How Have Disease Prevalence and Mortality after Diagnosis Contributed to Changes in Life Expectancy at the National Level?

Marcus Ebeling , Karolinska Institutet
Anna C. Meyer, Institute of Environmental Medicine, Karolinska institutet
Karin Modig, Karolinska Institutet

For many diseases, survival has improved at a faster pace than the improvement in incidence. This led to increasing prevalence proportions, and a changing population composition. It is unclear how improved survival and prevalence proportions contributed to life expectancy change at the national level. Using Swedish register data, we decompose the change in remaining life expectancy at age 60 between 1994 and 2016 into the contributions of changing mortality after diagnosis and changing disease prevalence. We perform separate decompositions for myocardial infarction, stroke, hip fractures as well as colon and breast cancer, distinguishing also between recent patients and long-term survivors. Improved survival after diagnosis contributed to life expectancy increase for all diseases analyzed, and most strongly for stroke and myocardial infarction. However, combined evidence across the analyzed disease suggests that the overall compositional change slowed the increase of life expectancy. This dynamic might be considered “cost” of saving lives.

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 Presented in Session 20. National Trends in Life Expectancy and Mortality