[Total and cause-specific mortality trends are analyzed in Pavia Province from 1991 to 2000].

Age-standardized mean two-years mortality rates are compared with those ones of Lombardy region in 1991-1998 period. A decreasing trend of total mortality (-19%) consistent with the regional rates was noticed and a tendency to convergence at the end of the observation period. The reduction is more evident for cardiovascular diseases (-25.48% M and -26.77% F) and for cancer (-16.89% M and -10.6% F), where provincial rates are more markedly diminishing than those ones observed in Lombardy region. Among the specific causes of death, colon and stomach cancer mortality shows a fall in both sexes as well as lung cancer in males and breast cancer in females, while lung cancer mortality in women is increasing. Respiratory diseases mortality, after an initial reduction, shows a modest raise in males, while digestive system disease mortality, always higher than the regional one, decreases by 29.09% in males and 12.15% in females as well as external causes (-27.82% M and -28.37% F). On the contrary infectious disease mortality is increasing, following the regional trend. The mortality surveillance and the comparison of local rates with regional or national ones is the first step to evaluate the population health status for the provision of prevention and care.