Cancer-specific contributions to life expectancy in Slovenia, 2008–2023: insights for screening

Abstract Background Life expectancy (LE) is still improving in Slovenia. This study examines cancer contributions to LE change in Slovenia (2008-2023), focusing on screen-relevant sites. Methods The analysis is based on national mortality data for 2008-2023. LE was calculated using partial death probabilities and smoothed with a 3-year moving average. Decomposition used the Arriaga method by age group and cause. Results Between 2008 and 2023, LE at birth increased by 3.38 years in men and 2.06 years in women. All cancers combined contributed 0.96 years to the increase in male LE and 0.49 years in female LE. The most pronounced positive contribution in men came from lung cancer (0.43 years), mainly in ages 50-79, reflecting declining smoking-related mortality. Lung cancer also contributed positively in women aged 40-59 (+0.06 years), but the overall effect was negative (-0.06 years), driven by increasing mortality in ages 60-79 (-0.12 years). Colorectal cancer ranked second in both sexes (0.20 in men, 0.17 in women). Breast and cervical cancers contributed positively to LE (0.13 and 0.03 years) in screened age groups. However, breast cancer had negative contributions in ages 20-39, which fall outside the screening range. Cervical cancer showed a small negative contribution even within the 20-29 group, despite being included in the screening age range. Prostate cancer contributed modestly in men (0.03 years) and remains a relevant screening candidate due to its high burden in terms of both incidence and mortality. Most gains occurred in middle and older age groups. Conclusions Cancers addressed through organized screening had the greatest positive impact on LE. New national initiatives for lung and prostate cancer screening are in development, and pilot studies on H. pylori screening for gastric cancer are underway. Findings support evidence-based planning of screening policies aligned with mortality trends. Key messages • Cancers covered by organised screening had the highest positive impact on life expectancy. • Results support the development of new screening programmes aligned with mortality trends.