Gains in life expectancy after elimination of major causes of death: revised estimates taking into account the effect of competing causes.

Background: It is generally acknowledged that conventional estimates of the potential number of life years to be gained by elimination of causes of death are too generous. This is because these estimates fail to take into account the fact that those who are saved from the cause are likely to have one or more other conditions ("competing" causes of death), which may increase their risks of dying. It is unknown to what extent this introduces bias in comparisons of life years to be gained between underlying causes of death.

Competing causes of death: a death certificate study.

Background: Despite the widespread interest in competing causes of death, empirical information on interrelationships between causes of death is scarce. We have used death certificate information to estimate the prevalence of competing causes of death at the moment of dying from specific underlying causes of death.

Materials And Methods: In a stratified sample of 5975 deaths occurring in The Netherlands in 1990, information contained in the death certificate was used to determine the presence of diseases which, in the hypothetical case of elimination of the underlying cause of death, could develop into a new underlying cause of death.

Competing causes of death: an analysis using multiple-cause-of-death data from The Netherlands.

The standard methodology for cause-elimination life tables assumes that the various causes of death are statistically unrelated to one another, so that the mortality risks of those who are saved from an eliminated cause equal the risks of dying from other causes which are observed for the general population. In the analysis reported in this paper, data on multiple causes of death for the year 1990 in the Netherlands were used to investigate whether this is likely to be a valid assumption. For four groups of underlying causes of death (malignant neoplasms, cardiovascular diseases, and external causes), the age-standardized prevalence at death of other conditions was calculated.