Estimating population-based incidence and prevalence of major coronary events

Population-based data on major coronary events (MCE) are generally lacking for large areas, such as at the nationwide level. While mortality data are currently and exhaustively collected in all developed countries and in most developing countries, incidence and prevalence are often available only for certain subgroups of the population under study. We propose a mathematical method to estimate incidence and prevalence using morality and survival data as input, and to forecast MCE occurrence using an age, period, and cohort approach. An application of the method is given to reconstruct incidence and prevalence of MCE in Italy from 1970 to 1990 and to project trends up to the year 2000. MCE incidence has been decreasing since 1974, four years before the observed mortality decline. Conversely, prevalence continues to increase up to the middle of the 1980, and declines thereafter.