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OVERVIEW

This electronic publication details summary data for registration year 2003 for underlying causes of death, multiple causes of death and perinatal deaths. It is a precursor to the hard copy publication Causes of Death Australia (Cat 3303.0) which is due for release 24 February 2005. This publication will contain the full standard set of tables.

SECTION 1 UNDERLYING CAUSE OF DEATH

INTRODUCTION

All deaths registered in 2003 have been coded using the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10) as release by the World Health Organization.

CAUSES OF DEATH

There were 132,292 deaths registered in 2003, consisting of 68,330 male and 63,962 female deaths. Diseases of the circulatory system (eg cardiovascular disease, stroke) were the underlying cause of death of 36.9% of all deaths registered in 2003 with Malignant neoplasms (cancer) contributing a further 28.4%. Other significant contributors were Diseases of the respiratory system (9.0%) and External causes (5.9%).

DISEASES OF THE CIRCULATORY SYSTEM

There were 48,835 deaths registered in 2003 with an underlying cause of death of Diseases of the circulatory system. There were 13,534 male deaths and 11,905 female deaths attributed to Ischaemic heart diseases. This represents 52.1% of all deaths with an underlying cause of Diseases of the circulatory system. Cerebrovascular diseases (stroke) comprised 25.1% (12,240 deaths).

MALIGNANT NEOPLASMS (CANCER)

In 2003, there were 37,558 deaths registered with an underlying cause of Malignant neoplasms. There were 21,081 male deaths and 16,477 female deaths in 2003 due to Cancer. Leading types of Cancer for males included Malignant neoplasms of the digestive organs (28.4% of all male Malignant neoplasms), Lung cancer (21.4%) and Prostate cancer (13.5%). For females the leading types of Cancer were Malignant neoplasms of the digestive organs (28.4%), Breast cancer (16.5%) and Lung cancer (15.0%). These contributions for both males and females are very similar to those recorded in 2002.

DISEASES OF THE RESPIRATORY SYSTEM

In 2003, there were 11,892 deaths registered due to Diseases of the respiratory system. The major contributors to these deaths in 2003 were Chronic lower respiratory diseases (including asthma, emphysema and bronchitis) (50.3%) and Influenza and pneumonia (30.0%). There were more male deaths (3,373) than female deaths (2,612) due to Chronic lower respiratory diseases, while deaths due to Influenza and pneumonia were higher for females (2,008) than males (1,558).

EXTERNAL CAUSES

External causes relate to deaths from accidents, poisonings and violence and were responsible for 7,749 deaths in 2003 compared to 7,820 in 2002. Deaths due to Intentional self-harm (suicide) accounted for 28.6% of all deaths due to External Causes. Deaths from Transport accidents comprised 23.4%. The 2,213 deaths registered due to Suicide is a 4.6% decrease on the number registered in 2002 (2,320).

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, such as an Accidental fall, leading to the fatal injury. 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 132,292 deaths registered in 2003, there were 398,559 causes reported (including 14,536 injuries or 3.6% of total causes mentioned) giving a mean of 3.0 causes per death. In 19.4% of all deaths, only one cause was reported, whereas 55.9% 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.

			Reported with.....................................................
Underlying cause of death and ICD code	Number of Deaths	Reported alone	One other cause	Two other causes	Three other causes	Four or more other causes	Total number of causes mentioned	Mean number of causes
Certain infectious and parasitic diseases (A00-B99)	1754	218	311	410	366	449	6173	3.5
Malignant neoplasms (C00-C97)	37558	14122	9094	6785	3770	3787	89726	2.4
Diabetes mellitus (E10-E14)	3389	38	356	921	890	1184	13965	4.1
Ischaemic heart diseases (I20-I25)	25439	2773	5459	6633	5206	5368	85380	3.4
Cerebrovascular diseases (I60-I69)	12240	2060	3230	3151	2104	1695	36067	2.9
Influenza and pneumonia (J10-J18)	3566	1141	1095	711	380	239	8340	2.3
Chronic lower respiratory diseases (J40-J47)	5985	414	1398	1652	1236	1285	20567	3.4
Renal failure (N17-N19)	1986	144	378	497	425	542	7296	3.7
Accidents (V01-X59)	4865	8	1979	928	730	1220	17118	3.5
Intentional self-harm (X60-X84)	2213	0	1539	391	166	117	5593	2.5
All causes	132292	25668	32672	30038	21167	22747	398559	3.0

Malignant neoplasms (cancer) were the underlying cause of death for 37,558 deaths in 2003. It was reported as the only cause of death in 37.6% of these deaths and has a relatively low incidence being reported with other associated causes. For males, Cancer was reported alone in 35.7% of deaths whereas for females they were reported alone in 40.0% of deaths with Cancer as the underlying cause.

Diabetes mellitus was reported alone in only 1.1% of deaths where it was the underlying cause. The most common associated causes reported with Diabetes mellitus were Ischaemic heart diseases (reported in 53.1% of Diabetes mellitus deaths), Renal failure (25.5%) and Cerebrovascular diseases (23.6%).

Influenza and pneumonia was reported alone in 32.0% of deaths where it was the underlying cause whereas Chronic lower respiratory diseases (including asthma, emphysema and bronchitis) was reported alone in only 6.9% of cases. The most common associated cause reported with Chronic lower respiratory diseases as the underlying cause was Influenza and pneumonia which was reported in 34.2% of these deaths.

In 2003, there were 4,865 deaths due to Accidents. For these deaths, 17,118 multiple causes were reported giving an average of 3.5 causes per death, reflecting the number of associated injuries.

SECTION 3 PERINATAL DEATHS

INTRODUCTION

Perinatal deaths comprise stillbirths (fetal deaths) and deaths of infants within the first 28 days of life (neonatal deaths). In Causes of Death Australia (Cat 3303.0) publications from 1997, these deaths have included infants and fetuses weighing at least 400 grams or having a gestational age of 20 weeks or more when birthweight is unknown. Prior to this, data was based on the World Health Organisation recommended definition which includes infants and fetuses weighing at least 500 grams or having a gestational age of 22 weeks (refer to Explanatory Notes, paragraphs 6-9 for further information on perinatal death statistics).

TRENDS IN PERINATAL DEATHS

In 2003, there were 2,020 perinatal deaths registered in Australia, compared with 2,019 registered in 2002. This represents a decrease of 18.1% on the number registered in 1993 (2,467 deaths). In 2003, there were 1,288 fetal deaths and 732 neonatal deaths. Fetal deaths increased by 3.9% on the number registered in 2002 while neonatal deaths decreased by 6.0%.

The perinatal death rate remained unchanged between 2002 and 2003 at 8.0 deaths per 1,000 total relevant births (see Glossary, death rates for further information).

In 2003, the sex ratio of male perinatal deaths for every 100 female perinatal deaths was 123, compared to the ratio of 122 recorded in 2002.

Between 1993 and 2003, the perinatal death rate declined from 9.4 to 8.0 deaths per 1,000 total relevant births. During this period the fetal rate declined by 10.5% (5.7 to 5.1 per 1,000 total relevant births) whilst the neonatal rate fell by 21.6% (3.7 to 2.9 per 1,000 live births).

For the first time, the neonatal death rate has dropped to below three deaths per 1,000 live births.