Changing mortality of peptic ulcer disease in Germany.

This study examines mortality of gastric ulcer and duodenal ulcer in the Federal Republic of Germany during the period 1952-1980. The data originate from tabulations of the German Federal Office of Statistics. In women, mortality due to gastric and duodenal ulcer increased; in men, duodenal ulcer mortality remained constant and gastric ulcer mortality declined. Overall mortality of peptic ulcer declined from 7.0 to 6.0 deaths per 100,000 inhabitants and year. Since 1952, the average age at death has increased for both ulcer types and sexes. This was due to an increase of mortality in the older age groups; in men, mortality concomitantly decreased in the younger age groups. Women died of peptic ulcer older than men. In the 1950s none but the group of women gastric ulcer patients died as old as the nonulcer subjects, all other groups of peptide ulcer (female duodenal ulcer, male gastric ulcer and duodenal ulcer) died younger than the nonulcer subjects. In more recent years, both male and female gastric ulcer and duodenal ulcer patients died at the same age or even older than nonulcer subjects. It is concluded that peptic ulcer has changed from a lethal disease of the mid- and old-age groups to a lethal disease predominantly in the old- and very-old-age groups. The time-course of peptic ulcer mortality is different in the Federal Republic of Germany from what has been described in other Western States, especially in the United States and England. This difference suggests that, similar to healing, mortality of peptic ulcer is characterized by geographic variations, and that the time-course observed in one country does not necessarily hold true for other countries.