Premature deaths in Switzerland from 1995-2006: causes and trends.
OBJECTIVE
Mortality expressed as potential years of life lost (PYLL) underscores premature and preventable mortality. We analysed causes of and trends in premature death in Switzerland to highlight the areas which provide the greatest potential outcome for preventive measures.


METHODS
Premature mortality rates and trends from 1995-2006 were examined by reviewing potential years of life lost between age 1 and 70, as the upper age limit, considering 4 main categories: circulatory diseases, cancer, external causes of mortality and other causes, and 19 specific causes of death. Trends were assessed using join point analysis with PYLL expressed as age-standardised rate. The analysis was based on the official death certification files provided by the Swiss Federal Statistical Office.


RESULTS
Age adjusted PYLL rates decreased for all categories of causes, but the decline in cancers was modest compared to circulatory diseases and external causes. The strongest downward trends were observed for AIDS, traffic accidents and ischaemic heart disease. In women breast cancer contributed most to the decline of premature mortality but remains the first cause of early death. Lung cancer in women is the only cause of premature mortality with rising trends.


CONCLUSIONS
Past efforts in prevention, early detection and treatment, but also a healthier lifestyle and other factors, have very probably contributed to the considerable reduction in the rate of potential years of life lost, but the rising rate of premature mortality caused by lung cancer in women is of concern. Persistent efforts in prevention and early detection are required to further reduce premature death and its burden on society.
Savidan
Anita
A
Cancer Registry, Krebsliga St. Gallen-Appenzell, Flurhofstr. 7, 9000 St. Gallen, Switzerland. anitasavidan@yahoo.com
Junker
Christoph
C
Cerny
Thomas
T
Ess
Silvia
S
D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008019:Life Style; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors; D013405:Suicide / Q000639:trends; D013557:Switzerland; D055815:Young Adult