THE EPIDEMIOLOGY OF PEPTIC-ULCER MORTALITY 1953-1989 A BIRTH COHORT ANALYSIS

Peptic ulcer (PU) disease is the cause of substantial morbidity and mo rtality in a number of countries including Australia. Despite diagnost ic and treatment advances, sustained mortality from PU disease has bee n reported. To understand this problem a birth cohort analysis using t he Median Polish Technique (MPT) was performed on 36 years of mortalit y data from New South Wales, Australia. The MPT allows cohort effects to be quantified, yet has rarely been applied to mortality data. Birth cohort effects detected using graphical presentation of mortality dat a for duodenal (DU) and gastric ulcer (GU) mortality data for both mal es and females, were supported by the results obtained using the MPT. The DU mortality rates for females increased significantly over the 36 -year period. This increase can be explained by the presence of a birt h cohort effect, with women born between 1898 and 1913 having a greate r risk of dying from DU than preceding or subsequent generations. Coho rt effects in GU and DU mortality data for males and in GU mortality f or females were also present, although these were masked by the overal l decline in PU mortality rates. The results support the findings of o ther studies of birth cohort effects in PU mortality data from England , Europe and Japan, and provide support for the existence of environme ntal factors which resulted in increased PU mortality among specific b irth cohorts. Demonstration of these birth cohort effects should influ ence the theories of PU disease aetiology and prevention and should be considered in developing approaches for further research.