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Time trends in incidence and mortality of respiratory diseases of high public health relevance in Germany – Focus – JoHM 3/2017

Respiratory diseases are major causes of disease burden and mortality throughout the world. In Germany, alongside
acute respiratory infections (ARI), chronic lung diseases – including lung cancer, chronic obstructive pulmonary
disease (COPD), and asthma – are of particular socioeconomic importance. ARI incidence rates differ significantly
according to age, season and year. They are recorded as weekly consultation rates as reported by selected outpatient
and inpatient care facilities. Between 2009 and 2016, the highest incidence rates of severe acute respiratory infection
(SARI) were recorded among young children in outpatient (9.4%) and inpatient (0.2%) care. Mortality rates for ARI
are also subject to seasonal and annual fluctuations. However, the official statistics on causes of death, which lead
to estimates of more than 17,000 annual deaths, provide an inadequate measure of death rates because chronic
underlying illnesses are often recorded as the cause of death rather than a more recently acquired acute infection.
Therefore, the excess mortality caused by ARI needs to be assessed in the context of influenza outbreaks. Regarding
lung cancer, COPD and asthma, the long-term time trends in disease incidence and mortality rates are of particular
interest from a health policy perspective. Analyses of data from the official statistics on causes of death for the years
1998 through 2015 show that mortality rates for lung cancer and COPD decreased on average by 1.8% and 1.1% per
year respectively, among men, whereas among women they increased by 2.5% (lung cancer) and 2.3% (COPD)
annually. Nevertheless, more men than women died of lung cancer or COPD in 2015 in Germany: 29,378 men and
15,881 women died from lung cancer, and 17,300 men and 13,773 women died from COPD. During the same period,
the asthma mortality rates decreased on average by 8.3% annually among women and by 11.2% annually among
men, and the absolute number of deaths came down to 659 among women and 393 among men. Lung cancer
incidence rates have been at similar levels as lung cancer death rates since 1998. No such data are available on
time trends in COPD or asthma incidence rates. Coordinated surveillance of respiratory diseases needs to be
expanded within the framework of international action plans for disease prevention.

Date of issue September 15, 2017 PDF (4 MB, File does meet accessibility standards.)