Australia’s leading causes of death, 2018



There were 158,493 registered deaths in Australia in 2018. This paper outlines the leading causes of those deaths with a particular focus on age and sex.



The table below shows the top 20 leading causes of mortality for 2018 compared with 10 years ago (2009) and 5 years ago (2013). Key points include:

The leading cause of death was Ischaemic heart disease. The standardised death rate from Ischaemic heart disease has decreased by 22.4% since 2009, with declines in heart disease mortality observed now for more than 50 years.

Dementia, including Alzheimer's disease, remained the second leading cause of death. Deaths due to dementia have increased by 68.6% since 2009.

Cerebrovascular diseases, Cancer of the trachea, bronchus and lung and Chronic lower respiratory diseases round out the top five leading causes of death.

The top five leading causes of death account for more than one-third of all registered deaths.

Influenza and pneumonia was the 12th leading cause of death. The number of influenza deaths is strongly linked to the severity of flu seasons and this can drive changes in ranking for this leading cause group.

Intentional self-harm was the 14th leading cause of death. It has the lowest median age at death among the top 20 leading causes, at 44.4 years of age.

Leading causes of death, Australia - selected years - 2009, 2013, 2018 (a)(b)(c)(d)(e)(f)(g) 2009 2013 2018 Median Age (2018) Cause of death and ICD code no. Rank no. Rank no. Rank years Ischaemic heart diseases (I20-I25) 22,587 1 19,778 1 17,533 1 84.7 Dementia, including Alzheimer disease (F01, F03, G30) 8,280 3 10,934 2 13,963 2 89.0 Cerebrovascular diseases (I60-I69) 11,216 2 10,543 3 9,972 3 86.2 Malignant neoplasm of trachea, bronchus and lung (C33, C34) 7,786 4 8,215 4 8,586 4 73.6 Chronic lower respiratory diseases (J40-J47) 5,984 5 7,151 5 7,889 5 80.9 Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0) (c) 5,244 6 5,373 6 5,420 6 77.0 Diabetes (E10-E14) 4,176 7 4,333 7 4,656 7 81.4 Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96) 3,811 8 4,093 8 4,612 8 78.2 Diseases of the urinary system (N00-N39) 3,315 9 2,987 11 3,384 9 86.8 Malignant neoplasm of prostate (C61) 3,111 11 3,113 10 3,264 10 82.6 Heart failure and complications and ill-defined heart disease (I50-I51) 3,219 10 3,243 9 3,192 11 88.5 Influenza and pneumonia (J09-J18) 1,790 17 2,497 15 3,102 12 89.3 Malignant neoplasm of pancreas (C25) 2,204 14 2,559 14 3,077 13 74.9 Intentional self-harm (X60-X84, Y87.0) (d) 2,337 13 2,610 13 3,046 14 44.4 Malignant neoplasms of breast (C50) 2,799 12 2,892 12 3,034 15 71.7 Accidental falls (W00-W19) 1,450 21 1,991 18 2,952 16 87.3 Cardiac arrhythmias (I47-I49) 1,552 19 1,890 19 2,442 17 88.9 Hypertensive diseases (I10-I15) 1,845 15 2,153 17 2,136 18 88.2 Malignant neoplasm of liver and intrahepatic bile ducts (C22) 1,328 22 1,574 22 2,104 19 71.9 Melanoma and other malignant neoplasms of skin (C43-C44) 1,837 16 2,208 16 2,094 20 77.5 Footnote(s):

(a) Causes listed are the top 20 leading causes of death for 2018, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 38-41 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecified nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.

(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data

(c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). Comparisons with data for this leading cause, and associated leading cause rankings, should therefore be made with caution. See Explanatory Note 40 in this publication for further details.

(d) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.

(e) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2009 and 2013 (final) and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).

(f) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

(g) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.



Age-standardised death rates



In order to measure and compare changes in leading causes over time, standardised death rates for the top five leading causes of death are presented in the graph below.



Key findings include :

Ischaemic heart disease decreased from 91.4 deaths per 100,000 in 2009, to 54.6 in 2018. This was largest rate decrease within the top 5 leading causes.

Dementia, including Alzheimer's disease increased from 32.3 deaths per 100,000 people in 2009 to 41.2 in 2018.

Death rates for Cerebrovascular diseases continue to decrease, with a rate reduction of 14.2 deaths, from 44.9 in 2009 to 30.7 in 2018.

Decreases in cardiovascular disease mortality have been recorded since 1968. These decreases and the advancements in treatment which have enabled them to happen are covered in the article Changing Patterns of Mortality in Australia, 1968-2017

Changing Patterns of Mortality in Australia, 1968-2017 The decrease in cardiovascular disease mortality and increases in Dementia, including Alzheimer's disease mortality constitute the largest changes in leading causes of death in Australia. Dementia, including Alzheimer's disease replaced Cerebrovascular diseases as the second leading cause in 2013 and on current trend will become the leading cause of death in coming years.

The death rate from Malignant neoplasms of trachea, bronchus and lung has decreased from 33.2 deaths per 100,000 in 2009 to 28.4 in 2018. Decreases in smoking rates have been observed over many decades and are eventually resulting in decreased rates of lung cancer mortality.



Leading causes of death, standardised death rates, 2009-2018 (a)(b)(c)(d)(e)(f)



Footnote(s):

(a) Causes listed are the top 20 leading causes of death for 2018, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 38-41 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecified nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.

(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data

(c) Standardised death rate. Death rate per 100,000 estimated resident population as at 30 June (mid year). See Explanatory Notes 46-49 for further information

(d) All causes of death data from 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this table are: 2009 - 2015 (final), 2016 (revised), 2017 and 2018 (preliminary). See Explanatory Notes 59-62 in this publication and Causes of Death Revisions, 2015 Final Data (Technical Note) and 2016 Revised Data (Technical Note) in Causes of Death, Australia, 2017 (cat. no. 3303.0).

(e) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

(f) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.



Years of Potential Life Lost



Years of potential life lost is a measure of premature mortality which weights age at death to gain an estimate of how many years a person would have lived had they not died prematurely. When considered in terms of premature mortality, the leading causes have a notably different profile. This is in part because of the high median ages at death for many leading causes (see Leading causes of death, Australia - selected years - 2009, 2013, 2018 above).



The graph below shows the number of Years of Potential Life Lost for the top 20 leading causes of death.



Key findings include:

Suicide accounted for the highest number of years of potential life lost, despite being the 14th leading cause overall. The median age at death is 44.4 years of age, which is considerably lower than any of the other top 20 leading causes. Suicide accounted for approximately 105,730 years of potential life lost in 2018.

Ischaemic heart disease accounted for the second highest number of years of potential life lost (68,532). It has both the highest number of deaths and the highest number of premature deaths (more than 6,000), but it has a considerably higher median age at death at 84.7 years of age.

Dementia, including Alzheimer's disease accounts for only 6,680 years of life lost, despite being the second leading cause of death. Dementia is predominantly a disease that affects the very elderly and has a median age at death of 89.0.

Some types of neoplasms can affect people at a broad range of ages. Lung cancer, Colon cancer and Breast cancer are the third, fourth and fifth leading causes of potential life lost and have median ages at death of 73.6, 77.0 and 71.7, respectively.

Years of Potential Life Lost (YPLL) for leading causes, 2018 (a)(b)(c)(d)(e)(f)(g)(h)



Footnote(s):

(a) Causes listed are the top 20 leading causes of death for 2018, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 38-41 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecified nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.

(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data

(c) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication

(d) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). Comparisons with data for this leading cause, and associated leading cause rankings, should therefore be made with caution. See Explanatory Note 40 in this publication for further details.

(e) The ranking of YPLL data presented in this table is based only on the top 20 causes of death. When considering the full listing of leading causes of death, including those not in the leading 20, the YPLL ranking would be different. See Explanatory Notes 42-45 for further information on Years of Potential Life Lost.

(f) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.

(g) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

(h) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.



Leading causes of death by sex



In 2018 there were 82,320 male deaths and 76,173 female deaths. The table below shows the top 20 leading causes of death for males and females.



Key findings include:

The top five leading causes are the same for both males and females, although the ranking of those causes differs.

Ischaemic heart disease was the leading cause of death for males (10,269 deaths). Dementia, including Alzheimer’s disease was the leading cause of death for females (8,973 deaths).

Changes in the top five leading causes for both males and females are being driven by decreases in deaths from cardiovascular diseases (Ischaemic heart disease and Cerebrovascular diseases) and increases in deaths from Dementia, including Alzheimer's disease.

Lung cancer is the leading cause of cancer-related death for both males and females. It is the second leading cause of death overall for men and the fifth for women.

The sex specific cancers (Malignant neoplasm of prostate and Malignant neoplasm of breast) were the sixth leading causes for males and females respectively. Prostate cancer was the cause of 3,264 male deaths while breast cancer caused 2,999 female deaths in 2018.

Colon cancer was the seventh ranked leading cause for both males and females.

External causes include deaths from accidents, assaults and suicide. Suicide is the top ranked external cause of death among males (ranked 10th), while accidental falls are the highest ranked for females (ranked 14th).

Leading causes of death, Australia - by sex - 2018 (a)(b)(c)(d)(e)(f)(g)(h) Males Females Cause of death and ICD code no. SDR(d) rank Cause of death and ICD code no. SDR(d) rank Ischaemic heart diseases (I20-I25) 10,269 74.4 1 Dementia, including Alzheimer disease (F01, F03, G30) 8,973 44.0 1 Malignant neoplasm of trachea, bronchus and lung (C33, C34) 5,000 35.5 2 Ischaemic heart diseases (I20-I25) 7,264 37.6 2 Dementia, including Alzheimer disease (F01, F03, G30) 4,990 36.5 3 Cerebrovascular diseases (I60-I69) 5,808 30.4 3 Cerebrovascular diseases (I60-I69) 4,164 30.4 4 Chronic lower respiratory diseases (J40-J47) 3,839 22.0 4 Chronic lower respiratory diseases (J40-J47) 4,050 29.3 5 Malignant neoplasm of trachea, bronchus and lung (C33, C34) 3,586 22.3 5 Malignant neoplasm of prostate (C61) 3,264 23.6 6 Malignant neoplasms of breast (C50) 2,999 19.1 6 Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0) (c) 2,905 20.9 7 Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0) (c) 2,515 15.1 7 Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96) 2,705 19.6 8 Diabetes (E10-E14) 2,110 11.8 8 Diabetes (E10-E14) 2,546 18.4 9 Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96) 1,907 11.4 9 Intentional self-harm (X60-X84, Y87.0) (d) 2,320 18.6 10 Diseases of the urinary system (N00-N39) 1,859 9.6 10 Malignant neoplasm of pancreas (C25) 1,596 11.4 11 Heart failure and complications and ill-defined heart disease (I50-I51) 1,795 8.9 11 Diseases of the urinary system (N00-N39) 1,525 11.1 12 Influenza and pneumonia (J09-J18) 1,676 8.4 12 Accidental falls (W00-W19) 1,428 10.4 13 Cardiac arrhythmias (I47-I49) 1,525 7.6 13 Influenza and pneumonia (J09-J18) 1,426 10.4 14 Accidental falls (W00-W19) 1,524 7.8 14 Melanoma and other malignant neoplasms of skin (C43-C44) 1,416 10.2 15 Malignant neoplasm of pancreas (C25) 1,481 9.0 15 Malignant neoplasm of liver and intrahepatic bile ducts (C22) 1,414 10.0 16 Hypertensive diseases (I10-I15) 1,336 6.7 16 Heart failure and complications and ill-defined heart disease (I50-I51) 1,397 10.1 17 Malignant neoplasm of ovary (C56) 968 6.1 17 Cirrhosis and other diseases of liver (K70-K76) 1,248 9.1 18 Diseases of the musculoskeletal system and connective tissue (M00-M99) 839 4.6 18 Parkinson's disease (G20) 1,172 8.6 19 Nonrheumatic valve disorders (I34-I38) 823 4.1 19 Malignant neoplasm of oesophagus (C15) 987 7.0 20 Septicaemia (A40-A41) 757 4.0 20 Footnote(s):

(a) Causes listed are the top 20 leading causes of death for 2018, based on the WHO recommended tabulation of leading causes. See Explanatory Notes 38-41 in this publication for further information. Groupings of deaths coded to Chapter XVIII: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) are not included in analysis, due to the unspecified nature of these causes. Furthermore, many deaths coded to this chapter are likely to be affected by revisions, and hence recoded to more specific causes of death as they progress through the revisions process.

(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data

(c) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). Comparisons with data for this leading cause, and associated leading cause rankings, should therefore be made with caution. See Explanatory Note 40 in this publication for further details.

(d) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.

(e) Standardised death rate. Death rate per 100,000 estimated resident population as at 30 June (mid year). See Explanatory Notes 46-49 for further information

(f) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.

(g) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication.

(h) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.



Sex ratios



The graph below depicts the causes with the largest sex ratios, within the top 20 leading causes of death in Australia in 2018 (excluding sex-specific causes such as prostate and breast cancer).



Key findings include:

The largest male to female ratio was observed in deaths from Intentional self-harm. More than three-quarters of intentional self-harm deaths occur in males.

The largest female to male ratio was observed in deaths from Dementia, including Alzheimer's disease.

Other diseases with a high male to female ratio include skin cancers, liver cancers and blood cancers.

Other diseases with a high female to male ratio include hypertension, cardiac arrythmias and cerebrovascular diseases.

Sex ratios within the top 20 leading causes of death, 2018 (a)(b)(c)(d)(e)(f)(g)



Footnote(s):

(a) Causes listed are the leading causes of death for all deaths registered in 2018, based on WHO recommended tabulation of leading causes. See Explanatory Notes 38-41 for further information.

(b) See Explanatory Notes 77-108 for further information on specific issues related to interpreting time-series and 2018 data

(c) The data presented for intentional self-harm includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to intentional self-harm. See Explanatory Notes 41 and 91-100 in this publication.

(d) The data presented for Malignant neoplasm of the colon, sigmoid, rectum and anus (C18-C21) includes deaths due to Malignant neoplasm of the intestinal tract, part unspecified (C26.0). Comparisons with data for this leading cause, and associated leading cause rankings, should therefore be made with caution. See Explanatory Note 40 in this publication for further details.

(e) Causes of death data for 2018 are preliminary and subject to a revisions process. See Explanatory Notes 59-62.

(f) Changes in coding processes have been applied to 2018 data. See Technical Note Updates to Iris coding software: Implementing WHO updates and improvements in coding processes in this publication

(g) Care needs to be taken when interpreting data derived from Victorian coroner-referred deaths including suicide, see Explanatory Note 111 in this publication.





In order to measure and compare changes in leading causes over time, standardised death rates for the top five leading causes of death are presented in the graph below.Key findings includeYears of potential life lost is a measure of premature mortality which weights age at death to gain an estimate of how many years a person would have lived had they not died prematurely. When considered in terms of premature mortality, the leading causes have a notably different profile. This is in part because of the high median ages at death for many leading causes (seeLeading causes of death, Australia - selected years - 2009, 2013, 2018above).The graph below shows the number of Years of Potential Life Lost for the top 20 leading causes of death.Key findings include:In 2018 there were 82,320 male deaths and 76,173 female deaths. The table below shows the top 20 leading causes of death for males and females.Key findings include:The graph below depicts the causes with the largest sex ratios, within the top 20 leading causes of death in Australia in 2018 (excluding sex-specific causes such as prostate and breast cancer).Key findings include: