Cancer Registry, Krebsliga St. Gallen-Appenzell, Flurhofstr. 7, 9000 St. Gallen, Switzerland.
Swiss Med Wkly. 2010 Aug 24;140:w13077. doi: 10.4414/smw.2010.13077. eCollection 2010.
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.
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.
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.
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.
以丧失潜在寿命年数（PYLL）表示的死亡率突出了过早和可预防的死亡。我们分析了瑞士早逝的原因和趋势，以突出提供最大预防措施效果的领域。
通过审查 1 至 70 岁之间丧失的潜在寿命年数，考虑到循环系统疾病、癌症、死亡的外部原因和其他原因以及 19 种特定死因这 4 个主要类别，研究了 1995 年至 2006 年的过早死亡率和趋势。使用 joinpoint 分析评估趋势，将 PYLL 表示为年龄标准化率。分析基于瑞士联邦统计局提供的官方死亡证明文件。
所有原因类别的年龄调整 PYLL 率均下降，但与循环系统疾病和外部原因相比，癌症的下降幅度较小。艾滋病、交通事故和缺血性心脏病的下降趋势最为明显。在女性中，乳腺癌对降低过早死亡率的贡献最大，但仍然是早期死亡的首要原因。肺癌是唯一死亡率呈上升趋势的导致过早死亡的原因。
过去在预防、早期发现和治疗方面的努力，以及更健康的生活方式和其他因素，很可能促成了潜在寿命年数丧失率的大幅下降，但女性肺癌导致的过早死亡率上升令人担忧。需要持续努力进行预防和早期发现，以进一步减少过早死亡及其给社会带来的负担。
