Is cancer overtaking cardiovascular diseases as the killer number one in men in Tuscany?

AIMS AND BACKGROUND: For the first time in 2006, cancer became the main cause of death in men in Italy, exceeding cardiovascular disease. The aim of the study was to verify whether the overtaking of cancer male mortality occurred also in Tuscany or in some of its 12 subregional areas and whether there was a geographical trend. METHODS: Age-standardized mortality rates from the Tuscan Regional Mortality Registry, 1987-2008, were calculated for neoplasms, cardiovascular diseases, and respiratory diseases, considering the whole region and its 12 areas. Joinpoint analyses were carried out to study temporal trend. RESULTS: Up to 2008, the number of male deaths for neoplasms (6786) in Tuscany did not exceed deaths from cardiovascular disease (7065). Instead, overtaking occurred in some subregional areas from 2004 onwards. When we compared age-standardized mortality rates, cancer became the first cause of death in Tuscany from 2004 onwards (age-standardized mortality rates for cancer 236.5 per 100,000; for cardiovascular disease 227.8 per 100,000). Age-standardized mortality rates for cardiovascular disease recorded an annual 2.4% decrease until 1998, then a 3.5% decrease. Age-standardized mortality rates for all cancers recorded an annual 1.6% decrease in the whole period. CONCLUSIONS: Our study confirmed a geographical trend in cancer overtaking as the main cause of death in males: from the more urbanized areas in northern Tuscany, where the phenomenon occurred earlier, to the southern part.

[Mortality among the elderly in Tuscany in the period 1987-2003]. / La mortalità in età anziana in Toscana nel periodo 1987-2003.

AIM: to assess cause-specific mortality and its temporal trend in Tuscan elderly residents. DESIGN: descriptive epidemiologic study based upon death certificates, collected and registered since 1987 by the Tuscan Regional Mortality Registry (RMR) according to standardized procedures. METHODS: Major groups of causes: temporal trends are described calculating annual truncated age-adjusted mortality rates (based on age-specfic rates subdivided in three classes: 75-79; 80-84 and > or =85; standard: European population) and estimating annual percent changes (EAPC, Estimated Annual Percent Change) using ]oinpoint regression models. Most frequent specific causes: number of deaths and truncated age-adjusted mortality rates (based on age-specific rates subdivided in three classes: 75-79; 80-84 and > or =85; standard: European population) are compared between the first and the last quinquennium (1987-1991 and 1999-2003) by percent change. RESULTS: during 1987-2003, an average of 26667 annual deaths (65% of total) occurred in persons aged 75 and over in Tuscany. In the same period the number of elderly residents increased (2003 vs 1987: men +43.6%; women +41.5%) with a consequent increase in number of deaths (2003 vs 1987: men +13.8%; women +15.9%). The truncated age-adjusted rates for all mortality causes decreased (EAPC = -1.35% in males; EAPC = -1.41% in females) while an increase was registered for few specific causes as Alzheimer's disease, senile dementia, arterial hypertension and lung cancer. CONCLUSIONS: the decreasing mortality trend observed in persons aged 75 and over in Tuscany is consistent with similar trends in other developed countries. The opposing trends for few specific causes of death need to be further investigated.