Age-Standardized Disability-Adjusted Life Years (DALYs) of Colorectal Cancer in Brunei Darussalam, 2002–2020: A Population-Based Registry Study

Abstract Purpose Colorectal cancer (CRC) incidence is rising in Brunei Darussalam, but its overall health burden has not been quantified using Disability-Adjusted Life Years (DALYs). We estimated the national CRC DALY burden for 2002–2020 by sex, disease stage, and age at onset, and tested sensitivity to the disability-weighting method. Methods In this retrospective, population-based study of 1,373 CRC patients diagnosed 2002–2020, DALYs were calculated as Years of Life Lost (YLL) plus Years Lived with Disability (YLD) via a phase-based model using stage-specific Global Burden of Disease weights. Rates were age-standardized and stratified by sex, stage, age group, and onset age; sensitivity analysis compared stage-specific versus generic weighting. Results CRC caused 17,234.3 DALYs (YLL 95.1%, YLD 4.9%; age-standardized rate 285.5 per 100,000 population per year), higher in males (9,574.1) than females (7,660.3). Distant-stage disease was almost entirely mortality-driven (95.2% YLL) versus localised disease (91.0% YLL). Early-onset cases (< 50 years, 21.5% of the cohort) contributed 19.5 DALYs per case versus 10.6 for common-onset, and 45.9 years of life lost per death versus 22.4. Annual DALYs rose significantly (+ 4.4%/year, p = 0.036) to a 2015 peak before declining; an age-standardized period analysis confirmed this pattern was not explained by population aging. A generic disability weight increased total DALYs by 5.9%, more than phase-duration assumptions (-0.4% to + 0.7%). Conclusion CRC imposes a substantial, mortality-dominated burden in Brunei Darussalam, disproportionately concentrated in early-onset cases. The disability-weighting method materially affects burden estimates, supporting stage-specific over generic weights and providing a baseline for evaluating Brunei’s CRC screening programme.