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Cancer has edged ahead of heart disease as the No. 1 killer in the state and in Guilford County, state health officials said Monday.

State analysis of 2006 mortality data showed that 17,267 North Carolina residents died of cancer in 2006, a rate of 195 deaths per 100,000 people. Some 17,189 deaths occurred from heart disease, a rate of 194 deaths per 100,000 people.

Heart disease had been the state's leading killer for almost 90 years, the state said. But the U.S. Centers for Disease Control and Prevention believes cancer will continue to be

No. 1 for years to come, said Merle Green, Guilford County's director of public health.

Cancer's rise as a killer is attributable primarily to a drop in heart disease death rates.

Death rates for both cancer and heart disease have been falling since the early 1980s, the state said. But although the overall death rate from heart disease has fallen by about 30 percent since 1990, the overall death rate from cancer has fallen by only about 2 percent.

After heart disease, the leading causes of death statewide in 2006 were cerebrovascular disease, including strokes; chronic lower respiratory disease; and unintentional injuries other than those caused by motor-vehicle accidents.

The rankings of causes of death statewide other than cancer and heart disease remained the same as in 2005, the state Department of Health and Human Services said.

Guilford County followed the state trend. It recorded a cancer death rate of 171.5 per 100,000 people and a heart-disease death rate of 162.6 per 100,000 people. The comparable rates in 2005 were 183.9 deaths per 100,000 people from heart disease and 173.5 deaths per 100,000 people from cancer.

The change is the result of long-term educational efforts regarding how to prevent heart disease, Green said.

"We've been really stressing to people the importance of exercise, a low-fat diet and avoiding smoking and even secondhand smoke," Green said. "I think these three things people have caught onto, and they're doing that now. So it made the rate fall."

Green also credited medical advances for the decline.

She said the slower decline in the cancer death rate is attributable in part to greater uncertainty about how to prevent the disease.

"We can really put a finger on how to reduce heart disease — change diets, manage stress and manage weight," she said. "But those particular methods weren't exactly the solution for the prevention of cancers. ... (For example), we can't put our finger on how to prevent breast cancer. It might be diet, but it's not as definitive as is lowering cholesterol to prevent heart disease."

In Guilford County, the 1-2 ranking of cancer and heart disease in 2006 held true across ranges of race and sex, but not age.

Motor-vehicle accidents were the most common cause of death among people 19 and younger. Heart disease remained the most frequent killer among Guilford residents ages 65 and older.

Contact Lex Alexander at 373-7088 or lalexander@news-record.com