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In 1975 diseases of the circulatory system were the major cause of death in our hospital autopsies, with neoplasia a poor second. In 1984 the situation was the reverse. The reduction in diseases of the circulatory system was due mainly to that in cerebrovascular cases, deaths from coronary artery disease being unchanged. The increase in neoplasia affected older women in particular, who died from less common types of cancer. It is suggested that these patients may have escaped death from cerebrovascular disease and avoided cancers that usually kill in middle age, to die later of other age-related types that were less common in 1975. The present findings emphasize the importance of recognizing and adjusting to a changing spectrum of disease that is developing in the ageing population found in a West European country.

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