Department of Medicine, West Virginia University, Morgantown, WV, USA.
Department of Medicine, Erie County Medical Center, Buffalo, NY, USA.
Eur Heart J Qual Care Clin Outcomes. 2022 May 5;8(3):315-323. doi: 10.1093/ehjqcco/qcaa099.
To compare premature heart disease- and cancer-related deaths in women in the USA.
We analysed the US national database of death certificates of women aged <65 from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database between 1999 and 2018. We measured annual percentage changes (APCs) in age-adjusted mortality rates (AAMRs) and years of potential life lost per 100 000 persons due to heart disease and cancer. Overall, cancer was a more prevalent cause of premature death compared with heart disease. Between 1999 and 2018, the AAMRs decreased for both cancer (61.9/100 000 to 45.6/100 000) and heart disease (29.2/100 000 to 22.6/100 000). However, while APC in AAMR for cancer declined consistently over time, after an initial decline, APC in AAMR for heart disease increased between 2010 and 2018 [0.53 95% confidence interval (0.18-0.89)], with a significant rise in Midwest, medium/small metros, and rural areas after 2008. Compared with cancer, APC in AAMR for heart disease increased in women aged 25-34 years [2.24 (0.30-4.22); 2013-18) and 55-64 years [0.46 (0.13-0.80); 2009-13], as well as Non-Hispanic (NH) Whites [APC, 0.79 (0.46-1.13); 2009-18] and NH American Indian/Alaskan Native [2.71 (0.59-4.87); 2011-2018]. Consequently, the mortality gap between cancer and heart disease has narrowed from an AAMR of 32.7/100 000 to 23.0/100 000.
The mortality gap between cancer and heart disease is decreasing among women <65 years. Intensive cardiovascular health interventions are required focusing on vulnerable young demographic subgroups and underserved regional areas to meet the American Heart Association's Impact Goal and Million Hearts Initiative.
比较美国女性中与早发性心脏病和癌症相关的死亡。
我们分析了美国疾病控制与预防中心广域在线流行病学研究数据库中 1999 年至 2018 年年龄<65 岁的女性的死亡证明国家数据库。我们测量了由于心脏病和癌症每 10 万人损失的潜在生命年数（YPLL）和年龄调整死亡率（AAMR）的年百分比变化（APC）。总体而言，癌症是早逝的比心脏病更为常见的原因。1999 年至 2018 年期间，癌症的 AAMR 下降（61.9/100000 至 45.6/100000），心脏病的 AAMR 下降（29.2/100000 至 22.6/100000）。然而，虽然癌症的 AAMR APC 随着时间的推移持续下降，但心脏病的 AAMR APC 在 2010 年至 2018 年期间有所增加[0.53（95%置信区间（0.18-0.89））]，在 2008 年之后，中西部、中/小都会区和农村地区的增幅显著。与癌症相比，25-34 岁[2.24（0.30-4.22）；2013-18 年]和 55-64 岁[0.46（0.13-0.80）；2009-13 年]的女性、非西班牙裔（NH）白人[APC，0.79（0.46-1.13）；2009-18 年]和 NH 美洲印第安人/阿拉斯加原住民[2.71（0.59-4.87）；2011-2018 年]的 AAMR 心脏病 APC 增加。因此，癌症和心脏病之间的死亡率差距已从 AAMR 的 32.7/100000 缩小到 23.0/100000。
<65 岁女性中，癌症和心脏病之间的死亡率差距正在缩小。需要进行强化心血管健康干预，重点关注弱势青年人群和服务不足的地区，以实现美国心脏协会的影响目标和百万心脏倡议。
