Klenk Jochen, Rapp Kilian, Büchele Gisela, Keil Ulrich, Weiland Stephan K
Institute of Epidemiology, Ulm University, Germany.
Eur J Public Health. 2007 Dec;17(6):587-92. doi: 10.1093/eurpub/ckm024. Epub 2007 Apr 2.
Between 1962 and 2002 the average life expectancy in Germany has increased from 67.1 years to 75.6 years in men and from 72.7 years to 81.3 in women.
The cumulative and annual contributions of different age- and disease-groups on life expectancy were calculated using Pollard's actuarial method of decomposing mortality rates. Mortality data were provided by the German Statistical Office.
Considering the cumulative contribution over the period of 40 years, the largest contributions came from persons with at least 65 years of age (2.9 years in men and 4.0 years in women). Reductions in cardiovascular disease mortality had the greatest cumulative impact on life expectancy (2.7 years in men and 3.0 years in women). The contribution from reduced cancer mortality on life expectancy was substantially lower (0.6 and 0.9 years, respectively). The annual contributions of several disease-groups varied considerably over time. The positive contribution from cardiovascular diseases started only after 1970, and in men it became solid only after 1980. Regarding malignant neoplasms, the largest cumulative contribution came from stomach cancer (0.4 in both sexes). The annual analyses showed increasing contributions from reduced cancer mortality after 1990. These were strongly influenced by lung, stomach, prostate and colorectal cancer in men, and by breast, colorectal and stomach cancer in women.
While life expectancy has increased by about 2.2 years per decade the observed variations in the age- and disease-specific contributions over time have implications for future health care planning and prevention strategies.
1962年至2002年间，德国男性的平均预期寿命从67.1岁增至75.6岁，女性从72.7岁增至81.3岁。
采用波拉德死亡率分解精算方法，计算不同年龄组和疾病组对预期寿命的累积贡献和年度贡献。死亡率数据由德国统计局提供。
考虑40年期间的累积贡献，最大贡献来自至少65岁的人群（男性为2.9岁，女性为4.0岁）。心血管疾病死亡率的降低对预期寿命的累积影响最大（男性为2.7岁，女性为3.0岁）。癌症死亡率降低对预期寿命的贡献则低得多（分别为0.6岁和0.9岁）。几个疾病组的年度贡献随时间变化很大。心血管疾病的积极贡献直到1970年后才开始，在男性中直到1980年后才稳固。关于恶性肿瘤，最大的累积贡献来自胃癌（男女均为0.4）。年度分析显示，1990年后癌症死亡率降低的贡献不断增加。这些受男性肺癌、胃癌、前列腺癌和结直肠癌以及女性乳腺癌、结直肠癌和胃癌的强烈影响。
虽然预期寿命每十年增加约2.2岁，但观察到的特定年龄和疾病贡献随时间的变化对未来医疗保健规划和预防策略具有影响。
