Incidence, survival, and prevalence trends for myocardial infarction, stroke, hip fracture, and cancer across Swedish birth cohorts: a population-based register study.

Authors

Anna-Kathleen Piereth, Katharina Schmidt-Mende, Karin Modig, Marcus Ebeling

Published in

The Lancet regional health. Europe. Volume 68. Pages 101785. Epub Jul 21, 2026.

Abstract

Medical progress reshapes population health through preventing disease onset and improving disease survival. It is unclear which of these forces has advanced and altered the disease landscape more. This study compares age-specific changes in incidence and survival and their influence on prevalence across major diseases.
Using register data covering the total Swedish population from 1994 to 2022 and the birth cohorts 1904 to 1960, we traced first events of myocardial infarction (MI), stroke, hip fracture, and cancer. We analysed incidence rates, one- and five-year survival for ages 60-90. We compared average cohort-to-cohort changes in all measures, and their effect on prevalence at ages 70, 80, and 90 by cohort and sex.
For MI, stroke, and hip fracture, relative improvements in incidence outpaced those in survival at every age. For example, MI incidence among men aged 60 declined on average by 2.0% (SD = 7.0%) every year, resulting in an absolute decrease from 7 (274/37,411; cohort 1934) to 4 (234/54,144; cohort 1960) cases per 1,000 person-years. One-year survival for the same group increased on average by 0.9% (SD = 3.2%) yearly, leading to an absolute increase from 70% (193/274) to 88% (206/234). Prevalence declined for MI, stroke, and hip fracture with the magnitude varying by age group. The largest decrease occurred for MI among women aged 80, where the prevalence declined from 4.5% (1,554 incident cases per 34,676 persons alive; cohort 1924) to 2.7% (1,105/41,122; cohort 1942), corresponding to a relative decrease of -40% during the observation period. Cancer showed increasing incidence, improvements in survival, and increases in prevalence. The largest prevalence increase was observed among women aged 80, where prevalence rose from 8.0% (2,832/35,568; cohort 1922) to 12.5% (4,563/36,609; cohort 1941), corresponding to a relative increase of 57%.
Progress against MI, stroke, and hip fracture was strongest before diagnosis (primary prevention), but for cancer, especially evident at or after diagnosis (secondary and tertiary prevention). This pattern reflects a shift in the disease landscape of the Swedish population from severe acute events to chronic conditions.
Not applicable.

PMID:
42494718
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.