Global estimates, trends and predictions of cardiovascular diseases, cancer and their shared risk factors: data from the global burden of disease 2021

Background Cardiovascular diseases (CVDs) and cancer are the leading causes of morbidity and mortality worldwide, accounting for over two-thirds of all premature deaths attributable to noncommunicable diseases. Given that CVD and cancers share common pathomechanistic pathways, understanding the shared risk factors of CVDs and cancer is crucial for developing effective interventions against them. Purpose This study aims to forecast mortality and disability-adjusted life years (DALYs) associated with CVDs and cancer and their risk factors from 2025 to 2050, to establish underlying shared risk factors stratified by age-groups, regions, sociodemographic index (SDI), health systems, and sex. Methods Mortality and DALYs associated with CVDs, cancers, and their risk factors were obtained from the Global Burden of Disease 2021 study. Historical estimates from 1990-2021 and forecast data from 2025-2050 were examined across age-groups, regions, SDI, health systems, and sex. Results In 2021, CVD and cancer collectively resulted in age-standardised DALYs rates of 8,009 per 100,000 population (63% contributed by CVD) and age-standardised mortality rates of 352 per 100,000 population (67% contributed by CVD) globally. While age-standardised DALYs of the combined CVD-cancer burden have declined by 30%, crude DALYs increased by 46% from 1990 to 2021. The largest reductions in age-standardised DALYs was on the CVD front (33%), compared to that of cancer (26%). CVD and cancer collectively resulted in 47% higher age-standardised DALYs rates in males (9,654 per 100,000 population) than in females (6,556 per 100,000 population). In 2021, Central Europe, Eastern Europe and Central Asia had the highest age-standardised CVD-cancer related DALY rates of 11,022 per 100,000 population (68% contributed by CVD) in 2021. While low-middle SDI regions had the highest CVD-related age-standardised DALY rates (6,744 per 100,000 population), high-middle SDI regions had the highest cancer-related rates (3,388 per 100,000) in 2021. The top risk factors driving the CVD-cancer morbidity burden in 2021 were high systolic blood pressure (largely CVD contribution), dietary risks (89% CVD contribution), and tobacco (60% CVD contribution). The key risk factors in 2050 are predicted to be high systolic blood pressure, dietary risks, and tobacco. Conclusion The global decline in age-standardised CVD and cancer burdens, reflecting advancements in medical care, is offset by rising crude rates, reflecting the impact of an aging, growing global population. Primordial preventive efforts should prioritise the key shared risk factors of CVD and cancer, namely hypertension, dietary risks and tobacco.