Sex differences in morbidity and mortality from peptic ulcer in Canada, 1950-1981.
Mortality from peptic ulcer disease in Canada declined significantly for males from 1950-1981, but changed little for females. Gastric and duodenal ulcer mortality, and mortality from perforated and bleeding peptic ulcer showed similar trends. Rates of hospitalization for male duodenal ulcer subjects also declined, with lesser effects among males with gastric ulcer, and females with either gastric or duodenal ulcer. Rates of partial gastrectomy and vagotomy and pyloroplasty or gastrojejunostomy declined from 1968-1981, especially for males. These changes in trends in peptic ulcer disease were contrasted with the overall mortality rate in Canada during the same period, which demonstrated a similar decline for both sexes. The trend to lower mortality, hospitalization and surgical procedures for peptic ulcer disease during this period was associated with a change in cigarette smoking habits in males but not females. The trends identified could not be correlated with the introduction of H2 antagonists for specific therapy of peptic ulcer disease.