The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 60:S110-S112 (2005)
© 2005 The Gerontological Society of America
Effect of Population Aging on Proportionate Mortality From Heart Disease and Cancer, U.S. 2000–2050
Elizabeth Sonnenschein and
Jacob A. Brody
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago.
Address correspondence to Dr. Jacob Brody, Department of Epidemiology and Statistics, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., M/C923, Chicago, IL 60612-3494. E-mail: Brodyj{at}uic.edu
 |
Abstract
|
|---|
Objectives. One-fourth of all deaths in the United States occur after age 85 (646,900 of 2,392,619 total deaths in 1999). By 2050 (assuming 1999 age-specific death rates), 47.4% of all deaths will occur after age 85 (2,994,935 of 6,314,725 total deaths). As we age, heart disease becomes increasingly important relative to cancer as a cause of death. Thus, as age at death is postponed, future populations will be dying of different age-specific causes. The study objective was to project the effect of population aging on future proportionate mortality rates for heart disease and cancer.
Methods. Using Census Bureau population projections and assuming 1999 age-specific death rates, the authors calculated the number of deaths from heart disease, cancer, and all causes in 10-year intervals from 2000 to 2050.
Results. During this period, the total number of deaths for heart disease and cancer will increase 2.8-fold and 2.3-fold, respectively. The proportionate mortality rate for heart disease will increase from 30% to 33%, and the rate for cancer will drop from 23% to 20%.
Discussion. Changes in age distribution between now and 2050 will cause heart disease to increase its dominance over all other causes of death, and proportionate mortality for cancer will decline.
A RECENT review of cancer statistics in the United States (Edwards, et al., 2002
) predicted that the number of cancers diagnosed in this country will double by the year 2050, a doubling that is caused entirely by the projected demographic shift rather than a change in age-specific cancer rates. During this period, the population will become older as the baby-boom generation, those born between 1946 and 1964, begins to retire in 2011 and, by 2050, ages into the 85+ age group. Concomitantly, increased life expectancy in the older age groups will add to the overall trend toward an older population (Cassel & Brody, 1990).
We have broadened the perspective taken by Edwards and colleagues (2002) to examine the relative impact of cancer and heart disease on mortality trends as the population ages over the next 50 years. Heart disease is the leading cause of death in this country, accounting for 30% of all deaths in 1999, and cancer ranks second, accounting for 23% of all deaths. Age-specific mortality rates tend to differ for heart disease and cancer (Figure 1). Death rates for heart disease increase with age in an exponential curve that is similar to the Gompertz curve for deaths from all causes, whereas cancer death rates increase with age, but not exponentially, and after age 65, the rate of increase slows (Brody & Grant, 2001) (Figure 1). Thus, in 1999, heart disease accounted for fully 39% of all deaths over age 85, whereas only 12% of deaths were attributed to cancer.
View larger version (19K):
[in this window]
[in a new window]
|
Figure 1. Age-specific death rates for all causes, heart disease, and cancer in the United States, 1999
|
|
|
METHODS
|
|---|
We projected the number of deaths for heart disease, cancer, and all causes in 10-year increments (2000, 2010, ... , 2050) using U.S. population projections from the 2000 Security Area Population Projections (middle series) (Population Projections Bureau, 2000) (see Hollman, Mulder, & Kallan [2000] for methodology used to develop projections). For each decennial year, age-specific numbers of deaths due to heart disease, cancer, and all causes were calculated by multiplying 1999 age-specific mortality rates (0–4, 5–14, 15–24, ... , 85+) (National Center for Health Statistics, 2002) by the projected number of persons in the age group for that year and summing over age. Proportionate mortality rates for cancer and heart disease were calculated.
|
RESULTS
|
|---|
The U.S. Census Bureau Population Projections (middle series) (Population Projection Bureau, 2000) indicate that by the year 2050, the U.S. population will increase from 275,306,000 to 403,687,000, a 47% increase. Between 2000 and 2050, the number of persons 65 and over will increase from 34,835,000 to 81,999,000—a 2.3-fold increase, representing a change from 12.7% of the population to 20.3%. The number of persons age 85+ will increase from 4,312,000 (1.6% of total population) to 19,352,000 (4.8% of total population), and by the year 2050, almost half of all deaths will occur after age 85 (Table 1).
View this table:
[in this window]
[in a new window]
|
Table 1. Projected Age Distribution of Deaths From all Causes, Heart Disease, and Cancer in the United States in 2000 and 2050.
|
|
Between 2000 and 2050, the projected number of deaths due to heart disease will increase 2.8-fold, from 739,658 to 2,104,834, and cancer deaths will increase 2.3-fold, from 558,723 to 1,259,518 (see Table 1). As the population ages (Figure 2), proportionate mortality for heart disease will increase from 30% in 2000 to 33% in 2050, whereas cancer will decrease from 23% of all deaths to 20%. The increase in number of deaths from heart disease and cancer will be most dramatic in the 85+ age group, while among those age 75–84, the number of deaths will peak in 2040 and then decline, commensurate with the projected populations for those age groups (Figure 3).
View larger version (89K):
[in this window]
[in a new window]
|
Figure 2. Projected proportionate mortality for heart disease and cancer in the United States, 2000–2050
|
|
|
DISCUSSION
|
|---|
Heart disease continues to be the number one killer in this country, and recent evidence suggests this will not change (Cooper, Cutler, Desvigne-Nickens, et al., 2000). The 40-year decline in heart disease incidence and mortality has recently leveled off, as has progress in reducing important risk factors. Incidence, prevalence, and mortality from congestive heart disease have all increased in the last 25 years and, as the population ages, will probably continue to do so (Cooper et al., 2000; Sutherland, Persky, & Brody, 1990). Mortality from all non-tobacco-related cancers has been going down since 1950 (Rodu and Cole, 2001), and all-sites cancer mortality has been declining since 1990 (National Center for Health Statistics, 2002), although efforts to reduce cancer risk factors have seen mixed results (Byers, Mouchawar, Marks, et al., 1999). Future trends in both heart disease and cancer will be subject to these and other developments, some as yet unknown.
An aging population will influence these trends such that heart disease mortality will increase at a faster rate than cancer. Heart disease, currently the number one cause of death, will increase its dominance over all other causes of death, and proportionate mortality for cancer will decline. Our demographic future demands that improved treatment and prevention of heart disease must continue to be a top priority.
|
Footnotes
|
|---|
Decision Editor: Charles F. Longino Jr., PhD
Received for publication August 12, 2004.
Accepted for publication October 14, 2004.
|
References
|
|---|
- Brody, J. A., Grant, M. D. (2001). Age-associated diseases and conditions: Implications for decreasing late life morbidity. Aging Clinical Experimental Research, 13,64-67.
- Byers, T., Mouchawar, J., Marks, J., Cady, B., Lins, N., Swanson, G. M, et al. (1999). The American Cancer Society challenge goals. How far can cancer rates decline in the U.S. by the year 2015? Cancer, 86,715-727.[Medline]
- Cassel, C. K., Brody, J. A. (1990). Demography, epidemiology, and aging. In C. K. Cassel, D. E. Riesenberg, L. B. Sorenson, & J. R. Walsh (Eds.), Geriatric medicine (pp. 16–27). New York: Springer-Verlag.
- Cooper, R., Cutler, J., Desvigne-Nickens, P., Fortmann, S. P., Friedman, L., Havlik, R., et al. (2000). Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States. Findings of the National Conference on Cardiovascular Disease Prevention. Circulation, 102,3137-3147.[Abstract/Free Full Text]
- Edwards, B. K., Howe, H. L., Ries, L. A., Thun, M. J., Rosenberg, H. M., Yancy, R., et al. (2002). Annual report to the nation on the status of cancer, 1973–1999, featuring implications of age and aging on U.S. cancer burden. Cancer, 94,2766-2792.[Medline]
- Hollman, F. W., Mulder, T. J., Kallan, J. E. (2000). Methodology and assumptions for the population projections of the United States: 1999 to 2100. Working paper no. 38. Washington, DC: Population Projections Branch, Population Division, Bureau of the Census.
- National Center for Health Statistics. (2002). Health, United States 2002, with chartbook on trends in the health of Americans. Hyattsville, MD. Available at www.cdc.gov/nchs/hus.htm.
- Population Projections Bureau, Population Division, U.S. Census Bureau. (2000). Summary files. (NP-T3) Projections of the total resident population by 5-year age groups, and sex with special age categories: middle series. Available at www.census.gov/population/projections/natsum-t3.html. Accessed September 19, 2002.
- Rodu, B., Cole, P. (2001). The fifty-year decline of cancer in America. Journal of Clinical Oncology, 19,239-241.[Abstract/Free Full Text]
- Sutherland, J. E., Persky, V. W., Brody, J. A. (1990). Proportionate mortality trends: 1950 through 1986. Journal of the American Medical Association, 264,3178-3184.[Abstract/Free Full Text]
This article has been cited by other articles:
|
|
|
|
 
B. L. Perrotta and A. L. Perrotta
Access to State-of-the-Art Healthcare: a Missing Dynamic in Consumer Selection of a Retirement Community
J Am Osteopath Assoc,
June 1, 2008;
108(6):
297 - 305.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Grundy and O. Kravdal
Reproductive History and Mortality in Late Middle Age among Norwegian Men and Women
Am. J. Epidemiol.,
February 1, 2008;
167(3):
271 - 279.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Jahangir, S. Sagar, and A. Terzic
Aging and cardioprotection
J Appl Physiol,
December 1, 2007;
103(6):
2120 - 2128.
[Abstract]
[Full Text]
[PDF]
|
|
|
TOP
Abstract
Methods
