Lea en español

Cancer has replaced heart disease as the No. 1 cause of death for Hispanics, Asians and Pacific Islanders, a recent federal report found. But it’s not because fewer are dying from heart disease. In fact, more are dying from both causes, and researchers have some guesses why.

The simplest explanation is that there are merely more people, said Kenneth W. Kizer, M.D., director of the Institute for Population Health Improvement at the University of California, Davis. Hispanics and Asians have been the two fastest-growing racial and ethnic groups in the United States in recent decades, Census Bureau data show.

Those growing populations are also getting older, and cancer and heart disease are conditions that become more common with age, said Kizer, whose institute focuses on cancer and heart disease prevention and research initiatives.

“[Aging] is an important change in a population health burden,” he said.

In the new report from the Centers for Disease Control and Prevention, the number of heart disease deaths in Hispanics and Latinos increased from 25,819 deaths in 2000 to 34,021 deaths in 2014. The number of cancer deaths for that period jumped from 21,160 deaths to 36,447 deaths.

Cancer deaths also outpaced heart disease deaths in Asians and Pacific Islanders, causing 9,069 deaths in 2000 compared with 16,292 deaths in 2014. The number of heart disease deaths rose from 8,949 to 13,021 during that time.


The rankings swap happened in 2009 for Hispanics and Latinos and in 2000 for Asians and Pacific Islanders. Learning that cancer deaths surpassed heart disease so long ago surprised CDC researchers, said Robert Anderson, Ph.D., co-author of the report and chief of the mortality statistics branch at the agency’s National Center for Health Statistics.

What’s also stumping researchers is that Hispanics and Latinos have high rates of diabetes and high blood pressure, both leading risk factors for heart disease. But they also have a high rate of obesity, a top risk factor shared by cancer and heart disease. Asian Americans, meanwhile, have a low obesity rate but are more likely than whites to have diabetes and uncontrolled high blood pressure.

But working in the favor of Hispanics and Asians is that they are less likely to smoke than whites and blacks, providing “perhaps the most persuasive explanation” for why the number of heart disease deaths isn’t higher for Hispanic and Asian Americans, said Gerardo Heiss, M.D., Ph.D., a professor and cardiovascular health researcher at the University of North Carolina’s Gillings School of Global Public Health.

The new report looked only at the number of U.S. deaths from heart disease and cancer. Those numbers illustrate how a disease impacts a community, but death rates — the number of people who die for every 100,000 people in that population — indicate true risk of a disease, Anderson said.

Separate CDC data released last year show Hispanics have a lower death rate overall compared with whites and blacks.

Even so, the new report gives doctors and researchers an opportunity to encourage the nation’s nearly 57 million Hispanics and Latinos and 17.4 million Asians to make “lifestyle choices to improve their risk factor profiles — as much as for heart disease as for cancer,” said Heiss, who has been studying heart disease in the United States and abroad for close to 40 years.

Doctors, he said, need to keep tabs on patients’ cholesterol and blood pressure, and educate patients about their heart disease and cancer risks.

For patients, Kizer said, it comes down to making healthy choices — exercise more, don’t smoke and lower cholesterol.

“It’s not just fate,” he said.