徳島県における死因別および悪性腫瘍臓器別の標準化死亡比の分析(1993-2002年)

To clarify the characteristics of mortality in Tokushima Prefecture, the authors analyzed the standardized mortality ratio（SMR）from 1993 to 1998 and 1999 to 2002. The sex-and 5-year-agespecific and cause-specific morality rates in Japan were used as the standard mortality, and the population of sex-and 5-year-age-specific category in the census year（1995 and 2000）was used as the population of Tokushima Prefecture. The 95 % confidence interval（CI）of SMR was estimated using the exact method, on the assumption that the number of deaths followed the Poisson distribution. The mortality from all-cause in Tokushima Prefecture was significantly lower than that of the entire Japanese population among women during 1993-1998, while it was significantly higher among men and women during 1999-2002. The SMRs of diabetes mellitus, bronchitis, emphysema and asthma, and chronic hepatitis and liver cirrhosis were significantly higher than 100, with the SMR of diabetes being as high as 130-140. On the other hand, mortality rate from suicide was significantly lower than that of all of Japan. Regarding malignant neoplasms, morality rates from cancers of all sites, esophagus, stomach, and colon and rectum were significantly lower than 100. However, the SMR of liver cancer was significantly high, suggesting that hepatitis C virus infection was endemic. The reason for the high mortality from diabetes should be clarified with regard to environmental and genetic factors, and the way of reporting diabetes as a cause of death in death certificates. In addition, the reason for the low mortality from cancers of the gastrointestinal tract remains unknown, and further investigations on life style factors are required.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html