[Chronic diseases: recent trends, challenges and prospects for change]. / Les maladies chroniques : tendances récentes, enjeux et perspectives d'évolution.

ABSTRACT

INTRODUCTION: The objectives were to describe available sources for epidemiological surveillance of chronic diseases, recent trends, and underlying phenomena for these changes and to deduce possible scenarios for the future. METHODS: Based on the examples of coronary heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD) and lung cancer, the authors describe recent trends in mortality and hospitalizations in the general population. RESULTS: Exceptfor diabetes, the morbidity and mortality of the diseases considered have globally declined over the last decade. However, trends varied according to age and gender and an increase in mortality from myocardial infarction, COPD and lung cancer was observed among women under the age of 55. Overall, decreased morbidity and mortality can be explained by improvements in primary prevention (blood pressure, cholesterol, smoking among men...) and prevention of recurrences and complications. DISCUSSION: It is unclear whether these improvements will continue in the future. Aging, obesity, diabetes and smoking among women should negatively impact the medium-term morbidity and life expectancy (especially disability-free life expectancy). It is still difficult to predict future trends, as other factors could attenuate (electronic cigarettes, bariatric surgery...) or, on the contrary exacerbate (increased social inequalities in times of economic crisis, continued increase in smoking among women, diabetes...) these trends.