Cancer Trends Progress Report: Years of Life Lost

The NCI Cancer Trends Progress Report tracks years of life lost (YLL) — not just deaths, but the years cut short by each cause of mortality. The metric is calculated from CDC/NCHS vital statistics linked to US life tables, with age- and sex-specific life expectancy applied to each death. It answers a different question than death counts: which diseases rob the most years of productive life?

In 2023, cancer caused 9,114,000 person-years of life lost — ranking first. Heart disease caused 8,110,000 person-years — ranking second. The gap is smaller than death counts alone would suggest, because heart disease kills at older average ages than the cancers most responsible for YLL. Accidents ranked third at 6,377,000, followed by cerebrovascular disease and chronic lung disease (tied at 1,748,000 each). Suicide and diabetes round out the top six non-cancer, non-accident causes.

The cardiovascular YLL data have a specific implication: heart disease’s YLL burden, while second, is concentrated in its premature presentations. The 8.1 million person-years represents deaths across all ages, but the years-per-death calculation is highest for people who die in their 50s and 60s from a first myocardial infarction with no prior diagnosis — exactly the population that aggressive subclinical detection and primary prevention would reach.

Atherosclerosis as a separate category (which excludes deaths coded as CHD, heart failure, or stroke) caused 35,000 person-years of life lost — a figure that reflects coding practices more than disease burden, since atherosclerosis underlies the vast majority of the 8.1 million heart disease YLL.

COVID-19’s impact on life tables is noted: 2020–2023 estimates reflect 1–2 years of reduced life expectancy in the underlying tables, which reduced the average YLL per cancer death calculation and may similarly affect heart disease estimates.

We rate the evidence strong. The NCI Years of Life Lost report provides a years-of-productive-life framework for comparing cardiovascular and cancer mortality burden — establishing that heart disease, despite killing at older average ages than cancer, still accounts for 8.1 million person-years of life lost annually.