Australia's leading causes of death, 2016

In 2016, there were 158,504 deaths in Australia (81,867 males and 76,637 females).The leading cause of death was Ischaemic heart disease with 19,077 deaths, or 12.0% of all deaths. People who died from Ischaemic heart diseases in 2016 had a median age at death of 85.1 years. Ischaemic heart disease is a condition that affects the supply of blood to the heart, and includes acute myocardial infarction, angina and chronic ischaemic disease.

Ischaemic heart disease has long been Australia's leading cause of death, but death rates have been declining now for more than 40 years. Even in the past decade, the death rate from Ischaemic heart disease has decreased by more than a third from 99.1 deaths per 100,000 people in 2007 to 62.4 per 100,000 in 2016.

Dementia, including Alzheimer's disease, remains the second leading cause of death in 2016, with 13,126 deaths. Dementia accounted for 8.3% of all deaths in 2016, up from 5.3% of all deaths in 2007. Cerebrovascular diseases (6.6%), Cancer of the trachea, bronchus and lung (5.3%) and Chronic lower respiratory diseases (5.1%) complete the top five leading causes of death. The top five leading causes of death remain unchanged from 2015 and in total these causes accounted for more than one-third (37.3%) of all deaths registered in 2016.

While leading causes for the whole population are unchanged, there has been a change in the leading cause for females. Dementia, including Alzheimer's disease has replaced heart disease as the leading cause among women following a small decrease in heart disease numbers and a further increase in dementia numbers. This is discussed further in relevant sections of this article.

In 2015, the ABS noted an issue with the leading cause grouping of 'Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21)' and deaths certified as 'bowel cancer' which were coded outside of this grouping. Following discussions with the World Health Organization, changes have been made to this grouping which ensure it is more reflective of the actual death count in the Australian context. A full description of the issue and the impact is included later in this section.

The ABS ranks leading causes of death in this publication based on research presented by the World Health Organization (WHO) in the Bulletin of the World Health Organization, Volume 84, Number 4, April 2006, 297-304. Leading causes of death are tabulated based on the underlying cause of death. The underlying cause of death is defined by the World Health Organization as the disease or external event which initiated the train of morbid events leading to death. The ABS also tabulates multiple causes of death, which incorporate all conditions on the death certificate. Multiple causes of death provide insights into diseases or injuries which are less likely to be an underlying cause of death, but are still significant health issues. Multiple cause analyses are provided in other chapters and data cubes of this publication.

2.1 Leading causes of death(a), Australia - selected years - 2007, 2011, 2016(b)(e)
	2007		2011		2016		Median Age (2016)
Cause of death and ICD code	no.	Rank	no.	Rank	no.	Rank	years
Ischaemic heart diseases (I20-I25)	22,956	1	21,526	1	19,077	1	85.1
Dementia, including Alzheimer disease (F01, F03, G30)	7,318	4	9,864	3	13,126	2	88.8
Cerebrovascular diseases (I60-I69)	11,505	2	11,245	2	10,451	3	86.3
Malignant neoplasm of trachea, bronchus and lung (C33, C34)	7,635	3	8,117	4	8,410	4	74.0
Chronic lower respiratory diseases (J40-J47)	5,787	5	6,565	5	8,048	5	81.7
Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0)(c)	4,954	6	5,206	6	5,462	6	77.0
Diabetes (E10-E14)	3,818	7	4,211	7	4,770	7	81.8
Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96)	3,608	8	3,979	8	4,372	8	77.2
Heart failure and complications and ill-defined heart disease (I50-I51)	3,438	9	3,486	9	3,379	9	88.5
Diseases of the urinary system (N00-N39)	3,237	10	3,384	10	3,352	10	87.2
Influenza and pneumonia (J09-J18)	2,634	13	2,487	13	3,334	11	88.8
Malignant neoplasm of prostate (C61)	2,939	11	3,294	11	3,248	12	82.0
Malignant neoplasms of breast (C50)	2,709	12	2,938	12	3,004	13	70.5
Malignant neoplasm of pancreas (C25)	2,252	14	2,416	14	2,911	14	75.0
Intentional self-harm [suicide] (X60-X84)(d)	2,227	15	2,392	15	2,862	15	43.3
Accidental falls (W00-W19)	1,337	21	1,872	17	2,666	16	87.2
Cardiac arrhythmias (I47-I49)	1,406	20	1,617	19	2,326	17	88.3
Hypertensive diseases (I10-I15)	1,640	17	1,805	18	2,228	18	88.1
Melanoma and other malignant neoplasms of skin (C43-C44)	1,728	16	2,087	16	1,960	19	77.2
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	1,109	26	1,423	23	1,864	20	71.3
(a) Causes listed are the top 20 leading causes of death for 2016, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecific nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.
(b) See Explanatory Notes 72-101 for further information on specific issues related to interpreting time-series and 2016 data.
(c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) that appear in this table now also includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). This differs to how these cancers have been grouped in leading cause data for previous Causes of Death, Australia publications. Comparisons with data for this leading cause, and associated leading cause rankings, that appear in previous publications should therefore be made with caution. See Explanatory note 37 in this publication for further details. (d) Excludes Sequelae of suicide (Y87.0) as per the WHO recommended tabulation of leading causes. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 88-96 in this publication. (e) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15.

Australia's aging population and causes of death

Globally, there are strong links between country incomes, the quality of healthcare systems, life expectancy and leading causes of death. WHO data shows that in low income countries, leading causes of death include many communicable diseases such as lower respiratory infections, HIV/AIDS and Diarrhoeal diseases. In contrast, leading causes for high income countries were primarily non-communicable diseases which affect mostly elderly people, such as heart disease, stroke and dementia (World Health Organization).

Australia is a high income country with a particularly high average life expectancy. Leading causes of death in Australia align closely with other high income countries, although dementia in Australia is ranked more highly (currently 2nd) than it is on average among other high income countries (currently 3rd) (World Health Organization).The proportion of elderly people in Australia has been increasing, and will continue to do so as life expectancy increases and medical treatments improve. This has implications for future health service planning, especially in relation to conditions such as heart disease, dementia and strokes which are common causes of death among elderly Australians.

Dementia death rate continues to increase

There were 158,504 deaths in Australia in 2016. 1 in 12 had dementia as the underlying cause of death (13,126 deaths). This equates to around 36 deaths per day. Measured as a standardised death rate, dementia accounted for 40.9 deaths per 100,000 people in 2016 compared to 30.7 in 2007.

When compared to other leading causes of death over this period, the mortality rate for dementia has increased by the largest margin. Rates for the top three leading causes in 2007 (heart disease, lung cancer and strokes) all decreased by 2016. In fact, the standardised death rate for heart disease decreased from 99.1 deaths per 100,000 people in 2007 to 62.4 in 2016. As a result dementia has moved from the fourth to the second leading cause of death in Australia.

Individuals who died from dementia were more likely to be over 85, with a median age of 88.8 in 2016, and more likely to be female (accounting for 64.4% of all dementia deaths).

Dementia is now the leading cause of death for females, with 8,447 deaths recorded in 2016, an increase of 196 deaths compared with 2015 (8,251). The corresponding standardised death rate was 43.3 deaths per 100,000 females. There were 8,207 female deaths from Ischaemic heart disease in 2016 compared with 8,702 in 2015. Heart disease is now the second leading cause of death for females.

Dementia is the third leading cause of death for males, with 4,679 deaths recorded in 2016. Ischaemic heart disease (10,870 deaths) and Lung cancer (5,023 deaths) are the first and second leading causes. Dementia deaths among males increased by 305 deaths from 2015 to 2016, whereas Ischaemic heart disease deaths decreased by 205 deaths.



Years of potential life lost

Counts of deaths provide one measure of the impact of particular diseases, but they do not take into account the ages at which deaths occur. Years of potential life lost (YPLL) measures the extent of 'premature' mortality from specific diseases or trauma, counting the total number of years between age at death and an 'average' life expectancy for deaths that occur before that average age. In Australia, this is assumed to be any death between the ages of 1-78 years, inclusive.

The graph below presents the YPLL count for the top 20 leading causes of death in 2016. While a cause of death may have a lower incidence than that of another, its impact when measured in terms of premature death may be greater as a result of that cause affecting a younger demographic. Intentional self-harm accounted for 1.8% of all deaths, while Ischaemic heart diseases accounted for 12.0%. However, with a median age at death of 43.3 years, intentional self-harm contributed 10.5% of total YPLLs in 2016, compared to 7.6% from Ischaemic heart diseases which had a median age at death of 85.1 years.



Leading causes of death by sex

In 2016, Dementia, including Alzheimer's disease became the leading cause of death for females, accounting for 8,447 deaths. This represents a very significant milestone, with heart disease having been the leading cause for both sexes since the early part of the 20th century. Numbers and rates of death from heart disease have been decreasing for almost 50 years, while deaths from diseases such as dementia have increased as life expectancy has increased. While heart disease remains the leading cause for men, it is likely that in time this will also be surpassed by dementia as treatments for other leading causes such as heart disease improve and men live longer lives.

Seven of the top 10 leading causes are common to both males and females. Malignant neoplasms of prostate (6th), Malignant neoplasms of lymphoid, haematopoietic and related tissue (9th) and Intentional self-harm (10th) are only represented within the male top 10 causes. Malignant neoplasms of breast (6th), Influenza and pneumonia (9th) and Heart failure (10th) are only represented in the female top 10 causes of death.

Males			Females
Cause of death and ICD code	no.	rank	Cause of death and ICD code	no.	rank
Ischaemic heart diseases (I20-I25)	10,870	1	Dementia, including Alzheimer disease (F01, F03, G30)	8,447	1
Malignant neoplasm of trachea, bronchus and lung (C33, C34)	5,023	2	Ischaemic heart diseases (I20-I25)	8,207	2
Dementia, including Alzheimer disease (F01, F03, G30)	4,679	3	Cerebrovascular diseases (I60-I69)	6,212	3
Cerebrovascular diseases (I60-I69)	4,239	4	Chronic lower respiratory diseases (J40-J47)	3,891	4
Chronic lower respiratory diseases (J40-J47)	4,157	5	Malignant neoplasm of trachea, bronchus and lung (C33, C34)	3,387	5
Malignant neoplasm of prostate (C61)	3,248	6	Malignant neoplasms of breast (C50)	2,976	6
Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0)	2,975	7	Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0)	2,487	7
Diabetes (E10-E14)	2,578	8	Diabetes (E10-E14)	2,192	8
Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96)	2,561	9	Influenza and pneumonia (J09-J18)	1,912	9
Intentional self-harm [suicide] (X60-X84)	2,149	10	Heart failure and complications and ill-defined heart disease (I50-I51)	1,887	10
Malignant neoplasm of pancreas (C25)	1,500	11	Diseases of the urinary system (N00-N39)	1,867	11
Heart failure and complications and ill-defined heart disease (I50-I51)	1,492	12	Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96)	1,811	12
Diseases of the urinary system (N00-N39)	1,485	13	Cardiac arrhythmias (I47-I49)	1,429	13
Influenza and pneumonia (J09-J18)	1,422	14	Malignant neoplasm of pancreas (C25)	1,411	14
Melanoma and other malignant neoplasms of skin (C43-C44)	1,314	15	Accidental falls (W00-W19)	1,380	15
Accidental falls (W00-W19)	1,286	16	Hypertensive diseases (I10-I15)	1,354	16
Malignant neoplasm of liver and intrahepatic bile ducts (C22)	1,231	17	Malignant neoplasm of ovary (C56)	938	17
Cirrhosis and other diseases of liver (K70-K76)	1,176	18	Diseases of the musculoskeletal system and connective tissue (M00-M99)	899	18
Parkinson's disease (G20)	1,102	19	Septicaemia (A40-A41)	870	19
Land transport accidents (V01-V89)	1,018	20	Symptoms, signs and ill-defined conditions (R00-R99)	861	20

(a) Causes listed are the top 20 leading causes of death for 2016, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecific nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.

(b) See Explanatory Notes 72-101 for further information on specific issues related to interpreting time-series and 2016 data.

(c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) that appear in this table now also includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). This differs to how these cancers have been grouped in leading cause data for previous Causes of Death, Australia publications. Comparisons with data for this leading cause, and associated leading cause rankings, that appear in previous publications should therefore be made with caution. See Explanatory note 37 in this publication for further details. (d) Excludes Sequelae of suicide (Y87.0) as per the WHO recommended tabulation of leading causes. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 88-96 in this publication. (e) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15.

The graph below depicts the causes with the largest sex ratios, within the Top 20 leading causes of death in Australia in 2016 (excluding sex-specific causes such as prostate and breast cancer). Intentional self-harm was the cause most likely to affect males, with 301 male deaths for every 100 female deaths. Dementia, including Alzheimer's disease, was the cause which most predominantly affected females, with 55 male deaths for every 100 female deaths.


Greatest sex ratios within the 20 leading causes of death. 2016 (a)(b)(c)(d)



(a) Causes listed are the leading causes of death for all deaths registered in 2016, based on WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 for further information.
(b) See Explanatory Notes 72-101 for further information on specific issues related to interpreting time-series and 2016 data.
(c) Excludes Sequelae of suicide (Y87.0) as per the WHO recommended tabulation of leading causes. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 88-96 in this publication.
(d) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15.

Bowel cancer now the sixth leading cause of death

When classifying causes of death, the ABS uses an internationally agreed common rule set determined by the World Health Organization (WHO). This rule set states that cancers of the digestive tract must be coded to a specified site within the digestive system (C15-C26). Where the site is not specified in sufficient detail on the death certificate, the rules state that the cancer should be coded to a less specified code - in this case C26.0 Malignant neoplasm of the intestinal tract, part unspecified. The term 'bowel cancer' does not specify the location of the cancer within the intestine, and deaths certified using this term are coded to C26.0.

In Australia the term 'bowel cancer' is commonly used by doctors to refer to cancer of the colon or rectum (Bowel Cancer Australia). Deaths certified with this term are coded to C26.0 in line with the internationally agreed rule set, and have not historically been included with the leading cause grouping of Colon, sigmoid, rectum and anus cancer (C18-C21).

The assignment of deaths certified as 'bowel cancer' to C26.0 leads to an underestimate of deaths due to colorectal cancer in the Australian context. Following conversations with Australian Cancer experts and the World Health Organization, in 2016 deaths with an underlying cause of Malignant neoplasm of intestinal tract, part unspecified (C26.0) have been included in the leading cause grouping for Colon, sigmoid and rectum and anus cancers (C18-C21).

In 2016, the change to the leading cause grouping Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0) meant that it increased from the seventh to the sixth leading cause of death, overtaking diabetes. Over the past ten years the number of deaths coded to C26.0 has been relatively consistent (see table and graph below), accounted for between 17% (2007) and 22.6% (2010) of this leading cause grouping. Any time series data in this publication will now include C26.0 in the C18-C21 leading cause grouping.

Cause of Death and ICD-10 code(a)	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016
Cancer of the colon, sigmoid, rectum and anus (C18-C21)	4,112	4,125	4,068	4,061	4,087	4,054	4,235	4,170	4,433	4,413
Intestinal tract, part unspecified (C26.0)	842	1,149	1,176	1,186	1,119	1,070	1,138	1,117	1,110	1,049
Total Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0)(c)	4,954	5,274	5,244	5,247	5,206	5,124	5,373	5,287	5,543	5,462
(a) Causes listed are the leading causes of death for all deaths registered in 2016, based on WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 for further information. (b) See Explanatory Notes 72-101 for further information on specific issues related to interpreting time-series and 2016 data. (c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) that appear in this table now also includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). This differs to how these cancers have been grouped in leading cause data for previous Causes of Death, Australia publications. Comparisons with data for this leading cause, and associated leading cause rankings, that appear in previous publications should therefore be made with caution. See Explanatory note 37 in this publication for further details. (e) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15

C18-C21, C26.0 Contribution toward total bowel cancer deaths, 2007-2016 (a)(b)(c)(d)

(a) Causes listed are the leading causes of death for all deaths registered in 2016, based on WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 for further information.
(b) See Explanatory Notes 72-101 for further information on specific issues related to interpreting time-series and 2016 data.
(c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) that appear in this table now also includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). This differs to how these cancers have been grouped in leading cause data for previous Causes of Death, Australia publications. Comparisons with data for this leading cause, and associated leading cause rankings, that appear in previous publications should therefore be made with caution. See Explanatory note 37 in this publication for further details.
(d) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15.

Leading causes of Aboriginal and Torres Strait Islander death

Measures of mortality relating to Aboriginal and Torres Strait Islander people are key inputs into the Closing the Gap strategy, led by the Council Of Australian Governments (COAG). This is a government partnership where work is undertaken with Aboriginal and Torres Strait Islander communities to close the gap in Indigenous disadvantage. Mortality data enables measurement of progress towards key Closing the Gap targets.

In 2016, the standardised death rate for Aboriginal and Torres Strait Islander persons was approximately 60% higher than that of non-Indigenous Australians (921.9 compared with 567.0 deaths per 100,000 people respectively). There were also significant differences in the leading causes of death. Causes including Intentional self-harm (X60-X84), Cirrhosis and other liver diseases (K70-K76) and Land transport accidents (V01-V89) feature prominently among leading causes of Aboriginal and Torres Strait Islander deaths. Diabetes is the second leading cause of death among Aboriginal and Torres Strait Islander people, but is ranked seventh for all Australians. In 2016 diabetes deaths occurred among Aboriginal and Torres Strait Islander people at a rate 4.9 times that of non-Indigenous Australians.

Analysis of Aboriginal and Torres Strait Islander deaths included in this section refers only to those that occurred in New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. Data for Victoria, Tasmania and the Australian Capital Territory are excluded in line with national reporting guidelines (for information on issues with Aboriginal and Torres Strait Islander identification, see Explanatory Notes 59-70).

2.4 Top 10 leading causes of death(a), NSW, Qld, SA, WA and NT(b) - by Aboriginal and Torres Strait Islander status - 2016(c)(i)
	Aboriginal and Torres Strait Islander	SDR(d)	Non-Indigenous	SDR(d)	Rate ratio(e)	Rate difference(f)
Cause of Death and ICD-10 code	no.	rate	no.	rate
All Causes Ischaemic heart diseases (I20-I25)	2 919 367	921.9 113.0	108 925 13,127	567.0 67.8	1.6 1.7	354.9 45.2
Diabetes (E10-E14)	228	81.2	3,187	16.4	4.9	64.8
Chronic lower respiratory diseases (J40-J47)	200	75.8	5,519	28.3	2.7	47.6
Malignant neoplasm of trachea, bronchus and lung (C33, C34)	184	62.6	5,836	29.6	2.1	33.1
Intentional self-harm [suicide] (X60-X84)(g)	162	23.8	1,906	11.4	2.1	12.3
Cerebrovascular diseases (I60-I69)	97	41.5	7,378	38.2	1.1	3.3
Cirrhosis and other diseases of liver (K70-K76)	93	22.0	1,217	6.4	3.5	15.7
Land transport accidents (V01-V89)(h)	80	13.7	910	5.4	2.5	8.3
Accidental poisoning (X40-X49)	75	12.9	869	5.4	2.4	7.5
Dementia, including Alzheimer disease (F01, F03, G30)	69	42.3	9,160	47.4	0.9	-5.1
(a) Causes listed are the leading causes of death for all deaths registered in 2016, based on WHO recommended tabulation of leading causes. See Explanatory Notes 35-37 for further information.
(b) Data are reported by jurisdiction of usual residence for NSW, Qld, WA, SA and the NT only. Data for Victoria, Tasmania and the Australian Capital Territory have been excluded in line with national reporting guidelines. For information on issues with Aboriginal and Torres Strait Islander identification, see Explanatory Notes 59-70.
(c) Causes of death data for 2016 are preliminary and subject to a revisions process. See Explanatory Notes 55-58 and A More Timely Annual Collection: Changes to ABS Processes (Technical Note) in this publication. (d) Standardised Death Rate. Deaths per 100,000 of estimated mid-year population. See the Glossary and Explanatory Notes 42-45 for further information. (e) The rate ratio is the rate for Aboriginal and Torres Strait Islander persons divided by the non-Indigenous rate. (f) The rate difference is the rate Aboriginal and Torres Strait Islander persons less the non-Indigenous rate. (g) Excludes Sequelae of suicide (Y87.0) as per the WHO recommended tabulation of leading causes. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 88-96. (h) Excludes Sequelae of transport accidents (Y85) as per the WHO recommended tabulation of leading causes. Care needs to be taken in interpreting figures relating to transport accidents. For further information, see Explanatory Note 85. (i) Deaths registered on Norfolk Island from 1 July 2016 are included in this publication for the first time, see Explanatory Notes 12-15.