TRENDS IN PEPTIC-ULCER MORTALITY IN SYDNEY FROM 1971 TO 1987

Gastric and duodenal ulcer (GU,DU) mortality in Western countries has varied over time by age and sex. Temporal variation raises the questio n of whether these ulcers have an environmental etiology. Using death certificate data, we investigated peptic ulcer mortality time trends f rom 1971 to 1987 in Sydney, Australia, and whether ulcer mortality and overall mortality in Sydney were similar with regard to time trends a nd associations with demographic and environmental factors. In men in all age groups and in women age <65, GU and DU mortality decreased. In women age greater-than-or-equal-to 70, GU mortality remained constant and DU mortality increased. Average age at ulcer death increased: fro m 1971 to 1987, ulcer deaths at age greater-than-or-equal-to 70 rose f rom 52 to 80% of all ulcer deaths. In men who died at age 30-54, GU an d DU mortality decreased relative to overall mortality. In women who d ied at age greater-than-or-equal-to 55, DU mortality increased relativ e to overall mortality. Compared with overall mortality, the ulcer mor tality rate was affected more adversely by lower social class and lack of the marriage tie, and smoking rates tended to correlate more stron gly with GU mortality. The greater-than-expected decrease in GU and DU mortality in younger men and the increase in DU mortality in elderly women suggest important changes in as yet unidentified environmental r isk factors for ulcer mortality within the young adult male and elderl y female general populations.