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Comparative Study
. 2017 Jun 21:357:j2765.
doi: 10.1136/bmj.j2765.

Benchmarking life expectancy and cancer mortality: global comparison with cardiovascular disease 1981-2010

Bochen Cao  1 , Freddie Bray  2 , Hiram Beltrán-Sánchez  3 , Ophira Ginsburg  4 , Samir Soneji  5 , Isabelle Soerjomataram  2
Affiliations
Comparative Study

Benchmarking life expectancy and cancer mortality: global comparison with cardiovascular disease 1981-2010

Bochen Cao et al. BMJ. .

Abstract

Objective To quantify the impact of cancer (all cancers combined and major sites) compared with cardiovascular disease (CVD) on longevity worldwide during 1981-2010.Design Retrospective demographic analysis using aggregated data.Setting National civil registration systems in member states of the World Health Organization.Participants 52 populations with moderate to high quality data on cause specific mortality.Main outcome measures Disease specific contributions to changes in life expectancy in ages 40-84 (LE40-84) over time in populations grouped by two levels of Human Development Index (HDI) values.Results Declining CVD mortality rates during 1981-2010 contributed to, on average, over half of the gains in LE40-84; the corresponding gains were 2.3 (men) and 1.7 (women) years, and 0.5 (men) and 0.8 (women) years in very high and medium and high HDI populations, respectively. Declines in cancer mortality rates contributed to, on average, 20% of the gains in LE40-84, or 0.8 (men) and 0.5 (women) years in very high HDI populations, and to over 10% or 0.2 years (both sexes) in medium and high HDI populations. Declining lung cancer mortality rates brought about the largest LE40-84 gain in men in very high HDI populations (up to 0.7 years in the Netherlands), whereas in medium and high HDI populations its contribution was smaller yet still positive. Among women, declines in breast cancer mortality rates were largely responsible for the improvement in longevity, particularly among very high HDI populations (up to 0.3 years in the United Kingdom). In contrast, losses in LE40-84 were observed in many medium and high HDI populations as a result of increasing breast cancer mortality rates.Conclusions The control of CVD has led to substantial gains in LE40-84 worldwide. The inequality in improvement in longevity attributed to declining cancer mortality rates reflects inequities in implementation of cancer control, particularly in less resourced populations and in women. Global actions are needed to revitalize efforts for cancer control, with a specific focus on less resourced countries.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Fig 2 Changes in overall life expectancy in ages 40-84 years between 1981-85 and 2006-10 due to cardiovascular disease (CVD), all cancers, and all other causes of death in men and women. HDI=Human Development Index
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Fig 3 Changes in overall life expectancy in ages 40-84 years between 1981-85 and 2006-10 due to specific major cancer types in men and women. HDI=Human Development Index
See this image and copyright information in PMC

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References

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