By AMERICAN HEART ASSOCIATION NEWS
Heart disease is the No. 1 cause of death in the United States. But after nearly three decades in decline, the number of deaths from heart disease has increased in recent years, a new federal report shows. Meanwhile, the number of cancer deaths have been climbing for decades, bringing the nation’s top two killers closer than ever in the rankings for leading cause of death.
The report, released Wednesday by the Centers for Disease Control and Prevention, showed that heart disease deaths increased by 3 percent between 2011 and 2014, and that cancer deaths rose by 2.6 percent during that time. This is the first time the CDC has published a report looking specifically at the number of deaths from heart disease and cancer.
Statisticians at the CDC’s National Center for Health Statistics had expected cancer to surpass heart disease as the top killer a few years ago and planned to release the report then, said Robert Anderson, Ph.D., chief of the CDC’s mortality statistics branch and coauthor of the report.
“When I started working here 20 years ago, I never thought that we’d see a convergence like this,” Anderson said. “As we’ve watched them get close and closer together, we started to think, ‘Gee, we might see a crossover here.’”
The number of cancer deaths is going up because the population is getting older, Anderson said. That makes the decline in heart disease deaths in the 1990s and 2000s “all that much more remarkable,” he said.
But the recent rise in deaths from both diseases caught the CDC’s attention, Anderson said.
It is “impossible to say” whether cancer will soon overtake heart disease as the No. 1 cause of death in the United States because “there’s a certain amount of randomness to mortality,” Anderson said. For example, preliminary data for the first quarter of 2016 indicate heart disease deaths are going down again, he said.
While the new report might seem like bad news, cardiovascular health researcher Wayne Rosamond, Ph.D., said it should not overshadow the “tremendous success story” in reducing the burden of heart disease in recent decades.
“That is remarkable when you think about it because the population gets bigger every year and there’s more people around and the population gets older every year,” said Rosamond, a professor of epidemiology at the University of North Carolina’s Gillings School of Global Public Health.
Even so, he said, the recent rise in heart disease deaths is “something to be concerned about and to encourage us to continue our efforts” to eat healthier, get more regular physical activity and reduce leading risk factors such as obesity and high blood pressure.
Avonne E. Connor, Ph.D., a breast cancer researcher at the Johns Hopkins Bloomberg School of Public Health, said smoking is a big risk factor shared by heart disease and cancer, as are obesity and diabetes.
“My first takeaway was thinking about smoking, as lung cancer is one of the prominent causes of cancer mortality,” said Connor, an assistant professor of epidemiology and oncology. People need to better understand their risks for both diseases, said Connor, and “how we can change these risk factors personally, but also as a population.”
The new findings might offer public health officials and others useful insights about where to focus their efforts. The CDC report showed that although heart disease continues to take the most American lives in the South and many other states, cancer is now the leading cause of death in 22 states, including Arizona, California, Maine and West Virginia. By comparison, in 2000, cancer was the No. 1 cause of death in only two states: Alaska and Minnesota.
The burden of each disease also appears to differ by race and ethnicity. While heart disease remains the leading cause of death for white and black Americans, cancer tops the list for Hispanics and Asians or Pacific Islanders.
What surprised researchers, Anderson said, was that cancer had become the leading cause of death for Asians and Pacific Islanders back in 2000. “We knew that cancer was higher than heart disease [for that population], but we didn’t realize cancer had crossed over so [long ago],” he said.
The new report specifically looked at the number of deaths from heart disease and cancer, which is the tally the CDC uses to determine the nation’s leading killers. Those numbers show the burden of disease on society, but they don’t give a picture of the risk of disease in the population, Rosamond said.
Rather, he said, death rates reflect the true risk by giving the number of people who die for every 100,000 people in the U.S. population. Based on a separate CDC report issued last December, heart disease was responsible for 167 deaths per 100,000 Americans in 2014. Cancer was a close second at 161.2 deaths.
“Heart disease deaths are still increasing, but the number of cancer deaths is increasing at a greater pace. This is worrisome because it means Americans are dealing with greater health burdens overall,” said Mariell Jessup, M.D., of the Penn Heart and Vascular Center at the University of Pennsylvania and a past president of the American Heart Association.
“Many of the risk factors for heart disease also increase the risk for cancer, especially smoking and poor diet,” Jessup said. “This report supports the need to create and strengthen partnerships with other public health organizations to align our efforts for both heart disease and cancer prevention.”