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Cancer is now the leading cause of death in 22 states. Surprisingly, that’s good news.


For a long time, if you lived in America, there was a very good chance you’d die of heart disease. For more than half a century, it’s been far and away the leading cause of death here.

In recent years, however, the picture has started to change. The gap is narrowing between deaths due to heart disease and deaths caused by cancer in the United States, according to new data from the Centers for Disease Control and Prevention.

After peaking in 1985, heart disease deaths have been falling (with a small uptick after 2010). Meanwhile, the number of deaths from cancer has nearly tripled since the 1950s.


The general rise in both diseases in the last half century is "largely due to the aging of the U.S. population," the CDC report states. But in the 1980s, the trend started to change: The gap between the two causes of death narrowed.

This means that while heart disease remains the leading killer in America, in some states cancer has caught up or passed it. "By 2014, cancer had replaced heart disease as the leading cause of death in 22 states," according to the report, or in about half of the country. That’s a big change. In coming years, cancer deaths could even outstrip heart disease deaths for the first time.

So what’s going on here?

It turns out several other high-income countries are also seeing cancer deaths creep up while heart disease deaths decline.

There are a few reasons for this. As a 2016 report from the American Cancer Society shows, better cancer detection means more cases are being diagnosed that would have otherwise gone unnoticed.

American Cancer Society trends in cancer incidence and death rates by sex, United States, 1975 to 2012.
American Cancer Society

Americans are also simply living longer, and the overwhelming majority — 86 percent — of all cancers in the US are diagnosed in older people, over the age of 50.

But while more people may be dying from cancer, the cancer death rate has actually been declining since the early 1990s. (In other words, of the people diagnosed with the disease, fewer are now dying from it.) These changes are mainly attributed gains in early detection and treatment advances, as well as declines in the smoking rate.

The drop in heart disease deaths is also clearly good news. According to the American Heart Association, it can also be attributed in part to the decline in smoking, as well as improvements in emergency care for heart disease patients, medications and procedures, and increased awareness about healthy eating and lifestyle.

The big picture

Cause of death for men, based on CDC mortality data from 2005 through 2014. Click here to play with the interactive and see how cause of death varies across age and sex.

Here's what these death trends look like over the life span. Nathan Yau at Flowing Data used mortality information from the CDC from 2005 to 2014 to make death trend graphics for men and women from the age of 0 to 100.

The chart shows percentages — not absolute counts — for the 20 categories of disease deaths the CDC tracks, as well as deaths from external causes. And you can see how much the risks change as we age.

For example, the risk of death from chronic diseases like cancer, circulatory causes (i.e., heart disease), and respiratory issues (for example, chronic obstructive pulmonary disease) starts to rise at about age 20 and keep climbing.

Meanwhile, the risk of death from "external causes" (like traffic accidents) starts to shrink at about 20.

In the chart below, you'll notice the trend lines look remarkably similar for women, except for when it comes to external causes. Yau points out, "For females, it [deaths from external causes] accounts for about 5 percent of deaths. It’s twice as common for males, and mostly at a young age pre-40s."

Cause of death for women.
Flowing Data

These trends have dramatically morphed over time. Yau's data covers a recent period (again, from 2005 to 2014). But if you go all the way back to 1900, as the New England Journal of Medicine did in the chart below, you can get an even richer view of how causes of death have transformed:

(New England Journal of Medicine)

The illnesses that did us in in 1900 — when life expectancy at birth was 47 — are quite different from what we see in 2010, when Americans could expect to live until 79. Chronic illnesses (such as cancer and heart disease) as well as diseases of aging (Alzheimer's) have overtaken infectious diseases like tuberculosis. The newest CDC data suggests that in a few years, the bar for cancer will be even larger.

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