1.4. Causes of death

In the current demographic scenario, chronic degenerative conditions associated with the ageing process, remain the primary causes of death: cardiovascular illnesses and cancer have for several years now constituted the two most frequent causes of death and were responsible in 2008 for 7 out of 10 deaths (396,692 out of 578,190 total deaths).

Amongst men, for the first time in 2008 cardiovascular diseases became the first cause of death (97,953 deaths out of a total of 281,824), overtaking cancer (97,441). Amongst women, on the other hand, cardiovascular diseases have been the main cause of death for a while, a position they maintained with 126,531 deaths out of 296,366 (43%), whereas cancer, which was responsible for 74,767 deaths (25%) was the second most frequent cause of death.

All other causes are far less frequent than cardiovascular diseases and cancer: respiratory diseases represented the third cause of death for both men and women (7% and 6%, respectively), followed by trauma amongst men (5%) and endocrine and metabolism disorders (5%) amongst women, primarily attributable to diabetes mellitus, which alone is responsible for 4% of all female deaths.

Cardiovascular diseases largely affect the older population. They are the main cause of death for men and women over 85 and, for the female population, they are as early as 65 years of age. Most cardiovascular diseases are associated with heart ischaemia (such as myocardial infarction) and cerebrovascular diseases (such as stroke).

Cancer, a prerogative of the adult and mature population, represents the first cause of death after 45 years of age and up to the age of 84 in men and 64 in women, before being overtaken by cardiovascular diseases. Lung cancer in men (with a mortality of 7.95 per 10,000) and breast cancer among women (3.67 per 10,000) are responsible for the highest number of cancer deaths. These two types of cancer are the most frequent in all age groups of the population over the age of 45.

Amongst young adults (15-44 years), trauma is the main cause of death. Of a total of 14,169 deaths, 5,073 were caused by trauma (primarily road accidents). This was followed by cancer, which in this age range primarily takes the form of leukaemia and lymphomas.

Important gender differences can be observed in this section of the population: the age-specific rate’s men: women ratio in relation to general death in this age range is the highest observed and is due mainly to the difference in terms of mortality due to trauma, which amongst men is 5 times higher than observed amongst women. For this reason, trauma represents the main cause of death between males aged 15-44, whereas for females in the same range, first place is once again occupied by cancer and, specifically, breast cancer.

Amongst children and adolescents under the age of 15, there were 2,739 deaths, due primarily to conditions originating in the perinatal period (40%) and to congenital malformations and chromosome abnormalities (22%); the majority of the cancers constituting the third most frequent cause (10%) of mortality in this group were leukaemia and other lymphatic or haematopoietic system cancers.

Region of residence-based analysis once again shows significant geographical differences in mortality, regardless of the different structures for the age of the populations considered. The region with the highest mortality in Italy for both men and women is Campania where, as in 2003, the values observed are significantly higher than in the other regions. The highest male and female mortality after Campania is recorded in Sicily. Cancer and cardiovascular mortality show a clear polarisation to the detriment of the country’s more industrialised regions as regards cancer deaths and to the detriment of the southern regions in terms of cardiovascular deaths. Within this context, Campania once again stands out for lung cancer deaths amongst men, the highest nationwide (9.57 vs. a national rate of 7.95).