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3303.0 - Causes of Death, Australia, 2005  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 14/03/2007   
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NOTES

ABOUT THIS ISSUE
This publication brings together statistics and indicators for deaths, including perinatal deaths, registered in Australia in 2005. These statistics have been compiled from data made available to the Australian Bureau of Statistics (ABS) by the Registrar of Births, Deaths and Marriages in each state or territory.

All deaths registered in 2005 have been coded using the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10) as released by the World Health Organisation.

CHANGES TO THIS ISSUE
This issue now includes a publication and spreadsheets. The number of tables in the publication has been reduced and some tables have been changed. All publication tables are available in the spreadsheets. The spreadsheets also include the data that have been removed from the publication and additional time series information. From 2005 onwards, Causes of Death, Australia (3303.0) will include a publication and spreadsheets.

CAUTION
The quality of cause of death coding is affected by a range of factors including delays in finalising coronial processes. Paragraphs 27 to 29 of the Explanatory Notes explain some recent improvements in the quality of cause of death coding and highlight areas where both the level of recorded deaths attributed to certain causes, and observed changes over time in those causes, are likely to have been affected by delays in finalising a cause.


UNDERLYING CAUSE OF DEATH

INTRODUCTION
All deaths registered in 2005 have been coded using the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10) as released by the World Health Organization (WHO).

CAUSES OF DEATH
There were 130,714 deaths registered in 2005, a lower number of deaths than the 132,508 registered in 2004. The standardised death rate recorded in 2005 was 598 deaths per 100,000 population, lower than the standardised death rate of 626 deaths per 100,000 population in 2004 and 778 deaths per 100,000 population in 1995.

Males accounted for 67,241 (51.4%) deaths registered in 2005, similar to previous years with 68,395 (51.6%) in 2004 and 68,330 (51.7%) in 2003. Female deaths totalled 63,473 (48.6%) in 2005, 64,113 (48.4%) in 2004 and 63,962 (48.3%) in 2003.

The standardised death rate for males in 2005 was 728 deaths per 100,000, a decrease from 770 per 100,000 in 2004 and 983 deaths per 100,000 in 1995. Over the same period, female standardised death rates have also decreased, from 623 per 100,000 population in 1995 and 511 in 2004, to 490 per 100,000 in 2005.

The Northern Territory recorded the highest standardised death rate in 2005 (855 deaths per 100,000 population), while the ACT recorded the lowest rate (563 deaths per 100,000 population). The Northern Territory experienced an increase from 2004 when it was 822. South Australia and the ACT both experienced small increases. All other states decreased from 2004. Decreases for New South Wales and Queensland are partly due to delays in processing death registrations. (See Explanatory Note 12 for more information).

All states have experienced decreases in standardised death rates from 1995. The Northern Territory had the largest decrease from 1,143 to 855 deaths per 100,000 population and the ACT the smallest, from 655 to 563.

In 2005, Malignant neoplasms were the main underlying cause for 38,380 deaths, representing 29.4% of all deaths. This was an increase from the 37,989 (28.7%) deaths with Malignant neoplasms as the main underlying cause in 2004. Ischaemic heart disease was the underlying cause of 23,570 deaths in 2005, and 24,576 deaths in 2004. This cause accounted for 18.0% and 18.5% of all deaths in 2005 and 2004 respectively. As the graph below shows, the gap between the proportion of deaths due to Malignant neoplasms and Ischaemic heart disease continued to widen. The proportion of deaths due to Ischaemic heart disease has consistently decreased from 23.7% in 1995 to 18.0% in 2005. The proportion of deaths due to Malignant neoplasms has increased from 27.0% to 29.4% over the same period.

Graph: Selected causes of death as a proportion of all deaths, Australia



MALIGNANT NEOPLASMS
There have been decreases in rates for most types of cancers between 1995 and 2005. The standardised death rate from Malignant neoplasms was 178 deaths per 100,000 population in 2005 compared with 205 per 100,000 in 1995.

Deaths from cancers of the Digestive organs fell from 57 deaths per 100,000 population in 1995 to 49 per 100,000 in 2005. More specifically, the largest decrease was for Colon cancer, which fell from 21 deaths per 100,000 in 1995 to 12 deaths per 100,000 population in 2005.

Over the same period, there were marginal increases (less than 1 death per 100,000) in cancers of the Liver and intrahepatic bile ducts, Melanoma of skin and Rectosigmoid junction, rectum, anus and anal canal.

The standardised death rate for males from Malignant neoplasms decreased from 271 to 226 per 100,000 population between 1995 and 2005. The corresponding decrease for females was from 160 per 100,000 in 1995 to 141 per 100,000 in 2005.

There were other major decreases in the standardised death rate in particular types of cancers for males between 1995 and 2005. Deaths from cancers of the Digestive organs fell from 75 to 62 deaths per 100,000 population between 1995 and 2005. The standardised death rate from Prostate cancer fell from 41 per 100,000 in 1995 to 33 per 100,000 in 2005.

There was also a major decrease in male deaths from Trachea, bronchus and lung cancers, which fell from 64 per 100,000 in 1995 to 48 per 100,000 in 2005.

There were increases in the standardised death rate in particular types of cancers for males between 1995 and 2005. These include cancer of the Liver and intrahepatic bile ducts from 5 to 6 per 100,000 and Melanoma of skin from 8 to 9 per 100,000.

For females there was a decrease in deaths from Breast cancer, which fell from 31 deaths per 100,000 of the female population in 1995 to 24 deaths per 100,000 in 2005. Female deaths from cancers of the Digestive organs fell from 44 to 38 per 100,000 population between 1995 and 2005.

Between 1995 and 2005, the standardised death rate for Liver and intrahepatic bile ducts for females increased from 2 to 3 per 100,000 and Trachea, bronchus and lung from 22 to 23 per 100,000.

Graph: Standardised Death Rates, Selected Malignant Neoplasms - Males



Graph: Standardised Death Rates, Selected Malignant Neoplasms - Females

ISCHAEMIC HEART DISEASE
The standardised death rate for Ischaemic heart disease was 106 deaths per 100,000 population in 2005 compared with 187 deaths per 100,000 in 1995.

The standardised death rate for Acute myocardial infarction, which in 2005 accounted for 50.3% of all Ischaemic heart disease deaths, fell from 115 deaths per 100,000 population in 1995 to 54 deaths per 100,000 in 2005.

The percentage decreases in Ischaemic heart disease for males and females over this period were similar at 23% and 17% respectively. However, the standardised death rates were different. In 2005, there were 137 male deaths per 100,000 males and 81 per 100,000 females compared with 248 per 100,000 for males and 141 per 100,000 for females, in 1995.

EXTERNAL CAUSES
Deaths from External causes include those from accidents, poisonings and violence. In 2005, External causes accounted for 8,015 deaths, or 6.1% of all registered deaths. This was a slight increase from 2004 when 7,966 deaths (6.0%) were attributed to external causes. The standardised death rate was 38 per 100,000 of population in 2005, a decrease from 39 in 2004 and from 42 per 100,000 population in 1995.

There were 2,101 deaths coded to Intentional self-harm (suicide) in 2005, more than the 2,098 deaths in 2004. The standardised death rate from suicide in 2005 was 16 per 100,000 males and 4 per 100,000 females, which were both decreases from the respective rates recorded in 2004.

It should be noted that there are a number of issues affecting the coding of intentional self harm (see Explanatory note 29).

DEATHS OF INDIGENOUS PEOPLE
Coverage of deaths of Aboriginal and Torres Strait Islander Australians is incomplete due to differential levels of recording of Indigenous status on death information forms across jurisdictions. Deaths by underlying cause by Indigenous status are presented for selected separate jurisdictions in Table 1.7 (see Explanatory Note 30).

Caution should be exercised in analysing these data, taking account of known coverage deficiencies. For recent analyses and advice on the preferred levels of jurisdictional analysis, users are referred to Chapter 9 of "The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2005" (ABS cat no 4704.0).

YEARS OF POTENTIAL LIFE LOST (YPLL)
Years of potential life lost is a measure of premature mortality for deaths occurring between the ages of 1 year and 78 years inclusive. (Refer to the Technical Note for further detail). In 2005, the estimates of years of potential life lost (YPLL) were 606,597 years for males and 328,904 years for females for all causes of death. This represents a decrease from 2004 for both males and females, when the estimated YPLL was 615,527 and 339,226 respectively.

There was a slight decrease in the proportion of the YPLL from Malignant Neoplasms from 30.4% for males in 2004 to 29.9% in 2005. In contrast, the proportion of the YPLL from Malignant Neoplasms for females increased slightly from 43.6% in 2004 to 44.4% in 2005. The proportion of the YPLL from Ischaemic heart disease for males decreased slightly from 13.4% in 2004 to 12.9% in 2005 however the proportion for females was 6.5% for both 2004 and 2005.

As years of potential life lost takes age at death into account, the proportion of YPLL for particular causes will vary compared to those causes as a proportion of deaths in the 1-78 years age group. Major contributors to YPLL are deaths in younger age groups and large numbers of deaths in older age groups within the 1-78 years group.

For males there is a difference between the proportion of the YPLL from Malignant Neoplasms (29.9%) and the proportion of all male deaths aged 1-78 years from the same underlying cause (38.3%). There is very little difference for females between the proportion of years of potential life lost (44.4%) and the proportion of all female deaths aged 1-78 years with Malignant neoplasms as the underlying cause (45.1%).

There were also significant variations when specific types of cancer are considered. Prostate cancer represented only 1.6% of the YPLL for males aged 1–78 years but was reported as the underlying cause in 3.5% of all male deaths within that age range.

In 2005, 71.7% of all Prostate cancer deaths were of males aged 65 years and over, with the 75-84 years age group accounting for 45.7% of all Prostate cancer deaths.

For females in 2005, Breast cancer represented 10.9% of YPLL while it was reported as the underlying cause in 8.6% of all deaths of females aged 1–78 years.

Nearly half (46.7%) of all Breast cancer deaths occurred among females aged under 65 years old and a further 17.9% occurred among females in the 65-74 years age group.



Graph: Percentage of years of potential life lost, selected underlying causes


MULTIPLE CAUSE OF DEATH

INTRODUCTION
Multiple causes of death include all causes and conditions reported on the death certificate (i.e. both underlying and associated causes; see Glossary for further details). Deaths due to External causes are those which occur as a result of accidents, poisonings and/or violence. They are classified according to the event, leading to the fatal injury (such as an Accidental fall). Multiple cause data for External causes include the nature of injury or poisoning, as well as any other causes reported on the death certificate.

NUMBER OF MULTIPLE CAUSES
For the 130,714 deaths registered in 2005, there were 404,333 causes reported giving a mean of 3.1 causes per death. In 19.1% of all deaths, only one cause was reported, whereas 57.1% of deaths were reported with three or more causes. The mean number of causes reported per death varies with age, sex and underlying cause of death.

SELECTED MULTIPLE CAUSES
In 2005, Malignant neoplasms represented 29.4% of all underlying cause of death. When associated causes were included it contributed to 40.6% of all deaths as an underlying or associated cause. Similarly, 18.0% of all deaths had Ischaemic heart disease as the underlying cause, but it was found to contribute to 35.1% of all deaths as either an underlying or associated cause. The following table lists the top ten multiple causes of death (underlying and associated causes) appearing on death certificates for deaths registered in 2005, and their corresponding ranking in terms of underlying causes.

Selected multiple causes of death

Multiple causes(a)
Underlying cause
Cause of death and ICD code
no
%
rank
%
rank

Malignant neoplasms (C00-C97)
53,066
40.6
1
29.4
1
Ischaemic heart disease (I20-I25)
45,831
35.1
2
18
2
Cerebrovascular diseases (I60-I69)
22,870
17.5
3
8.8
3
Influenza and pneumonia (J10-J18)
17,442
13.3
4
2.3
7
Heart Failure (I50)
16,763
12.8
5
1.7
10
Hypertensive diseases (I10-I15))
16,115
12.3
6
1.1
15
Renal failure (N17-N19)
15,103
11.6
7
1.4
12
Chronic lower respiratory diseases (J40-J47)
13,977
10.7
8
4.2
4
Organic, including symptomatic, mental disorders (F00-F09)
11,940
9.1
9
2.2
8
Diabetes mellitus (E10-E14)
11,874
9.1
10
2.7
6
Deaths from all causes
404,333
100
100

— nil or rounded to zero (including null cells)
(a) Number of deaths and percentages may add to more than totals because a death certificate can report more than one leading multiple cause.


RELATIONSHIP OF CAUSES
The following table illustrates relationships between the various causes of death in 2005. Malignant neoplasms, the most prevalent underlying cause (38,380 deaths), was reported alone in 36.8% of cases and is less likely to be reported with other more prevalent causes. In contrast, Renal failure was reported alone as the underlying cause in only 6.3% (1,886) of deaths attributed to this cause. It was reported more frequently with associated causes of Ischaemic heart disease and Heart failure.


Selected underlying causes with associate cause(a)

SELECTED UNDERLYING CAUSE
REPORTED WITH SELECTED ASSOCIATED CAUSE


Total no of deaths
Reported alone
Malignant neoplasms (C00-C97)
Ischaemic heart diseases (I20-I25)
Cerebro-
vascular diseases (I60-I69)
Chronic
lower respiratory diseases (J40-J47)
Influenza and pneumonia (J10-J18)
Heart failure (I50)
Renal failure (N17-N19)
no.
%
%
%
%
%
%
%
%

Malignant neoplasms (C00-C97)
38,380
36.8
8.3
3.9
6.3
7.6
3.5
5.9
Ischaemic heart diseases (I20-I25)
23,570
11.4
6.3
10.4
10
6
24.3
11.2
Cerebrovascular diseases (I60-I69)
11,513
14.8
4.9
11.3
4
15.1
5
4.5
Chronic lower respiratory diseases (J40-J47)
5,428
7.6
7.6
19.5
5.4
32.9
17.5
7.9
Influenza and pneumonia (J10-J18)
3,034
28
1.1
16.9
2.3
1.4
10.3
11.3
Heart failure (I50)
2,225
12.8
6.3
0.5
8.2
11.9
23
21
Renal failure (N17-N19)
1,886
6.3
5.9
29.2
9.6
7.5
12.8
29.6

— nil or rounded to zero (including null cells)
(a) This table presents data for selected causes only. Therefore numbers and percentages due to reporting of underlying cause with selected associated causes doe not add to totals.

EXTERNAL CAUSES
In 2005, there were 8,015 deaths due to External causes, with an average of 3.3 causes coded per each of these deaths. The average number of multiple causes coded due to Accidental Falls was 4.5 and reflects the number of injuries sustained. In 2005, Transport accidents accounted for 21.2% of all injuries due to External causes, with 43.6% of these injuries being to the head or thorax. Intentional self-harm accounted for 23.8% of total injuries due to External causes, and of these injuries, Asphyxiation was the most common (42.7%).

PERINATAL DEATHS

INTRODUCTION
Perinatal deaths comprise stillbirths (fetal deaths) and deaths of infants within the first 28 days of life (neonatal deaths). In this publication (and in previous editions since 1997), these deaths are defined to include infants and fetuses weighing at least 400 grams or having a gestational age of 20 weeks.

The exception to this is Table 3.1, which is based on the World Health Organisation (WHO) recommended definition and includes infants and fetuses weighing at least 500 grams or having a gestational age of 22 weeks. Refer to Explanatory Notes, paragraphs 6-10 for further information on perinatal death statistics. Further tables based on either definition are available from the ABS.

TRENDS IN PERINATAL DEATHS
In 2005, there were 2,213 perinatal deaths registered in Australia, compared with 2,048 registered in 2004. The number of fetal deaths in 2005 was 1,411, an increase of 4.8% on the number registered in 2004 (1,347). Neonatal deaths have increased 14.4% from 701 in 2004 to 802 in 2005. Compared with 1995, the number of registered perinatal deaths is 8.6% lower (207). The proportion of perinatal deaths where birth weight was less than 1000 grams was 49.5% in 2005, while 48.8% of deaths had a gestational period of less than 28 weeks.

In 2005, there were 117 male perinatal deaths for every 100 female perinatal deaths, compared with a ratio of 128 in 2004.

The perinatal death rate increased from 8.0 deaths per 1,000 total relevant births in 2004 to 8.5 deaths per 1,000 total relevant births in 2005 (see Glossary, death rates for further information). The perinatal death rate was higher ten years ago in 1995 at 9.4 per 1,000 total relevant births. Over the same period, the fetal rate also decreased from 5.9 to 5.4 per 1,000 total relevant births and the neonatal rate decreased from 3.5 to 3.1 deaths per 1,000 total relevant births.

Graph: Trends in perinatal deaths



Northern Territory had the highest perinatal death rate in 2005 (14.6 per 1,000 total relevant births), while South Australia had the lowest rate (7.3 per 1,000 total relevant births).

AGE OF MOTHER
The highest perinatal death rates in 2005 occurred in the under 20 years age group at 17.7 per 1,000 total relevant births and the 40 years and over age group at 12.5.

The numbers of deaths for these age groups were small. Mothers aged 40 years and over accounted for the lowest proportion of births (3.4%) and perinatal deaths (5.0%). The youngest group of mothers (aged under 20 years) accounted for 4.1% of all births and 8.7% of all perinatal deaths.

In contrast, the perinatal death rate for mothers aged 30-34 years was the lowest (6.8 per 1,000 total relevant births) while mothers in this age group accounted for the highest proportion of births (34.3%) and perinatal deaths (27.6%).

While the overall perinatal death rate has decreased between 1995 and 2005, this is not consistent across all age groups. In 2005, the perinatal death rate for mothers aged less than 20 years was 17.7 per 1,000 total relevant births, an increase from 14.2 per 1,000 total relevant births in 1995.

The perinatal death rate for mothers aged 40 years or more was 12.5 per 1,000 total relevant births in 2005, a decrease from 13.4 per 1,000 total relevant births in 1995.



Graph: Perinatal deaths, rates - age of mother

CONDITION IN FETUS/INFANT
In 2005, nearly a third (29.8%) of all perinatal deaths were not assigned a specific cause of death in the fetus/infant. Most of these were fetal deaths. While 44.9% of all fetal deaths registered in 2005 reported no specific cause, the corresponding figure for neonatal deaths was 3.2%.

Congenital malformations, deformations and chromosomal abnormalities accounted for 18.8% of perinatal deaths, while Respiratory and cardiovascular disorders specific to the perinatal period contributed a further 15.5% and Disorders related to length of gestation and fetal growth contributed 14.0%.

Congenital malformations, deformations and chromosomal abnormalities was also the most commonly reported cause for fetal deaths (14.2%) and neonatal deaths (26.9%).

Other conditions reported in fetal deaths registered in 2005 included Respiratory and cardiovascular disorders specific to the perinatal period (12.1%), and more specifically Intrauterine hypoxia (11.3%). Disorders related to length of gestation and fetal growth accounted for 8.2% including Extremely low birth weight (4.3% of fetal deaths).

Disorders related to length of gestation and fetal growth accounted for 24.1% of neonatal deaths in 2005, more specifically Extremely low birth weight (22.8%). Respiratory and cardiovascular disorders specific to the perinatal period accounted for 21.3% of neonatal deaths.

CONDITION OF MOTHER
Perinatal deaths differ from general deaths because a condition may be reported in the record for the fetus/infant, the mother, or for both. A maternal condition was reported in 1,292 (58.4%) of the 2,213 perinatal deaths registered in 2005. Complications of placenta, cord and membranes was the most frequently reported maternal cause, accounting for 533 or 24.1% of all perinatal deaths, followed by Maternal conditions that may be unrelated to present pregnancy (342 or 15.5% of perinatal deaths) and Maternal complications of pregnancy (335 or 15.1% of perinatal deaths).

YEAR OF OCCURRENCE

INTRODUCTION
Information contained in the preceding chapters of this publication refer to deaths registered during the 2005 calendar year. In this chapter, death statistics are based on a year of occurrence, i.e. the year in which the death actually occurred.

Some countries publish death statistics on a year of registration basis, some on a year of occurrence basis, and others on both. Although some deaths can be registered many years after their date of occurrence, the international standard for publishing on a year of occurrence basis is to include deaths registered within the relevant occurrence year and the year immediately following. Accordingly, this practice has been adopted for the presentation of year of occurrence data in this publication to facilitate international comparisons. Analysis of deaths in Australia has shown that the number of deaths registered after the second year are not significant (less than 0.1%).

Year of occurrence data allow for seasonal analysis, and data are not distorted by the effects of late registrations or changes in time lags in processing registrations. In those countries where registration systems are complete and timely, there is not a significant difference between the number of deaths derived on a registration basis and those on a year of occurrence basis. For Australia, approximately 95% of deaths occurring in a particular year are registered in that year. However, variations can occur in certain subsets of the population and for particular causes of death. For instance, while 96.1% of the total 132,230 deaths that occurred in 2004 were registered in 2004, only 90.0% of the 2,092 Indigenous deaths and 93.3% of deaths due to External causes that occurred in 2004 were registered in that year. More detailed data for specific causes or population groups are available from the ABS on request.

COMPARISON OF YEAR OF OCCURRENCE AND YEAR OF REGISTRATION DATA FOR 2004
The following table shows the percentage differences for selected underlying causes of death and indigenous deaths, presented on a year of occurrence and year of registration basis in 2004. In 2004, the percentage differences were small. The biggest differences occurred with Accidents followed by Intentional self harm and Influenza and pneumonia.

Selected underlying causes of death

YEAR OF REGISTRATION
YEAR OF OCCURRENCE
- 2004 (a)
DIFFERENCE(b)
Year of occurrence
2004 (c)
Total
2004 (d)

INDIGENOUS
All Causes
1,883
2,136
2,092
-2.1

Cause of death and ICD code
no
no
no
%

TOTAL
All Causes
127,014
132,508
132,230
-0.2
Malignant neoplasms (cancer) (C00-C97)
36,593
37,989
38,004
0.0
Ischaemic heart diseases (I20-I25)
23,578
24,576
24,541
-0.1
Cerebrovascular diseases (stroke) (I60-I69)
11,580
12,041
12,015
-0.2
Chronic lower respiratory diseases (including asthma, emphysema and bronchitis (J40-J47)
5,573
5,785
5,789
0.1
Accidents (V01-X59)
4,844
5,209
5,176
-0.6
Diabetes mellitus (E10-E14)
3,422
3,599
3,564
-1.0
Influenza and pneumonia (J10-J18)
3 255
3 381
3,363
-0.5
Diseases of arteries, arterioles and capillaries (including atherosclerosis and aortic aneurysm (I70-I79)
2,384
2,477
2,472
-0.2
Heart failure (I50)
2,185
2,279
2,255
-1.1
Intentional self-harm (X60-X84)
1,953
2,098
2,109
0.5
External causes of morbidity and mortality (V01-Y98)
7,414
7,966
7,948
-0.2
All other causes
31,030
32,415
32,279
-0.4

— nil or rounded to zero (including null cells)
(a) Deaths occurring in 2004, registered in 2004
(b) Deaths occurring in 2004, registered in 2004 and in 2005
(c) A positive percentage difference indicates that more deaths occurred than were registered in the calendar year.
(d) Includes deaths occurring in years prior to 2004.



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