The Shift From Heart Disease to Cancer as the Leading Cause of Death in High-Income Countries: A Social Epidemiology Perspective
Authors: Silvia Stringhini, Idris Guessous
Journal: Annals of Internal Medicine (2018)

Editorials18 December 2018The Shift From Heart Disease to Cancer as the Leading Cause of Death in High-Income Countries: A Social Epidemiology PerspectiveSilvia Stringhini, PhD and Idris Guessous, MD, PhDSilvia Stringhini, PhDLausanne University Hospital, Lausanne, Switzerland, and Geneva University Hospitals, Geneva, Switzerland (S.S., I.G.)Search for more papers by this author and Idris Guessous, MD, PhDLausanne University Hospital, Lausanne, Switzerland, and Geneva University Hospitals, Geneva, Switzerland (S.S., I.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2826 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A combination of increased prevention and improved medical treatment of cardiovascular disease (CVD) has allowed cancer to gradually replace heart disease as the leading cause of death in high-income countries (1). Although mortality from both diseases has decreased steadily in recent decades, CVD mortality has decreased more rapidly. A 2016 report from the Centers for Disease Control and Prevention concluded that cancer will become the leading cause of death in the United States by 2020 (2), and this shift has already occurred in some European countries (1). These changes are part of what has been referred to as the fourth ...References1. Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37:3232-45. [PMID: 27523477] CrossrefMedlineGoogle Scholar2. Weir HK, Anderson RN, ColemanKing SM, Soman A, Thompson TD, Hong Y, et al. Heart disease and cancer deaths – trends and projections in the United States, 1969–2020. Prev Chronic Dis. 2016;13:E157. [PMID: 27854420] doi:10.5888/pcd13.160211 CrossrefMedlineGoogle Scholar3. Hazra NC, Gulliford M. Evolution of the “fourth stage” of epidemiologic transition in people aged 80 years and over: population-based cohort study using electronic health records. Popul Health Metr. 2017;15:18. [PMID: 28499387] doi:10.1186/s12963-017-0136-2 CrossrefMedlineGoogle Scholar4. de Mestral C, Stringhini S. Socioeconomic status and cardiovascular disease: an update. Curr Cardiol Rep. 2017;19:115. [PMID: 28965316] doi:10.1007/s11886-017-0917-z CrossrefMedlineGoogle Scholar5. Hastings KG, Boothroyd DB, Kapphahn K, Hu J, Rehkopf DH, Cullen MR, et al. Socioeconomic differences in the epidemiologic transition from heart disease to cancer as the leading cause of death in the United States, 2003 to 2015. An observational study. Ann Intern Med. 2018;169:836-44. doi:10.7326/M17-0796 LinkGoogle Scholar6. Drope J, Liber AC, Cahn Z, Stoklosa M, Kennedy R, Douglas CE, et al. Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA Cancer J Clin. 2018;68:106-15. [PMID: 29384589] doi:10.3322/caac.21444 CrossrefMedlineGoogle Scholar7. Yu Y. Four decades of obesity trends among non-Hispanic whites and blacks in the United States: analyzing the influences of educational inequalities in obesity and population improvements in education. PLoS One. 2016;11:e0167193. [PMID: 27893853] doi:10.1371/journal.pone.0167193 CrossrefMedlineGoogle Scholar8. Prager GW, Braga S, Bystricky B, Qvortrup C, Criscitiello C, Esin E, et al. Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO Open. 2018;3:e000285. [PMID: 29464109] doi:10.1136/esmoopen-2017-000285 CrossrefMedlineGoogle Scholar9. Smith CE, Fullerton SM, Dookeran KA, Hampel H, Tin A, Maruthur NM, et al. Using genetic technologies to reduce, rather than widen, health disparities. Health Aff (Millwood). 2016;35:1367-73. [PMID: 27503959] doi:10.1377/hlthaff.2015.1476 CrossrefMedlineGoogle Scholar10. Burnett-Hartman AN, Mehta SJ, Zheng Y, Ghai NR, McLerran DF, Chubak J, et al; PROSPR Consortium. Racial/ethnic disparities in colorectal cancer screening across healthcare systems. Am J Prev Med. 2016;51:e107-15. [PMID: 27050413] doi:10.1016/j.amepre.2016.02.025 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Lausanne University Hospital, Lausanne, Switzerland, and Geneva University Hospitals, Geneva, Switzerland (S.S., I.G.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2826.Corresponding Author: Silvia Stringhini, PhD, Institute of Social and Preventive Medicine, Lausanne University Hospital, Route de la Corniche 10, 1010 Lausanne, Switzerland; and Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland; e-mail, silvia.[email protected]ch.Current Author Addresses: Dr. Stringhini: Institute of Social and Preventive Medicine, Lausanne University Hospital, Route de la Corniche 10, 1010 Lausanne, Switzerland.Dr. Guessous: Division of Primary Care, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205 Geneva, Switzerland.This article was published at Annals.org on 13 November 2018. 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