Cancer is now the leading cause of death in high-income countries

Two reports published in The Lancet providing new data on the common incidence of diseases in high-, middle-, and low-income countries revealed that while cardiovascular disease remains the leading cause of death in high-income countries, cancer is now the leading cause of death in middle-aged adults. The reports are part of the Urban Rural Rural Epidemiology (PURE) study and were presented together at the ESC 2019 Congress this week in Paris.

The first study looked at the variation in common illnesses, hospitalizations and mortality among 162,534 middle-aged adults (aged 35 to 70) in 21 countries worldwide. Globally, CVD remains the leading cause of death among middle-aged adults, accounting for 40% of all deaths. They found that adults were 2.5 times more likely to die from CVD in low-income countries, compared to high-income countries, although low-income countries have fewer CVD risk factors than countries with low-income countries. richer. The authors suggest that the quality of health care is lower or that economic factors prohibiting people seeking health care may be a factor. However, in HIC, they discovered that cancer was becoming the leading cause of death, with 10 cancer deaths out of 4 deaths from CVD.

"The world is witnessing a new epidemiological transition between different categories of noncommunicable diseases, CVD being no longer the leading cause of death in HIC," said lead author Dr. Gilles Dagenais, professor emeritus at Laval University. "Our report found that cancer was the second leading cause of death in the world in 2017, accounting for 26% of all deaths, but as CVD rates continue to decline, cancer could likely become the leading cause of death. in the world, in just a few decades. "

The second report focused on cardiovascular disease. According to their findings, 70% of CVD cases and deaths worldwide are due to modifiable risks. These risks include metabolic, behavioral, socio-economic and psychosocial factors, strength and the environment. Metabolism was the main contributor, reaching 41.2% of all cases. Hypertension was the main factor in this group, with just under a quarter of cases (22.3%).

Globally, the leading risk factor for death from cardiovascular disease was behavioral risk, but in low- and middle-income countries, air pollution in households, poor nutrition, Low level of education and low adherence were much larger than in high income countries. .

"Certain risk factors certainly have major global impacts, such as hypertension, tobacco and a low level of education, but others, such as an Poor diet, household air pollution, vary widely depending on the economic level of the countries, "said Sumathy Rangarajan, coordinator of the study said. "It is now possible to realign global health policies and adapt them to different groups of countries according to the risk factors with the greatest impact in each context".

The results are informative and indicate the need to improve resources and focus on more ad hoc solutions for different countries. That said, the authors admit the limitation of studies; focus on only 21 countries (not including the countries of North Africa and West or Australia) means that it is not possible to generalize for each country .