Heart Disease and Cancer Deaths - Trends and Projections in the United States, 1969-2020.
Level 4 - case-series / case-control
Ecological time-series and demographic projection analysis using aggregate national vital statistics (by design analogy, Level 4).
PubMed 27854420 · doi:10.5888/pcd13.160211
What was done
US national mortality records, population estimates, and population projections from 1969 through 2020 were analyzed to estimate and project total heart disease and cancer deaths. Researchers decomposed changes in deaths over time into contributions from baseline population risk reduction, overall population growth, and population aging.
What was found
Between 1969 and 2020, the total number of heart disease deaths was projected to decrease by 21.3% among men (-73.9% risk reduction, +17.9% population growth, +34.7% aging) and by 13.4% among women (-73.3% risk reduction, +17.1% population growth, +42.8% aging). Conversely, cancer deaths were projected to increase by 91.1% among men (-33.5% risk reduction, +45.6% population growth, +79.0% aging) and by 101.1% among women (-23.8% risk reduction, +48.8% population growth, +76.0% aging). Cancer was projected to overtake heart disease as the leading cause of US death around 2016.
Why it matters
Steep reductions in cardiovascular risk have outpaced demographic aging, whereas smaller reductions in cancer risk were insufficient to offset population aging and growth, shifting the leading national disease burden.
Limits
The analysis relies on aggregate mortality projections and historical trend extrapolation rather than individual-level longitudinal data. Projections assume continuation of existing demographic and risk trends and could not anticipate unexpected epidemiological shifts or sudden changes in treatment or cause-of-death coding practices.
Cited by
- supports Breast cancer accounts for 3% of deaths in women, all cancers combined account for 20% to 21%, and cardiac disease accounts for 22% to 23%.