Cancer seems to turn to heart disease as a major cause of death in the United States, especially in higher income populations, according to an observational study of 12 year county death records.
Heart disease was the main cause of death in 79% of the US counties in 2003 and 59% in 2015, while cancer was the main cause of death in 21% of counties in 2003 and 41% in 2015, Katherine Hastings, MPH, said Stanford University School of Medicine in California, and colleagues.
Although mortality rates for cardiovascular disease (CVD) and cancer have declined, change has occurred faster for heart disease. During the 12 year period, all cases of mortality rates across the country decreased by 1% per annum, with 2.7% annual fatalities for heart disease and 1.4% in cancer deaths, and the group stated in the Annals of Internal Medicine.
From 2003 to 2015, adjusted mortality rates for age and sex for CVD increased by 28% (30% in high income counties by 22% in low-income counties), while those for cancer dropped by 16% (18 % income counties against 11% in low income counties).
"Data shows that heart disease is more likely to be the main cause of death in low-income counties," the authors wrote. "Low income counties have not had the same reduction in mortality rates such as high income counties, which suggest later transition to cancer as the main cause of death in low-income counties."
They said that the findings were consistent with research on this "epidemiological transition", including a 2016 report suggesting cancer more than a heart disease by 2020 (the main cause of death throughout the country since 1950). However, a study restriction was the use of county median household income as a proxy for socio-economic status.
Current data "offers a more particulars perspective on this change based on county income levels and racial / ethnic groups. We show transfers that occur earlier in high-income USA counties and earlier for Hispanic, Hispanic / Latino (Spanish) and non-Hispanic Americans (NHW) than for black and American Indians / Alaska Natives. "
The researchers compared the change in mortality by a racial / ethnic group, and said cancer was the leading cause of death in 2015 among Asian Americans, Hispanics and NHW, while heart disease was the main cause of death in 2003. But there was These patterns are not obvious about American Indians / Alaska or Black Natives in 2015, they added.
For the study, researchers examined the US death records of Multiple Multiple Multiple Cases of the National Center for Health Statistics for all adult deaths, ages ≥25 years (n = 32,510,810), across 3143 of the US counties, in each of the 50 states and the Columbia District. The death rates of each case, heart disease, and cancer deaths were matched by the county's median home income quintets.
In an invitation commentary, Silvia Stringhini, PhD and Idris Guessous, MD, PhD, both of Geneva's University Hospitals in Switzerland, stated that the study provided another lens for interpreting the dynamics of the population associated with. The epidemiological transformation, which occurred during the twentieth century, of "pestilence and hunger" to "hand-made diseases", stimulated by an improvement in socio-economic conditions such as living standards, health practices , nutritional hygiene.
"As the authors discuss, these [observed] Sociodemographic differences are likely to be explained by trends in inconsistencies in the number of major risk factors for CVD, such as smoking, obesity and diabetes, "generally more common in people with lower education levels], Stringhini and Geussous wrote.
"However, the effects of genetic tests, screening, and personal treatment of cancer cases and survival are unclear [especially given social disparities in access to these modalities]. Finally, recent reports have also shown an increase in the number of deaths of cardiometabolic and neuro-dangerous disorders. Further research looking at the socio-economic and demographic relationships of these new aspects of epidemiological bridging will help to refine mortality projections in the United States and around the world. "
The Hastings group reported an "Eight Americas" analysis (eight different US prescriptions based on sociological and geographical indicators), which identified differences in chronic disease risk factors, such as alcohol use, smoking, obesity and high blood pressure and glucose levels as key contributors to the differences in mortality among these groups.
"However, persistent reductions in CVD deaths remain, although increased risk factors, such as obesity and diabetes, suggest that the prevention of risk factors can be a small contribution to case-specific mortality, and our county level analyzes can produce information for local factors as additional contributors, "they said.
"Although racial gaps continue … we also found that earnings have been made, especially for deaths of heart disease … and especially for black. [In contrast], American Indians / Alaska Natives was the only group with increasing pre-case mortality rates from 2003 to 2015 in each income quint, "Hastings wrote and coauthors.
"Failure to figure out differences in mortality due to socio-economic status and race / ethnicity in nationally expanding national reports may already be at increasing risk for some diseases or deaths," the group noted. "Our findings may help inform better policies, research and clinical agendas as the US moves through the epidemiological transformation of chronic maternal disease – from heart disease to canker – in the next decades. "
The restrictions recognized by the authors include the use of county median household income as a proxy for socio-economic status, and potential redirect of the cause of death, in terms of race / ethnicity on death records.
The study was funded by the National Institute for Minority Health and Health Needs.
Hastings and co-authors, as well as Stringhini and Guessous, revealed no relatives related to industry.
Robert Jasmer, MD Medical Assistant MD, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nursing Planner
2018-11-12T18: 30: 00-0500