Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Box 210, 171 77 Stockholm, Sweden.
Eur J Epidemiol. 2012 Feb;27(2):139-45. doi: 10.1007/s10654-012-9653-2. Epub 2012 Feb 18.
It is often taken for granted that an ageing population will lead to an increased burden for the health care sector. However, for several diseases of big public health impact the rates have actually come down for a substantial period of time. In this study we investigate how much the incidence rates for myocardial infarction (MI), stroke, and cancer will have to decline in order to counterbalance future demographic changes (changes in population size and age structure) and compare these figures with observed historical trends. Information on incidence rates were obtained from the National Board of Health and Welfare and referred to the total Swedish population. Population projections were obtained from Statistics Sweden. We projected the number of MI events to increase 50-60% between 2010 and 2050. The decline in incidence rates that is required to keep the number of events constant over time is, on average, 1.2%/year for men and 0.9%/year for women, somewhat higher than the trend for the past 10 years. For stroke the corresponding figures were 1.3% (men) and 1% (women), well in line with historical trends. For cancer the results indicate an increasing number of events in the future. Population ageing is more important than population growth when projecting future number of MI, stroke and cancer events. The required changes in incidence rates in order to counterbalance the demographic changes are well in line with historical figures for stroke, almost in line regarding MI, but not in line regarding cancer. For diseases with age dependence similar to these diseases, a reduction of incidence rates in the order of 1-2% is sufficient to offset the challenges of the ageing population. These are changes that have been observed for several diseases indicating that the challenges posed by the ageing population may not be as severe as they may seem when considering the demographic component alone.
人们通常认为人口老龄化将给医疗保健部门带来更大的负担。然而，对于一些具有重大公共卫生影响的疾病来说，在相当长的一段时间内，这些疾病的发病率实际上已经下降了。在这项研究中，我们调查了心肌梗死 (MI)、中风和癌症的发病率需要下降多少才能抵消未来的人口变化（人口规模和年龄结构的变化），并将这些数字与观察到的历史趋势进行比较。发病率信息来自国家卫生和福利委员会，并参考了整个瑞典人口。人口预测来自瑞典统计局。我们预计 2010 年至 2050 年间 MI 事件的数量将增加 50-60%。为了使事件数量随时间保持不变，所需的发病率下降率平均为男性每年 1.2%，女性每年 0.9%，略高于过去 10 年的趋势。对于中风，相应的数字分别为男性 1.3%和女性 1%，与历史趋势非常吻合。对于癌症，结果表明未来的事件数量将会增加。在预测未来的 MI、中风和癌症事件数量时，人口老龄化比人口增长更为重要。为了抵消人口变化，所需的发病率变化与中风的历史数据非常吻合，与 MI 几乎吻合，但与癌症不吻合。对于与这些疾病年龄依赖性相似的疾病，发病率降低 1-2%就足以应对人口老龄化带来的挑战。这些变化已经在几种疾病中观察到，这表明仅考虑人口因素，人口老龄化带来的挑战可能并不像人们想象的那么严重。
