Cancer is now the leading cause of death in many US counties

In fact, cancer will replace heart disease as the leading cause of death in the United States in two years, according to forecasts from US Centers for Disease Control and Prevention mentioned in the study published Monday in the medical journal Annals of Internal Medicine.

"We are about to move from heart disease to cancer, the leading cause of death," said Dr. Latha Palaniappan, lead author of the study and internist, professor and clinical researcher at the Center's Medical Center. Stanford University.

Changes in socio-economic and ethnic groups

A decades-old theory described a change in the health and structure of the disease in the United States over the last century. At the beginning of the 100-year period, infectious diseases such as tuberculosis, diphtheria and influenza cost more American patients than other diseases. Yet by the end of the century, chronic diseases, including heart disease and cancer, had become the leading cause of death. The theory described these complex models and suggested that such changes stemmed from economic and social conditions.

Recent data suggests that the country is undergoing a new transition, this time in the category of chronic diseases itself. To understand these changes, researchers at Stanford Medical School examined more than 32 million deaths in 3,143 US counties from 2003 to 2015. The research team focused not only on medical information, but also on demographic data. , including income and race.

During the 13-year study period, the mortality rate of the total population decreased by 12%, from about 823 deaths per 100,000 population to about 724 deaths per 100,000 population.

In more than three quarters of countries (79%), heart disease was the leading cause of death in 2003, but this remained true for only 59% of countries in 2015.

Cancer, on the other hand, caused the highest number of deaths in about two counties out of ten in 2003, and the same is true for four out of ten counties in 2015.

While the overall death rate from heart disease declined by 28%, high-income counties dropped by 30%, compared with 22% in low-income counties. The death rate from cancer has also declined, but less dramatically: it has decreased by 16%, with a decline of 18% in high-income countries against 11% in low-income countries.

According to the researchers, causes of death may change more slowly in low-income areas because of socio-economic, geographic, demographic, and other factors that affect health and death.

The researchers also compared changes in the habits of racial and ethnic groups. Here, they discovered that among Americans of Asian, Hispanic and white descent, cancer was replacing heart disease as the leading cause of death. However, a similar trend has not been observed among Native Americans / Native Americans of Alaska or Blacks.

Economic factors also affect the new structure of death rates across the country. The researchers found that heart disease had outpaced other causes of death in the lowest-income counties in 2015, but only Americans of Asian descent, Hispanics and whites from the highest-income counties considered cancer a major cause. in 2015.

Make cancer care improvements accessible to all

The research "provides another lens" for interpreting transition dynamics in mortality patterns, wrote Silvia Stringhini, researcher at Lausanne University Hospital, Switzerland, and Dr. Idris Guessous, doctor and epidemiologist at University Hospitals. Geneva in Switzerland, in an editorial published with the study.

"The improvement of socio-economic conditions, such as standard of living, health habits, hygiene and nutrition," writes Stringhini and Guessous, explains that "the motor of the transition between l & # 39, age of "plague and starvation" and age "human-caused diseases" is improving.

The effects of genetic testing, screening and personalized medicine on cancer rates remain unclear, they noted. New and expensive anti-cancer therapies are being introduced, but they could contribute to "increasing social inequalities in cancer survival, with better-off people experiencing a faster decline in mortality," they added. And the same may be true for genetic testing and cancer screening, they noted.

It is likely that differences in smoking, obesity and diabetes trends among high- and low-income groups could be explained by differences in mortality trends, the authors said. For example, between 1960 and 2015, the prevalence of smoking in the United States decreased from 39% to 6% among college graduates, but from 46% to 23% among people who did not finish their studies. secondary education, "they wrote.

With cancer on the brink of overcoming heart disease as the leading cause of death, what do most Americans need to know?

"All the recommended cancer screenings," advises Palaniappan, and adopt "lifestyle prevention practices, such as a healthy diet and exercise, that are beneficial for reducing cancer mortality and reducing the risk of cancer." heart disease".

"Investments in heart disease and cancer research have paid off in recent decades as heart disease and cancer rates have declined," she said. "Without all the wonderful new therapies we have now, it would not have happened."

Nevertheless, there is still much to be done, she said: "We need to work harder in low-income areas of the United States so that they can see the same mortality improvements. to focus more on the prevention and treatment of heart disease and cancer in African-American populations in particular. "