Deaths from chronic obstructive pulmonary disease in France, 1979-2002: a multiple cause analysis

Background: A study was undertaken of deaths with an underlying or associated cause of chronic obstructive pulmonary disease ( COPD), and trends in COPD mortality from 1979 to 2002 in France were analysed. Methods: Data were obtained from the Centre of Epidemiology on the Medical Causes of Death ( CepiDc) for individuals aged 45 years and over. Owing to implementation of ICD-10 in 2000 for recording causes of death, two separate periods were analysed ( 1979 - 99 and 2000 - 2). Results: In 2000 - 2, COPD was the underlying cause of 1.4% of deaths ( deaths from COPD) and was mentioned on the death certificate in 3.0% ( deaths with COPD). The other main underlying causes in these cases were cardiovascular diseases ( 32.0%) and cancers ( 24.5%). In 1979 - 99, age standardised rates of death with COPD remained stable in men ( -0.01%/year) and increased in women (+ 1.7%/year). The mean annual rates of death with COPD per 100 000 were 84 for men and 19 for women in 2000 - 2. Conclusion: Multiple cause analysis improved the estimate of COPD related mortality. In 1979 - 99, COPD related mortality rates in France were stable in men but increased in women. Implementation of ICD-10 in 2000 introduced substantial discontinuities in mortality trends.