Cardiovascular diseases remain the leading cause of death across the Western Balkans, mirroring trends seen in the European Union, where diseases of the circulatory system accounted for the largest share of deaths in 2023, according to data from Eurostat.
Across the region – including North Macedonia, Serbia, Albania, Bosnia and Herzegovina, Montenegro and Kosovo – heart attacks, strokes and other cardiovascular conditions account for the largest proportion of deaths, while cancer ranks as the second most common cause.
Health experts often link the region’s relatively high mortality rates from cardiovascular diseases to risk factors such as high smoking prevalence, unhealthy diets, physical inactivity, air pollution and limited access to preventive healthcare.
In the European Union, there were 313 deaths from diseases of the circulatory system per 100,000 inhabitants in 2023, Eurostat data showed.
These diseases include conditions related to high blood pressure, heart disease and disorders of veins and arteries.
The highest death rates from circulatory diseases in the EU were recorded in Bulgaria with 923 deaths per 100,000 people, followed by Romania with 787 and Latvia with 726.
The lowest rates were reported in France with 163 deaths per 100,000 inhabitants, Spain with 200 and Denmark with 208.
Overall, 4.84 million deaths were reported across the EU in 2023, with around 85% occurring among people aged 65 and over.
Diseases of the circulatory system accounted for 32.8% of all deaths in the EU, followed by cancer with 23.9%. Respiratory diseases made up 7.8% of deaths, while external causes such as accidents and injuries accounted for 5.0%.
Within circulatory diseases, the most common causes of death were ischaemic heart disease and cerebrovascular diseases such as stroke.
Among cancers, lung cancer was the leading cause of death, accounting for 19.8% of cancer-related deaths in the EU in 2023. It was followed by colorectal cancer with 11.4%, pancreatic cancer with 7.6%, breast cancer with 7.3% and prostate cancer with 5.9%.
Differences by sex and age
Standardised death rates were generally higher for men than for women for most of the main causes of death in 2023, with the exception of dementia and breast cancer.
Dementia accounted for 34.5 deaths per 100,000 female residents compared with 32.3 per 100,000 male residents. Breast cancer caused 29.8 deaths per 100,000 women, while the figure for men was considerably lower at 0.5 per 100,000.
Among men under the age of 65 in the EU, the leading cause of death in 2023 was ischaemic heart disease, followed by accidents, lung cancer, intentional self-harm, chronic liver disease and cerebrovascular diseases.
For women under 65, the main cause of death was breast cancer, followed by lung cancer and ischaemic heart disease. Other leading causes included accidents, colorectal cancer and cerebrovascular diseases.
Among people aged 65 and over, ischaemic heart disease remained the leading cause of death for both men and women.
Trends over the past decade
Between 2013 and 2023, standardised death rates in the EU declined for several leading causes of death.
Deaths from circulatory diseases fell by 23.2%, while cancer mortality declined by 11.1%. Death rates from respiratory diseases fell by 1.3% over the same period.
Within cardiovascular diseases, deaths from ischaemic heart disease dropped by 25.6%, including a 35.3% decline in deaths from heart attacks, while deaths from cerebrovascular diseases decreased by 31.1%.
Among different types of cancer, the death rate for colorectal cancer declined by 16.4% between 2013 and 2023, while lung cancer mortality fell by 13.4%. In contrast, the death rate from pancreatic cancer rose by 4.7%.
In 2023, about 1.56 million EU residents died before the age of 75, representing 32.1% of all deaths.
Cancer accounted for the largest share of potential years of life lost before age 75, followed by circulatory diseases and external causes of death such as accidents and injuries. Together, these three categories represented 63.5% of all potential years of life lost.