Common diseases in transition: Cancer and heart disease now the leading cause of DEATH in 21 countries

A large cohort study published in the Lancet announced a shift in the leading causes of death among middle-aged adults in 21 countries, with cancer creeping in to number one currently held by heart disease.

The countries in question ranged from high income (HI) to middle income (MI) to low income (LI). Although cardiovascular disease is still the number one cause of death globally, this is no longer the case in HI countries. Cancer is now responsible for the majority of deaths in these areas. Researchers further remarked that cancer-related deaths will rise throughout the decades and will account for most deaths globally.

Cancer outpacing heart disease in leading cause of death

In the first report of the study, the researchers followed 162,534 middle-aged adults over an average of nine-and-a-half years. They found that 40 percent of all deaths is due to cardiovascular disease. Next to it is cancer at 26 percent.

CVD death is particularly prevalent among LI countries, occurring 2.5 more times than HI countries. The researchers explained that this is due to poorer access to healthcare. Governments in LI and even MI countries should focus their health budget on managing non-communicable diseases such as CVD, the team recommended.

However, they also said that CVD deaths are declining; in its place, cancer could later on be the number one cause of death across the globe. (Related: Popular cancer drugs increase risk of death, study finds.)

“Our report found cancer to be the second most common cause of death globally in 2017, accounting for 26% of all deaths. But as CVD rates continue to fall, cancer could likely become the leading cause of death worldwide, within just a few decades,” explained Dr. Gilles Dagenais, the leading author of the first report.


These trends seem to be mimicked by the United States, as shown by a study published in the Annals of Internal Medicine. Heart disease remains the leading cause of death in low-income counties, but ranked second to cancer in high-income counties. The researchers predicted that low-income areas will only later transition to cancer as the leading cause of death. That’s because these areas have yet to decrease their cases of CVD deaths.

Leading risk factors for heart disease are controllable

The second report of the current study demonstrated the importance of placing better policies to address CVD. It also reiterated that many of the leading risk factors to developing CVD are modifiable, which means deaths can be prevented.

In the study, the team explored the relative contribution of 14 modifiable risk factors among 155,722 community-dwelling, middle-aged people without a prior history of CVD.

Seventy percent of all worldwide CVD cases is due to metabolic, behavioral, socioeconomic and psychosocial factors, strength and environment. Out of these, metabolic risk factors especially hypertension contributed the most to CVD globally at 41.2 percent. In deaths, however, behavioral factors played the biggest role at 26.3 percent.

People living in HI countries, in particular, should watch out for these risk factors. The Centers for Disease Control and Prevention (CDC) reported that almost half of all Americans have at least one of three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

Moreover, the researchers stressed the role of household air pollution, poor diet, low education and low grip strength in LI and MI countries.

“While some risk factors certainly have large global impacts, such as hypertension, tobacco, and low education, the impact of others, such as poor diet, household air pollution, vary largely by the economic level of countries,” said Sumathy Rangarajan, who coordinated the study.

These findings should serve as a call to both policy makers and individuals to make the necessary move to prevent death.

Learn more on how to prevent cancer and heart disease at

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