Incorporating risk factor epidemiology in mortality projections
van Genugten, M Hoogenveen, Rrivm den Hollander, A
van Genugten, M
Hoogenveen, Rrivm
den Hollander, A
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Open Access
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Book chapter
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Date of publication
2001
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Research Projects
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Title
Incorporating risk factor epidemiology in mortality projections
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In: E Tabeau, A van den Berg Jeths, C Heathcote (eds.). Forecasting mortality in developed countries. Insights from a statistical, demographic and epidemiological perspective. - 2001. - (European Studies of Population (ESPO) ; vol. 9); pp. 189-204
Abstract
Mortality projections tend to be based on past trends in mortality statistics. These demographic projections do not deal explicitly with trends in major risk factor prevalence and disease survival. To assess the relevance of such trends, we applied a multistate life table to make lung cancer and coronary heart disease mortality projections for 2015. We implemented different scenarios for smoking prevalence and for disease survival in the Netherlands. We subsequently compared our results with demographic disease-specific mortality projections.
The exercise demonstrates substantial discrepancies between the results of trend extrapolation of cause-specific mortality and those of the epidemiological projections using a reference scenario for risk factor prevalence. Differences in lung cancer mortality can be largely explained by trends in smoking prevalence over the last four decades. Differences in coronary heart disease, however, can be explained only for a small part by past trends in smoking prevalence. The improved survival from myocardial infarction is of much greater relevance.
Mortality projections can be improved by incorporating underlying epidemiological processes, such as risk factor prevalence and disease survival. Demographic and epidemiological projections should be regarded as being complementary rather than mutually exclusive.
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Dordrecht : Kluwer, 2001