Paris (AFP)

Mortality due to AIDS, transport accidents and cardiovascular disease has "particularly decreased" in sixteen years in metropolitan France, according to a study of trends in causes of death, which covers the years 2000 to 2016.

At the same time, it rose sharply for lung cancer in women, an effect of smoking, and more moderately for both sexes for pancreatic and brain cancers, according to the latest Weekly Epidemiological Bulletin (BEH). of Public Health France, published Tuesday.

"These general results highlight successes and gaps" in prevention and care, say Grégoire Rey, Director of CépiDC-Inserm (which establishes the medical causes of death), and his colleagues, authors of this analysis of trends between the periods 2000-2007 and 2008-2016.

In general, the all-cause mortality rate has continued to decline since the 2000s, likely due to advances in medicine and prevention.

The risk of dying from cancer decreases, even if the number of people affected increases. Cancer is the leading cause of death in France for both sexes, in 2004 in front of cardiovascular diseases.

"The big trend of declining mortality is rather reassuring," Mr. Rey told AFP.

In 2016, out of 579,000 registered deaths, deaths by tumors (29%) and cardiovascular diseases (24.2%) predominate. The proportion of premature deaths (before age 65) of all causes in men remains higher than that observed among women (22.6% against 11.3%).

- "Alert points" -

HIV / AIDS-related mortality, after a first decline in the 1990s, continues to decline over the last 16 years due to advances in prevention and especially treatment. In 2016, there are 300 deaths by AIDS, against 4,800 in 1994.

Deaths by suicide are also declining: nearly 8,500 deaths in 2016 against 11,400 ten years ago. Since the 1980s, however, they still outnumber the deaths caused by transport accidents.

The latter, which have been declining since 2002-2003, have dropped from around 8,000 deaths in 2000 to 3,000 in 2016. The sharp reduction in road accident mortality over the last 16 years can be attributed in particular to speed cameras.

Deaths from cardiovascular diseases are fewer: mortality rates decreased by a quarter between the two periods studied. This is thanks to the development of interventional cardiology techniques (to remove clots, put a stent ...) in infarction and the development of specialized neurovascular units to manage stroke, the authors note.

In women, where cardiovascular disease is the leading cause of death, stroke death outweighs stroke death, unlike men.

"The warning points" are the increase of lung cancer in women, as well as those of the brain and pancreas, says Rey.

Pancreatic cancer has increased in 16 years for both sexes and brain cancer has increased over the second period, 2008-2016, in "a context of radio-frequency technology boom". Research is needed to explain why, according to this specialist.

In addition, melanoma mortality increases in men and remains stable in women while the prevention of this skin cancer is known, the authors point out.

Finally, the trend towards increased dementia, which has been very significant since the 2000s, seems to be slowing down or even reversing in men, possibly due to a decrease in cardiovascular risk factors (hypertension, smoking, diabetes, etc.). .), they argue.

© 2019 AFP