases, especially among the conservative society in the East Coast of Peninsular Malaysia.

Matched MeSH terms: Disabled Persons
Fulltext Effectiveness of Home Care Nursing Program (HCNP) on The Activities of Daily Living of Stroke patients

Samsiah, M., Santhna, L.P., Hamidah, H., Ruth, P.R.D.

Medicine & Health, 2007;2(2):117-124.
MyJurnal

Home Care Nursing Program (HCNP) at HUKM was started in 1998 and evaluation of the program was required. The objective of this study is to evaluate the effectiveness of HCNP on stroke rehabilitation at HUKM. A retrospective study using a matched pair design involving 69 stroke patients admitted to HUKM from August 1998 to December 2000 was carried out. The participants of this study were the HCNP group (n=35), and Non- HCNP (n=34). The matching was based on five criteria; age, sex, race, data of admission and severity of disability. The HCNP group was identified through data at the HCNP unit and their medical reports were traced. For the Non-HCNP group, the participants were identified based on criteria which were similar to that of the HCNP group. Based on the criteria identified, there was no significant difference between the two groups. The Activities of Daily Living was measured using the Modified Barthel Index twice; once on admission (based on record) and one post stroke. The t-test was applied to parametric data and non-parametric data; Chi-square was used to detect any significant relationships between the scores of the two groups. Results showed no significant difference (p=0.1990) in ADL on admission and ADL post stroke patients between the two groups. However, there were significant difference (HCNP p=0.000 and Non-HCNP p=0.000) in ADL on admission and post stroke for stroke patients who sought alternative treatment compared to those who had not.

Matched MeSH terms: Disabled Persons
Fulltext A smart wheelchair prototype based on hand gesture control

Shaari AR, Mohd Jani MN, Mohamed Yunus AS

Journal of Engineering and Science Research, 2017;1(2):209-214.
MyJurnal

Wheelchair has been an important assistive device and the demand are ever rising because of the increasing physically handicapped and old age populations. The recent development in the robotics artificial intelligence extends vast scope for developing the more advanced and intelligent one to overcome limitations of the existing traditional wheelchairs. The prototype smart wheelchair were present on this paper using hardware implementation with the help of simple hand gesture which is comprises of an accelerometer mounted on the hand glove senses the tilt angle of the user hand movements and transmits control signal to the receiver mounted on wheelchair. This will interpret the movement accordingly required by user. The wheelchair control unit is developed by integration of ATMEGA328 microcontroller with Arduino UNO. The wheelchair is developed to allow peoples to move safely and put reliability in accomplishment of some important tasks in daily life.

Matched MeSH terms: Disabled Persons
Fulltext Burden of disease attributable to overweight and obesity in Malaysia

Foo, Lee Peng, Hanny Zurina Hamzah, Norashidah Mohamed Nor, Rusmawati Said

Malaysian Journal of Public Health Medicine, 2018;18(1):0-0.
MyJurnal

The overweight and obese population may affect the population health which can lead to economic stability and development of the countries to be compromised. Thus, this study estimates the burden of disease attributable to overweight and obesity in Malaysia for adults aged 20-59 years old. Population attribution fraction (PAF) and disability-adjusted life year (DALY) have been used to quantify years of life lost from premature death and number of years lost due to disability resulting from obesity and overweight. The burden of disease attributable to overweight was 1582 and 1146 PYs per 1000 persons for male and female, respectively. Meanwhile, the burden of disease attributable to obesity was 2951 PYs per 1000 persons with women in the lead at 1657 PYs per 1000 persons. The burden of overweight and obesity among Malaysian adults is substantial. The outcome of this study is crucial as it gives a comprehensive information on the burden of overweight and obesity in Malaysia. The information from this study also enables the authorities to develop activities and programs to combat obesity and tomaintain healthy lifestyle among Malaysian.

Matched MeSH terms: Disabled Persons
Fulltext Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study

Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, et al.

JAMA Oncol, 2019 Dec 01;5(12):1749-1768.
PMID: 31560378 DOI: 10.1001/jamaoncol.2019.2996

IMPORTANCE: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.
OBJECTIVE: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.
EVIDENCE REVIEW: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.
FINDINGS: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs).
CONCLUSIONS AND RELEVANCE: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

Matched MeSH terms: Disabled Persons

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