ABC | Volume 114, Nº2, February 2020

Short Editorial Martins Death from cancer and cardiovascular disease Arq Bras Cardiol. 2020; 114(2):207-208 1. World Health Rankings: live longer liver better. [Cited in 2019 Dec 08]. Availablefrom: https://www.worldlifeexpectancy.com/world-health-rankings. 2. Silva Júnior JB, Ramalho WM. Cenário epidemiológico do Brasil em 2033. Uma prospecção sobre as próximas duas décadas. Rio de Janeiro: Fundação Oswaldo Cruz; 2015. [Citado em 12 dezembro de 2019]. Disponível em: https://saudeamanha.fiocruz.br/wp-content/uploads/2016/07/17- PJSSaudeAmanha_Texto0017_A4_07-01-2016.pdf. 3. Reis C, Barbosa L, Pimentel V. Odesafio do envelhecimento populacional na perspectiva sistêmica da saúde. BNDES Setorial. 2016; 44:87-124. [Acesso em 29 novembro de 2019]. Disponível em: https://web.bndes.gov.br/ 4. OrganizaçãoMundialdaSaúde(WHO).OrganizaçãoPan-AmericanadaSaúde (OPAS)-Brasil.10Principaiscausasdemortenomundo.FolhaInformativa.2018. [Citadoem04janeiro2020].Disponívelem:Disponívelem: https://www.paho. org/bra/index.php?option=com_content&view=article&id=5638:10- principais-causas-de-morte-no-mundo&Itemid=0 5. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad A. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2019 Sep 3. pii: S0140-6736(19)32008-2. 6. Organização Pan-Americana da Saúde (OPAS)/Brasil. Câncer. Folha Informativa. Setembro 2018. [Citado em 04 janeiro de 2020]. Disponível em: https://www.paho.org/bra/index.php?option=com_content&view=a rticle&id=5588:folha-informativa-cancer&Itemid=1094 7. Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends - an update. Cancer Epidemiology, Biomarkers and Prevention. 2016;25(1):16-27. 8. MartinsWA, Matos R, RosaML, Souza SilvaWD, Souza Filho E, Jorge AJL, et al. Tendência das taxas de mortalidade por doença cardiovascular e cancer entre 2000 e 2015 nas capitais mais populosas das cinco regiões do Brasil. Arq Bras Cardiol. 2020; 114(2):199-206. 9. Wilson L, Bhatnagar P, Townsend N. Comparing trends in mortality from cardiovascular disease and cancer in the United Kingdom, 1983-2013: joinpoint regression analysis. Popul Health Metr. 2017;15 (1):23. 10. Curtin SC. Trends in cancer and heart disease death rates among adults aged 45–64: United States, 1999–2017. National Vital Statistics Reports 2019 May; 68(5):1-8. [Cited in 2010November 12]. Available from: https://www. cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_05-508.pdf 11. Soares GP, Klein CH, Souza e Silva NA, de Oliveira GMM. Evolution of mortality from diseases of the circulatory system and of gross domestic product per capita in the Rio de Janeiro statemunicipalities. Int J Cardiovasc Sci. 2018;31(2):123-32. References This is an open-access article distributed under the terms of the Creative Commons Attribution License from cancer in developed countries, this figure increases in undeveloped countries. Mortality rates due to malignant neoplasms have been increasing in countries with low levels of development, as a consequence of increased prevalence of risk factors, such as increased tobacco use, excess body weight, physical inactivity, and better treatment. 7 The article “Trends in Mortality Rates from Cardiovascular Disease and Cancer between 2000 and 2015 in the Most Populous Capital Cities of the Five Regions of Brazil” 8 presents important conclusions regarding the incidence of cancer and CVD in relation to a country’s level of development. In England, for instance, the rate of mortality from CVD decreased more than the rate from cancer. In individuals over the age of 75, in particular, the impact of advances made in diagnosis and treatment on the mortality rate from cancer was even lower. In 2011, the age-standardized mortality rate from cancer exceeded that of CVD in both sexes, in the United Kingdom, long before this is observed in Brazil. 9 In the USA, mortality rates from cancer in adults between the ages of 45 and 64 decreased by 19%, from 1999 to 2017, whereas rates of mortality from heart diseases decreased by 22%, from 1999 to 2011, and then increased by 4% from 2011 to 2017. The mortality rate from cancer has always been higher than that from heart diseases in that country. 10 Final considerations In this manner, Brazil continues with its demographic transformation and its epidemiological transition. Population aging, as previously observed, is a foreseeable trend, allowing society and individuals to plan for this new profile. As a national panorama, our demographic profile is already similar to that of large countries. The elderly group (individuals over the age of 60) is growing faster than any other age group in Brazil. Nevertheless, the epidemiological transition continues with inequality: The group of Brazilians who live with housing and income conditions similar to those in developed countries also demonstrate morbidity and mortality similar to those countries, whereas the rest of the population, which constitutes the majority of Brazilians, lives in poverty with scarce healthcare resources. A correlation was recently demonstrated between the evolutionary variation of gross domestic product (GDP) per capita in the municipalities of the state of Rio de Janeiro and reduced mortality from coronary artery disease. 11 This once again emphasizes the importance of the need for better living conditions in order to reduce cardiovascular mortality. For this and other reasons, Martins et al. 8 draw attention to the need to fragment the discussion regarding death trends in Brazil, due to the distinct profiles the country presents, which correspond to different GDP and indicators of education. The main challenge in Brazil will be that of recognizing this new profile that is being unveiled and designing targeted strategies according to the peculiarities found, leading to greater health promotion for the entire population in an equitable manner. 208