Genomics and Burden of Disease in the Netherlands: An Estimate of Genetic Contribution to DALYs

Background

Genomics is an increasingly recognised but poorly quantified contributor to disease burden. Existing frameworks for burden of disease — including the Dutch Public Health Foresight Study — cover 106 diseases and 120 determinant groups, but genetic factors have not yet been systematically integrated. This study presents first estimates of the genomic contribution to disability-adjusted life years (DALYs) in the Netherlands.

Methods

For a selection of the most relevant diseases, the proportion of disease burden attributable to genomic factors was estimated using three primary sources: VZinfo.nl, Erfelijkheid.nl, and Zicht op Zeldzaam. Where possible, minimum and maximum attributable fractions were derived and combined with current DALY estimates from Dutch burden of disease data. Scientific literature requiring targeted searches was not included in this version. No distinction was made between morbidity and mortality contributions.

Results

Genomic attribution varied substantially across disease groups. The highest attributable fractions were found for breast cancer (∼25%), diabetes (10–20%), anxiety and stress disorders (∼10%), and neck and back complaints (∼10%). Expressed in absolute DALYs, anxiety disorders, breast cancer, neck and back complaints, and diabetes showed the largest genomic contributions. Across all selected diseases, total genomically attributable DALYs range from approximately 100,000 to 132,000. As a proportion of total burden, this represents 3.1–4.0% of DALYs for selected diseases and 1.9–2.5% of all Dutch DALYs.

Discussion

This is a first and exploratory step toward integrating genomics into burden of disease frameworks. Validation is challenging given the limited availability of comparable approaches. Genetic factors also modify risk factor pathways, including addiction and overweight, suggesting that current estimates are conservative. Further methodological development is needed.

Key messages

• Genomic factors account for 1.9–2.5% of total disease burden (DALYs) in the Netherlands, with highest impact in breast cancer, diabetes, and anxiety disorders.

• This study is a first step in systematically integrating genomics into public health burden frameworks, highlighting the need for further research and validation.