Cardiovascular disease remains the leading cause of mortality among middle aged adults globally, accounting for 40% of all deaths, but in high-income countries cancer is now responsible for twice as many deaths as CVD (55% vs 23%), according to a new report from the Prospective Urban and Rural Epidemiologic (PURE) study published in The Lancet.
The research, lead by Gilles Dagenais, from Laval University in Quebec, Canada, is the largest in of its kind: the authors collected data on deaths and related causes in 162,534 adults between 35 and 70 years, from 2005 to 2016, in several low, medium and high income countries.
“Our report found cancer to be the second most common cause of death globally in 2017, accounting for 26% of all deaths. But as CVD rates continue to fall, cancer could likely become the leading cause of death worldwide, within just a few decades” said Dagenais. Despite being one of the largest prospective cohort study on the topic, PURE does have limitations: for example, it does not value sex differences in the prevalence of risk factors and their associations with cardiovascular disease and mortality, and representativeness of Africa or the Middle East is modest.
Low income countries studied were Tanzania, Zimbabwe, Bangladesh, Pakistan and India, medium income countries were Philippines, Iran, South Africa, Colombia, China, Brazil, Malaysia, Turkey, Poland, Argentina and Chile; and high income countries were Saudi Arabia, United Arab Emirates, Canada and Sweden.
However, as Stephanie Read and Sarah Wild concluded in a comment, “the value of collecting similar data to inform policy in a wider range of countries is clear, while improving lifestyle choices and modifying their social and commercial determinants remain a challenge”.
Based on the results, some of the authors published (again in The Lancet) another study in which they investigated the risk factors for cardiovascular diseases; they conclude that, alongside the well know hypertension, smoking and fat, also a low level of education and pollution are responsible for increasing the risk. All modifiable factors.
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