Mortality: Causes of death, 2007

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by Anne Milan

This section on causes of death examines the leading causes for men and women in Canada, including changes during the past several decades, as well as current patterns by age group. For both men and women, as in many previous years, the leading causes of death between 2005 and 2007 were malignant neoplasms (or cancer) and diseases of the heart (often referred to as heart disease). Overall, mortality due to these two leading causes accounted for more than half (51.1%) of all deaths in 2007 and have been declining for both sexes although mortality rates are decreasing at a more rapid pace for heart disease.

Leading causes of death

The trend first observed for men in 1994, that cancer claimed more lives than heart disease, was still evident between 2005 and 2007 (Table 1). As deaths due to heart disease decreased more quickly than did those from cancer, the gap in the mortality rates of these two causes continues to grow in recent years. In 2005, cancer was responsible for 204.8 deaths per 100,000 men while there were 151.2 deaths per 100,000 men from heart disease (Figure 1). By 2007, there were 197.6 cancer deaths per 100,000 men, an overall decline which has occurred since the late 1980s and a further drop to 138.6 deaths per 100,000 men in 2007 due to heart disease. This is a substantial change from 1981 when deaths due to heart disease accounted for 370.5 deaths per 100,000 men while 239.7 deaths per 100,000 men were the result of cancer.

Table 1 Mortality rates of leading causes of death by sex, Canada, 1981 to 2007

Figure 1 Standardized mortality rate from malignant neoplasms (cancer) and from diseases of the heart (heart disease) by sex, Canada, 1981 to 2007

The evolution in causes of death for women has followed the same trend as for men, and since 1998 the mortality rate from cancer for women surpassed that from heart disease. In both 2006 and 2007, there were 181.9 deaths per 100,000 women from cancer (down from 184.8 deaths per 100,000 women in 2005). There were 126.1 deaths per 100,000 women due to heart disease in 2007 (down from 128.9 in 2006 and 139.7 in 2005). Close to three decades earlier, in 1981, there were 295.1 deaths per 100,000 women due to heart disease and 188.0 deaths per 100,000 women from cancer.

The third leading cause of death for women in 2007, and the fourth leading cause of death for men, was cerebrovascular diseases (or stroke). Again, there have been large decreases in the mortality rate in the data recorded since 1981. For men the mortality rate was 75.7 deaths per 100,000 population in 1981 falling to 29.7 deaths per 100,000 population in 2007. Women have a higher mortality rate from strokes than do men and the corresponding drop was from 100.1 deaths per 100,000 population to 43.2 deaths per 100,000 population from 1981 to 2007.

The mortality rate from unintentional injuries (or accidents) remained fairly stable since the early 2000s for men and the late 1990s for women, although it has been higher for men than for women for all the years recorded since 1981. It was the third leading cause of death for men in 2007, with 34.5 deaths per 100,000 men compared with 21.5 deaths per 100,000 women, for whom it was the fifth leading cause of death. The mortality rate due to accidents has dropped compared with several decades ago, especially for men. In 1981 the mortality rate was 64.1 deaths per 100,000 men while it was 29.9 deaths per 100,000 women.

The fourth leading cause of death for women, and the fifth leading cause of death for men, was chronic lower respiratory diseases. In 2007, the mortality rate was 29.0 and 27.5 deaths per 100,000 men and women, respectively. While the 2007 rate is relatively close for men and women, the mortality rate due to this cause of death has evolved differently for men and women in recent decades. In 1981, the mortality rate was 43.3 deaths per 100,000 men, increasing during the 1980s to a high of 48.5 deaths per 100,000 men in 1986. Since that time there has been an overall decrease, although it did increase slightly from 27.7 deaths per 100,000 men in 2006 to 29.0 deaths per 100,000 men in 2007. For women, the 1981 morality rate was 14.0 deaths per 100,000 population. This rate rose fairly steadily throughout the 1980s and 1990s reaching a high of 29.4 deaths per 100,000 population in 1999. After some fluctuation throughout the 2000s, the rate fell slightly to 25.9 deaths per 100,000 women in 2006 before slightly increasing again to 27.5 deaths per 100,000 women in 2007.

Other causes of death

In 2007, the sex differential that had historically existed with higher mortality rates for men than for women due to heart disease had been largely reduced. While mortality rates from many of the leading causes remained higher for men than women, there are some trends which have developed in recent years. Specifically, mortality rates for women due to malignant neoplasms of the trachea, bronchus and lung (or cancer of the respiratory system) have been on an overall upward trajectory, unlike men, who have experienced an overall decline in mortality rates from this cause. This is because younger cohorts of women have a much higher prevalence of smoking early in life compared with older cohorts of women. In fact, although mortality rates from cancers of the respiratory system for women were still lower than men in 2007 (45.1 deaths per 100,000 women and 56.8 deaths per 100,000 men) the mortality rate for women from this cause was more than double the 1981 rate of 21.6 deaths per 100,000 women (Figure 2). However, after more than a decade of increase in the mortality rates from this cause for women, there was a slight decline in 2007 compared with the previous year (45.7 deaths per 100,000 women in 2006). In contrast, after peaking in the late 1980s at 82.2 deaths per 100,000 men, the male mortality rate from these types of cancers has been on an overall decline for close to 20 years. The growing convergence between male and female mortality rates due to cancers of the respiratory system partially explains the narrowing gap in life expectancy between the sexes over the last three decades.

Figure 2 Standardized mortality rate for cause of death from malignant neoplasms of trachea, bronchus and lung by sex, Canada, 1981 to 2007

There are changes that have occurred in patterns of other causes of death which may be at least partially related to an aging population. Deaths due to chronic diseases such as diabetes have accounted for an overall increasing number of deaths from the early 1980s to the early 2000s for both men and women. However, there has been a downward trend for both sexes over the past few years but it is too soon to determine if this is a new trend, perhaps as the result of greater awareness and publicity campaigns, or simply annual fluctuations. In 2007, there were 7,400 deaths related to diabetes, accounting for 3.1% of all deaths that year (Figure 3). This is lower than in 2003 when there were close to 8,000 deaths.

Figure 3 Number of deaths due to diabetes mellitus (diabetes) by sex, Canada, 1981 to 2007

Alzheimer's disease is another example of a chronic disease that could affect a growing number of older persons and potentially account for more deaths as the population ages. While it is not a new disease, it is now differentiated from overall senile dementia. It has only been classified separately since 1979 and further conceptual changes over time have resulted in difficulty making historical comparisons prior to 2000. In 2007, there were 5,900 deaths that were attributed to Alzheimer's disease, which represented 2.5% of all deaths that year (3.6% of all deaths for women and 1.5% of all deaths for men). The majority of deaths from Alzheimer's disease (82.4%) occurred for seniors aged 80 years and over.

Leading causes of death by age group

The leading cause of death in 2007 varied according to age groups. For newborns in their first year of life, the leading cause of death was congenital malformations, deformations and chromosomal abnormalities. In total, deaths from these causes accounted for 21.7% of all deaths to babies during the first year of life (Table 2). The second leading cause of death for infants was disorders related to short gestation and low birth weight which were responsible for 13.2% of infant deaths in 2007.

Table 2 Leading cause of death by age group, Canada, 2007

For individuals from age one to age 44, the leading cause of death was from accidents, particularly for those in their late teens and early twenties. More than two-fifths of 15 to 24 year olds (42.3%) died from such causes, as did close to three in ten (29.0%) children aged one to 14 years and 22.7% of 25 to 44 year olds. While the second leading cause of deaths for both one to 14 year olds and 25 to 44 year olds was cancer (17.4% and 20.8%, respectively), for those aged 15 to 24 years, it was suicide or intentional self-harm, accounting for more than one in five (21.1%) deaths to this age group in 2007. Suicide was the third leading cause of death among 25 to 44 year olds, accounting for 15.1% of deaths in this age group in 2007.

For 45 to 64 year olds, cancer was the leading cause of death in 2007 (44.5% of all deaths) followed by heart disease (17.3%) and accidents (5.2%). For 65 to 79 year-olds, cancer caused 40.4% of all deaths for this age group followed by heart disease (20.0%) and chronic lower respiratory diseases (5.4%). More than three-fifths of all deaths in each of the 45 to 64 year age group (61.7%) and 65 to 79 year age group (60.3%) were attributed to the two causes of cancer and heart disease in 2007.

For people in their eighties and over, the leading cause of death was heart disease, accounting for 25.6% of all deaths to this age group in 2007. The second leading cause of death for seniors age 80 and over was cancer (19.2%) followed by stroke (8.1%).

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