Government

Quick access to information based on government's structure



Ministry of Health

Quarterly Digest
Volume 11 - Number 2 October 2001

  • Preface

  • Map: B.C. Local Health Areas

  • British Columbia: Local Health Areas (LHA) within Health Regions

  • Vital Event Statistics - April 1, 2001 - June 30, 2001 and Year-to-date
    (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)

  • Selected Birth Statistics - April 1, 2001 - June 30, 2001 and Year-to-date
    (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)

  • External Causes of Death - April 1, 2001 - June 30, 2001 and Year-to-date
    (Accidents - [Motor Vehicle Accidents, Poisoning, Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)

  • Neoplasm Deaths - April 1, 2001 - June 30, 2001 and Year-to-date
    (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)

  • Heart Disease Deaths - April 1, 2001 - June 30, 2001 and Year-to-date
    (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)

  • Respiratory Disease Death Statistics - April 1, 2001 - June 30, 2001 and Year-End
    (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)

  • Other Selected Death Statistics - April 1, 2001 - June 30, 2001 and Year-to-date
    (Diabetes, Alcohol-Related, AIDS, Other Infectious Disease, Cerebral and Other Vascular, Liver Disease, Amyotrophic Lateral Sclerosis and Multiple Sclerosis, Alzheimer's Disease, Parkinson's Disease)

  • Summary Article:
    Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease)
    Deaths in British Columbia, to year 2000

    by Z. Kashaninia, M. Marquette, and S. Fricke

Preface

This "Quarterly's" standard tables of vital event data are for the second quarter and to-date June 30, 2001. The British Columbia Vital Statistics Agency makes every effort to achieve optimal data collection, timely processing, and regular data editing to provide the best data possible within the constraints of relative currency.

Mortality data in year 2000 and 2001 Quarterly Digests are the first in Canada to have been derived from the tenth revision of the International Classification of Diseases (ICD-10). ICD code groupings used in these publications for standard cause of death tables have been "translated" from ICD-9 to ICD-10 and the glossary provides complete new code listings and a note of the few minor inclusions/exclusions that could affect comparative counts.

In addition to the impact of added detail and category reassignment of some diseases in ICD-10 there have been changes in the complex rules used to select the single underlying cause of death (UCOD) - most notably as relates to cancers (see Volume 10, Number 4, July 2001) and pneumonia. This Agency, concerned about the impact, medical validity, and the new rules' interpretation of certifier intent, conducts an extensive daily editing of automated systems output. This has resulted in construction of two data sets - the primary (edited) for more accurate and consistent use in BC. In addition, the Agency has constructed a more precise automated ICD-9 to ICD-10 translation. This has included recovery of many thousands of selected historical (to 1986) death records containing codes that cannot "translate" and/or lack desired ICD code detail. These have been recoded in ICD-10 and modifications have been made to the VSA system to handle "parallel" codes. This process will provide current accuracy with historical consistency, recover detail in previous years, and be entirely ICD-10 derived.

Due to the fact that Vital Statistics Agency files are continually being updated, totals compiled by the addition of the annual quarters will not correspond exactly to year-to-date and year-end figures. For the same reason, depending on the date the data are extracted, there may be differences in numbers presented in the year-end "Quarterly" and those eventually reported in the 2001 Annual Report. Therefore, the numbers provided in this publication should be considered provisional. Finally, the usual cautions regarding random fluctuations in values, particularly those involving small numbers, must be noted.

Amyotrophic Lateral Sclerosis (ALS) is the focus of this quarter's feature article. In BC, from 1986 to year 2000, 1001 individuals died of this progressive (death usually within five years) neuromuscular disease. An additional 159 died of other causes but had ALS at the time. The article begins with an historical summary of ALS mortality counts from the early 1950s; compares BC to the other provinces; and then examines age, gender, regional comparisons and non ALS causes (using 1986 to 1999) for ALS related death. Some year 2000 updates are also provided.

As always, requests for changes and suggestions or contributions for articles continue to be welcome. Your support and input into this publication is greatly appreciated.

R.J. Danderfer Soo-Hong Uh
CEO/Director Manager
British Columbia Information and Resource
Vital Statistics Agency Management Branch
  Vital Statistics Agency

[Return to Table of Contents]

British Columbia
Local Health Areas


image


[Return to Table of Contents]

British Columbia:
Local Health Areas (LHA)
within Health Regions

01 East Kootenay
LHA

01 Fernie
02 Cranbrook
03 Kimberley
04 Windermere
05 Creston
18 Golden

02 West Kootenay-Boundary
LHA

06/07 Kootenay Lake/Nelson
09 Castlegar
10 Arrow Lakes
11 Trail
12/13 Grand Forks/Kettle Valley

03 North Okanagan
LHA

19 Revelstoke
20 Salmon Arm
21 Armstrong-Spallumcheen
22 Vernon
78 Enderby

04 South Okanagan-Similkameen
LHA

14 Southern Okanagan
15 Penticton
16 Keremeos
17 Princeton
23 Central Okanagan
77 Summerland

05 Thompson
LHA

24 Kamloops
26 North Thompson
29 Lillooet
30 South Cariboo
31 Merritt

06 Fraser Valley
LHA

32 Hope
33 Chilliwack
34 Abbotsford
75 Mission
76 Aggassiz-Harrison

07 South Fraser Valley
LHA

35 Langley
36 Surrey
37 Delta

08 Simon Fraser
LHA

40 New Westminster
42 Maple Ridge
43 Coquitlam

09 Coast Garibaldi
LHA

46 Sunshine Coast
47 Powell River
48 Howe Sound

10 Central Vancouver Island
LHA

65 Cowichan
66 Lake Cowichan
67 Ladysmith
68 Nanaimo
69 Qualicum
70 Alberni

11 Upper Island/Central Coast
LHA

71 Courtenay
72/84 Campbell River/
Vancouver Island West
83 Central Coast
85 Vancouver Island North

12 Cariboo
LHA

25 100 Mile House
27 Cariboo-Chilcotin
28 Quesnel
49 Bella Coola Valley

13 North West
LHA

50 Queen Charlotte
51 Snow Country
52 Prince Rupert
53 Upper Skeena
54 Smithers
80 Kitimat
87/94 Stikine/Telegraph Creek
88 Terrace
92 Nisga'a

14 Peace Liard
LHA

59 Peace River South
60 Peace River North
81 Fort Nelson

15 Northern Interior
LHA

55/93 Burns Lake/Eutsuk
56 Nechako
57 Prince George

16 Vancouver
LHA

161 Vancouver City Centre
162 Vancouver Downtown East Side
163 Vancouver North East
164 Vancouver West Side
165 Vancouver Midtown
166 Vancouver South
Unknown Vancouver

17 Burnaby
LHA

41 Burnaby

18 North Shore
LHA

44 North Vancouver
45 West Vancouver-Bowen Island

19 Richmond
LHA

38 Richmond

20 Capital
LHA

61 Greater Victoria
62 Sooke
63 Saanich
64 Gulf Islands


[Return to Table of Contents]

Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease) Deaths in British Columbia, to year 2000

by z. Kashaninia, M. Marquette, & S. Fricke

Introduction

Amyotrophic Lateral Sclerosis (ALS) was first identified by Jean-Martin Charcot (a French neurologist) in 1869. ALS is also commonly known as Lou Gehrig's disease, named after a famous US baseball player in the1930s who developed ALS at the height of his career and died of it at the age of 38. ALS itself comes from the Greek language meaning "no muscle nourishment". The disease starts by a progressive deterioration of motor neurons (nerve cells) in the brain and spinal chord (upper and lower motor neurons). When the motor neurons deteriorate to a point that they can no longer send impulses to the muscles, the muscles will not receive any nourishment and gradually will atrophy (waste away). Once diagnosed, the disease progresses rapidly, leading to paralysis within two to five years. The majority of patients die within five years after diagnosis (www.focusonals.com and www.alsa.org).

In Canada, approximately 1500 to 2000 Canadians live with ALS with 600 new cases of ALS diagnosed every year. In 1996 alone, 1110 individuals (520 males, 590 females) died of ALS in Canada. This total far surpassed deaths from Cystic Fibrosis and Multiple Sclerosis in the same year (47 and 294 respectively) [ALS Society of Canada]. In BC, 1001 individuals (524 males, 477 females) died as a direct result of ALS between 1986 and 2000. During the same years, 159 individuals (113 males, 46 females) died directly of other causes but had ALS noted as a significant contributor to their death.

This report will provide an analysis of all ALS and ALS-related deaths primarily focusing on 1986-1999 in British Columbia. A regional analysis based on age, gender and regional differences as well as Age Specific Death Rates, Age Standardized Mortality Rates (ASMRs) and Standardized Mortality Ratios (SMRs) are provided. In addition, this report will also provide an analysis based on average age of death for those individuals who died of ALS during the study period. A historical summary based on mortality counts from the early 1950s to the present will also be provided.

Methodology

The British Columbia mortality data used in this report were obtained from Registrations and Medical Certifications of Death submitted to the British Columbia Vital Statistics Agency. All disease entities were coded to the International Classification of Diseases 9th Revision (ICD-9). A small portion of the report uses data that are coded to other revisions accordingly.

For the majority of the report, the data were extracted on the basis of ICD-9 codes as indicated for deaths directly due to ALS (i.e. based on UCOD) and deaths for which ALS was a contributor to the death (indirect). The combination of direct and indirect ALS deaths is referred to as ALS related.

Age Standardized Mortality Rates (ASMRs) are a summary of age adjusted death rates by genders that are standardized to a specific population to compare different time periods or geographical locations. The Vital Statistics data that are used in this report are standardized to 1991 Canada Census population.

Standardized Mortality Ratios (SMRs) are the ratio of the actual number of deaths in a Local Health Area (LHA) or region to the expected number of deaths in that area based on provincial, age-specific mortality rates. (SMRs are used for comparing each LHA's observed ALS death to the Province as a whole.)

The ICD codes used for ALS for this report were:

YearsICD revisionICD code*
1952-1957(ICD-6)3561
1958-1968(ICD-7)3561
1969-1978(ICD-8)3480
1979-1980(ICD-9)3352
1981-1985(ICD-9)335
1986-1999(ICD-9)3352
2000(ICD-10)G1221-G1224

* Although, in the early years, ALS was sometimes referred to as motor neuron disease or progressive muscular atrophy, it is certain that over 95 percent of all these entities were real cases of ALS. For continuity, year 2000 counts include codes for the three conditions, which, for this report have been considered one and the same.

Table 1
ALS Direct Deaths
British Columbia, 1952 to 2000
ALS Direct Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 1
ALS Direct Deaths
British Columbia, 1952 to 2000
ALS Direct Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • Overall, total ALS deaths were four times higher in year 2000 than in 1952. Both male and female ALS deaths showed a definite upward increase in the last decade or so.

  • Until 1969, the total number of ALS deaths remained under 20 in every year.

  • With 98 deaths, year 2000 showed the highest total ALS deaths.

  • The highest number of male deaths was 52 in 2000 while the highest number of female deaths was 51 in 1996.

Table 2
Direct Deaths due to ALS
British Columbia, 1986 to 1999
Direct Deaths Due to ALS

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 2
Direct Deaths due to ALS
British Columbia, 1986 to 1999
Direct Deaths Due to ALS

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • A total of 903 individuals (472 males, 431 females) died as a direct result of ALS between 1986 and 1999.

  • The highest number of male deaths occurred in 1998 with 41 deaths while females had their highest number of deaths in 1996 with 51 deaths.

  • The number of deaths for males stayed relatively the same throughout the 1980s and 1990s but there has been a definite increase in the number of female deaths in the 1990s compared to the 1980s.

Table 3
Indirect Deaths due to ALS
British Columbia, 1986 to 1999
Indirect Deaths Due to ALS

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 3
Indirect Deaths due to ALS
British Columbia, 1986 to 1999
Indirect Deaths Due to ALS

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • A total of 150 individuals (108 males, 42 females) died directly of other causes but had ALS at the time of their death.

  • The highest indirect male deaths occurred in 1995 with 12 deaths while for females, the highest number of indirect deaths occurred in 1991 with six deaths.

  • There were no indirect female deaths in 1988 and 1989.

  • Male indirect ALS deaths far surpassed female indirect deaths in every year of the study period.

Table 4
ALS Indirect Deaths
British Columbia, 1986 to 1999
ALS Indirect Deaths

Note: *Circulatory diseases include ischemic heart diseases, cerebrovascular diseases and other cardiac diseases.
**Respiratory diseases include pneumonia/influenza and other respiratory diseases.

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 4
ALS Indirect Deaths
British Columbia, 1986 to 1999
ALS Indirect Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • Nearly half (44 percent) of the individuals, who had ALS at the time of their death, died of circulatory diseases. Respiratory system diseases were responsible for 23 percent of indirect ALS deaths. Thirteen percent of all indirect ALS deaths were caused by cancer.

  • Circulatory and respiratory disorders accounted for over 67 percent of all ALS indirect deaths.

Table 5
Age Specific Death Rates for ALS Deaths
British Columbia, 1986 to 1999
ALS Indirect Deaths

Note: Rates per 10,000 age and gender specific population.
Excludes non residents. Rerun for these rates was derived from later (updated) dataset and includes 1 additional male and female.

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 5
Age Specific Death Rates for ALS Deaths
British Columbia, 1986 to 1999
Age Specific Death Rates for ALS Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • The highest Age Specific Death Rate for ALS occurred for males aged 85 and over (2.38 per 10,000 population). The lowest rate of death was for males aged 30-34 (0.005 per 10,000 population).

  • Age Specific Death Rates were much lower for the younger age groups (those between 25 and 54) than the higher age groups (those 55 and over) for both males and females. For those aged 50 and over, males had a much higher death rate from ALS than females.

  • No deaths from ALS were reported for those under the age of 25 between 1986 and 1999.

  • Except for those between ages 45 and 49, males had a higher death rate than females in all other age groups during the study period.

Table 6
Age Standardized Mortality Rates for ALS Related Deaths
British Columbia, 1986 to 1999
Age Standardized Mortality Rates for ALS Related Deaths
Note: Age Standardized Mortality Rate (ASMR) per 10,000 standard population (1991 Canada Census).
Excludes non residents.

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 6
Age Standardized Mortality Rates for ALS Related Deaths
British Columbia, 1986 to 1999
Age Standardized Mortality Rates for ALS Related Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • Males had higher Age Standardized Mortality Rates (ASMRs) for ALS than females in every year of the study except in 1996.

  • The highest ASMR for males occurred in 1986 (0.34) while the highest rate for females was 0.24 in both 1993 and 1996.

  • The lowest ASMR for males was 0.22 for years 1990 and 1999. For females, the lowest ASMR was 0.10 in both 1988 and 1989.

Table 7
Standardized Mortality Ratios for ALS Related Deaths by Local Health Area
British Columbia, 1986-1999
Standardized Mortality Ratios for ALS Related Deaths by Local Health Area

[Click here to download a Microsoft Excel Spreadsheet of the above table]

  • Based on Standardized Mortality Ratios, the following Local Health Areas showed statistically significantly higher ALS related deaths than were expected: Kootenay Lake/Nelson (1.91), Nanaimo (1.52), West Vancouver-Bowen Island (1.49), and North Vancouver (1.42).

  • Vernon (0.37) was the only Local Health Area in the province that showed statistically significantly lower ALS deaths than were expected.

Figure 1
Standardized Mortality Ratios for ALS Related Deaths by Local Health Area
British Columbia, 1986-1999
Standardized Mortality Ratios for ALS Related Deaths by Local Health Area

Table 8
Average Age at Time of Death for ALS Related Deaths
British Columbia, 1986 to 1999
Average Age at Time of Death for ALS Related Deaths

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Chart 7
Average Age at Time of Death for ALS Related Deaths
British Columbia, 1986 to 1999
Average Age at Time of Death for ALS Related Deaths
[Click here to download a Microsoft Excel Spreadsheet of the above chart]

  • Over the 14 year period, death related to ALS occurred at an average age of 69.9(68.9 for males and 70.8 for females).

  • The lowest average age at the time of death for ALS was 66 for males in 1990 and 69 for females in 1993 and 1997.

  • The highest average age at the time of death for males was 71 in 1995. For females, the highest average age was 73 in 1998.

  • Except for 1991, 1993 and 1995, males had a lower average age at the time of death from ALS than females in every year of the study period.

  • The average age at death has stayed relatively constant between 68 and 70 during the 14 year period with no evident prolongation of life.

ALS in 2000

In year 2000, a record number of 98 individuals (52 males, 46 females) died as a direct result of ALS. A large number of these (82 deaths) occurred for those aged 60 and higher. There were no deaths under the age of 35. Only one female death occurred for those in the 35 to 39 age group. In the same year, nine individuals died of other causes but had ALS at the time of their death. The majority of these deaths also occurred for individuals over 75 years of age.

Table 9
ALS Direct and Indirect Deaths
British Columbia, 2000
ALS Direct and Indirect Deaths
Note: Includes non residents
Based on ICD-10 codes (G1221-G1224).

[Click here to download a Microsoft Excel Spreadsheet of the above table]

Conclusion

In British Columbia, the number of deaths from ALS has grown from single digits in the 1950s to almost one hundred per year in 2000. With 98 deaths, ALS deaths have far surpassed Cystic Fibrosis (5 deaths) and Multiple Sclerosis (43 deaths) in year 2000 and in fact, were only 13 percent less than AIDS deaths.

Between 1986 and 1999, 903 individuals died as a direct result of ALS. Compared to the 1980s, a definite increase in the number of deaths (particularly for females) was seen in the 1990s. Although small, ALS indirect deaths also showed an overall increase. The majority of those who had ALS at the time of their death died of circulatory and respiratory diseases (67 percent). There were no deaths from ALS for those under 25 years of age during the study period of 1986 to 1999. The number of deaths for those 55 and over more than doubled for both males and females. The Age Standardized Mortality rates were much higher for males than females except for the year of 1996 where the female rate was slightly higher than the male rate.

Year 2000 also showed the same trend as there were no deaths under the age of 35 and a higher number of deaths were seen in the 60-84 age groups. A lower number of indirect deaths were seen in year 2000 as compared to previous years of the study.

Glossary

[Return to Table of Contents]

Age Standardized Mortality Rate (ASMR):
A summary of age adjusted death rates by gender which have been standardized to a specific population for the purpose of rate comparisons of different time periods or different geographical locations. ASMRs in this report are per 10,000 standard population (1991 Canada Census).

Alcohol-Related:
This category includes all deaths considered as being directly or indirectly related to alcohol as indicated by inclusion by the certifier of selected alcohol identifying conditions anywhere on the death record (including "lifestyle" field). It should be noted that where alcohol is an indirect cause of death (i.e. not UCOD) and the direct underlying cause of death falls within one of our selected causes (e.g. motor vehicle accidents), then this death may be counted in both columns. That is, not all of "alcohol-related" are exclusive. This category includes ICD-10 codes: F100-F109, K700-K709, O993, P043, O354, Q860, G312, G621, G721, I426, K292, K860, X45, X65, Y14, T510-T512, T519. Note: now excludes acute pancreatitis, and cirrhosis not specifically identified as alcohol induced.

Assignment of Health Region:
Cases are assigned to Health Regions by the aggregation of appropriate LHAs.

Assignment of Local Health Area (LHA):
Allocation of LHA in the case of births and deaths is based upon the usual residence (by postal code) of the mother and deceased respectively. Marriages are assigned to LHAs according to the place of event. Community name, is used in the absence of postal code.

Elderly Gravida:
Any mother who was 35 years of age or older at the time of delivery of a live born infant.

External Causes of Death:
Deaths due to environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects. Broad categories include accidents, suicide, medical or abnormal reactions (considered accidents), homicide, legal intervention, misadventures (counted as accident) and injury from war operations. Standard "Quarterly" tables under this heading include deaths due to accidents, suicide, homicide, and other. Accidents are subdivided by the following categories; motor vehicle accidents (MVA) (ICD-10 V020-V049, V090-V092, V093, V120-V149, V190-V196, V200-V249, V260-V349, V360-V449, V460-V549, V560-V649, V660-V749, V760-V799, V803-V805, V820-V821, V823-V839, V840-V875, V877-V8999, Y850), poisoning (X40-X49), falls (W00-W19), burns/fire (X00-X19), drowning (V900-V909, V920-V929, W65-W74), other accidents (V010-V019, V050-V069, V091, V099, V100-V119, V150-V189, V198-V199, V250-V259, V350-V359, V450-V459, V550-V559, V650-V659, V750-V759, V800-V802, V806-V819, V822, V876, V910-V919, V930-V949, V950-V978, V98-V99, W20-W64, W75-W99, X20-X39, X50-X59, Y40-Y849, Y859, Y86, Y880-Y883). Suicide ICD-10 codes are X60-X84, Y870; homicide (X85-Y09, Y871); "other [external]" consists of events of undetermined intent, legal interventions, and operations of war (Y10-Y369, Y890-Y899).

Note: the late effects of accidental poisoning, falls, and burns/fire are no longer identified separately for inclusion in these categories and are now part of "other accidents"). Trains are now considered motor vehicles in ICD-10 but for consistency, have been excluded from MVA counts to still be considered as "other transport".

Heart Disease:
Tables under this heading include deaths due to:

  • rheumatic/valvular: (I050-I099, I340-I38)
  • hypertension/hypertensive: (I10-I159)
  • ischemic: (I200-I259) (Note: now includes cardiomyopathy specified as ischemic)
  • conductive & dysrythmic: (I440-I499)
  • heart failure: (I500-I509)
  • congenital: (Q200-Q249)
  • other: pulmonary (I260-I289), inflammatory (I300-I339, I400-I409), cardiomyopathy (I420-I429)(Note: now excludes ischemic),
    other ill-defined or unspecified heart disease (I510-I519)(includes myocardial degeneration)

ICD-9:
The ninth revision of International Classification of Diseases, World Health Organization, Geneva, 1977. An internationally used system of approximately 12,000 four (and some three) digit numbers representing a system of categories to which morbid entities are assigned according to an established criteria. ICD provides a common basis of disease and injury classification that facilitates storage, retrieval, and tabulation of statistical data.

ICD-10:
The tenth revision of International Classification of Diseases and Related Health Problems, World Health Organization, 1992. In use beginning with year 2000, update of ICD-9 revised with alpha-numeric system and increased code detail (approximately 18,000). The BC Vital Statistics Agency and all their provincial counterparts utilize an ICD-10 that has been modified by the National Center for Health Statistics (NCHS) for use in the classification and analysis of medical mortality data in the United States (October, 1998).

Infant Deaths:
Deaths of children under one year of age.

Live birth:
The complete expulsion or extraction from its mother, irrespective of the duration of the pregnancy, of a product of conception in which, after the expulsion or extraction, there is:

  • breathing;
  • beating of the heart;
  • pulsation of the umbilical cord; or
  • unmistakable movement of voluntary muscle, whether or not the umbilical cord has been cut or the placenta attached.

Low Birth Weight:
Any liveborn infant weighing less than 2500 grams.

Neoplasms (ICD-10 C000-D489):
Although the vast majority of deaths in this category are due to malignant cancer, also included are benign, in-situ, and unspecified "tumours". Detailed ICD-10 breakdown used in "Neoplasm Deaths" tables are;

  • lung: includes trachea, bronchus, lung and pleura (C33, C340-C349, C384, C450). Note: now excludes mesothelioma of lung and trachea.
  • female breast: (C500-C509)
  • colorectal: (C180-C218)
  • other G.I.: includes esophagus, stomach, small intestine and duodenum, liver & intrahepatic bile ducts, gallbladder and extrahepatic ducts, pancreas, peritoneum, other and ill-defined within digestive organs (C150-C179, C220-C269)
  • female reproductive: includes uterus, cervix, placenta, ovary and adnexa, vagina & external genitalia (C510-C58)
  • prostate: C61
  • blood lymph: includes lymphatic and haematopoietic tissue (C810-C969, C463).
  • other malignancy: includes malignant neoplasms of other (e.g. lip, oral cavity, pharynx, nose, ear, larynx, heart, bone and connective tissue, urinary tract, eye, brain, endocrine glands)and ill-defined or unspecified sites (C000-C148, C300-C449, C451-C462, C467-C499, C600-C609, C620-C768, C5099*, C80*). Note: * codes used exclusively by BC Vital Statistics Agency for male breast cancer and for unknown primary site cancer.
  • non-malignant & unspecified: includes benign, in-situ, and neoplasms of uncertain or unknown behaviour (D000-D489).
    Note: This neoplasm group now includes myeloproliferative disease, thrombocythemia, monoclonal gammopathy, and lymphoproliferative disease which were not previously considered neoplastic in ICD-9 and were counted in other ICD chapters.

Other Selected Death Statistics:
Tables under this heading include deaths due to:

  • diabetes (E100-E149).
  • alcohol related - see above.
  • AIDS/HIV: (B200-B24).
  • other infectious and parasitic disease: (A000-B199, B250-B999) Note: Now includes obstetrical and neonatal tetanus.
  • cerebro and other vascular disease: (I600-I698, I700-I879, I950-I959, I880-I899, I970-I979, I99). Includes cerebrovascular disease, disease of arteries and veins, hypotension, and other circulatory system disease. Note: "Other circulatory system disease" now includes post procedural disorders of the circulatory system (I970-I979) which are never selected as the UCOD. However they are confirmed by editing and either recoded to the more specific disease (embolism, stroke, M.I.) or double coded if the complication is confirmed.
  • liver disease: (K700-K7699). Note: Now includes toxic liver disease with cholestasis.
  • ALS/MS: Amyotrophic lateral sclerosis and multiple sclerosis: (G122, G1221, G35). Note: In order to maintain continuity with ICD-9, unspecified motor neuron disease (G122) is included in this category as it was previously not distinguishable from ALS.

Premature/Pre-term:
Any live born infant less than 37 weeks gestation at delivery.

Respiratory Disease Death Statistics:
Tables under this heading include deaths due to the following:

  • emphysema: (J430-J439) Note: Now excludes when described as or resulting in obstructive disease -see note at COPD.
  • COPD: (440-J449). Note: Now includes specific code within the group for COPD when accompanied with acute lower respiratory infection, or with acute exacerbation. This inclusion has no statistical impact on UCOD. Also, this category now includes asthma and emphysema described as obstructive not previously included in ICD-9.
  • pneumonia: (J120-J181, J188-J189) Note: ICD-10 has a new code for chlamydial pneumonia (J160). It is uncertain if this condition would have previously been coded to "pneumonia due to other specified bacteria" (ICD-9 4828) or to "other diseases due to viruses and chlamydia" (0788), or to both. This disease is very rare on death records so if not coded to 4828, the impact to comparison of historical data would still be minimal. Daily VS edits have been implemented to ensure consistent selection of pneumonia.
  • influenza: (J100-J118)
  • asthma: (J450-J459, J46) Note: Now excludes when described as obstructive - see note at COPD.
  • lung disease due to external agents: (J60-J709)
  • pulmonary fibrosis: (J841)
  • other respiratory diseases: (J00-J069, J182, J200-J42, J47, J80-J840, J848-J9899) Note: Now includes post procedural respiratory disorders (J950-J959) which formerly used to be injury codes. These codes are never selected as the UCOD so their impact would only effect multiple code analyses. The Vital Statistics Agency includes these in daily data edits to confirm them as post procedural and to double code for the specific respiratory condition (e.g. pneumonia). As a result, respiratory disease statistics in BC are more consistent with historical data.

Standardized Mortality Ratio (SMR):
The ratio of the number of deaths occurring to residents of a geographical area (e.g. LHA) to the expected number of deaths in that area based on provincial age specific mortality rates.

Stillbirth:
The complete expulsion or extraction from its mother after at least twenty weeks of pregnancy or after attaining a weight of at least 500 grams, of a product of conception in which, after expulsion or extraction, there is no breathing, beating of the heart, pulsation of the umbilical cord or unmistakable movement of voluntary muscle.

Teenage Mother:
Any mother who was age 19 or less at the time of delivery.

UCOD:
Underlying cause of death - based upon application of standard international coding rules for determining sequential relationships of conditions and diseases from immediate cause backwards to underlying cause.

[Return to Table of Contents]

Editor's Note:

Due to a new Government cost constraint directive, the Quarterly Digest, beginning with Volume 10, Number 4 (last quarter of year 2000) will only be published at the BC Vital Statistics web site. Regular subscribers should have received notification of availability and information regarding distribution options.

Readers who would like to receive e-mail notification when new "Quarterly" issues are available, please provide your e-address to vsadmin@moh.hnet.bc.ca. Include the word "subscribe" in the subject and indicate that notification is for the Quarterly Digest.

Contributors' Note:

The editorial staff would like to invite any researchers of health-related topics who wish to contribute an article or paper summary for publication in this Quarterly Digest to contact the Information and Resource Management Branch of the British Columbia Vital Statistics Agency. Articles should focus on health status issues in British Columbia. It is preferable that submissions be in "electronic media" format (e.g. Word, Word Perfect, Excel, Power Point, Corel, Pagemaker, etc.). Article presentation will be subject to space allowances and publishing deadlines.

Readers' Note:

Re: "Letters to the Editor", or mailing and distribution.

Comments, suggestions, questions, or criticisms regarding this publication?

Use the Feedback Form