Cancer Perspectives

As a killer, cancer catching up to heart disease


Heart disease has had the scary title of being the country’s number one killer for decades, but cancer is hard on its heels. According to the National Vital Statistics Report data for 2013 (the latest year available), the age-adjusted death rate for heart disease was 169.8 per 100,000. Cancer was just a smidgen behind, at 163.2 per 100,000. In 1999, heart disease was way out ahead, with an age-adjusted death rate of 266.5 per 100,000 compared with cancer’s 200.8 per 100,000. Both rates have been falling steadily since then, but the rate has fallen faster for heart disease (36%) than for cancer (19%), bringing them into a near tie.

Leading causes of death in U.S., 1999–2013

Age-adjusted death rates per 100,000

Source: CDC, National Vital Statistics Report, Deaths: Final Data for 2013, Table 9

Heart disease death rates are falling for several reasons, ranging from Americans eating healthier foods to better control of LDL cholesterol levels with statins to more effective surgical and other interventions. Experts debate which factors should get the most credit.

Credit for the decline in cancer’s mortality rate must also be spread around. Cancer death rates peaked in the early ’90s largely because of lung cancer deaths among male smokers, so rates have declined since as smoking rates have fallen. The American Cancer Society also cites advances in prevention, detection, and treatment. But as with heart disease, there’s debate about the relative importance of particular efforts. Last year, two economists, Dana P. Goldman and Tomas Philipson, published a commentary in Health Affairs that argued that 80% of cancer survival gains from1988 to 2000 were from treatment.