Raleigh, N.C. — Cancer has replaced heart disease as the leading cause of death in North Carolina, officials said Monday.

Mortality data for 2006 show that heart disease dropped to second place as a cause of death in the state for the first time in nearly 90 years. Heart disease continues to be the leading cause of death nationally.

Cancer accounted for 17, 267 deaths of the total of 74,419 resident deaths in North Carolina last year, or about 195 deaths per 100,000 people. Heart disease accounted for 17,189 deaths, or 194 deaths per 100,000 people.

Heart disease death rates have been declining dramatically since the early 1980s. Cancer death rates have also been declining, but much more slowly.

Since 1990, the overall death rate for heart disease in North Carolina declined by more than 30 percent, compared with a decline in the cancer death rate of under 2 percent, officials said.

“The decline in deaths from heart disease is good news,” State Health Director Dr. Leah Devlin said in a statement, “especially since about half of the decrease appears to be linked to improvements in major risk factors."

Such factors include smoking, blood pressure, cholesterol levels, diet and exercise.

“People can also greatly reduce their risk of dying from heart disease and cancer by getting the right health screenings on a regular basis – blood pressure checks, cholesterol checks and cancer screenings," Devlin said. "For women, those screenings should include mammograms and Pap tests. Men should have prostate checks, and both men and women should talk to their doctors about other appropriate cancer screenings for colorectal, prostate and skin cancers."

The leading causes of death statewide differed by gender, age and ethnicity in 2006:

• For males, the leading cause of death was cancer, but heart disease continued to be the leading cause of death for females.

• As in 2005, heart disease remained the leading cause of death for North Carolinians ages 65 and over.

• While cancer was the leading cause of death for non-Hispanics, whites and African Americans in 2006, heart disease remained the leading cause of death for American Indians.

• As in 2005, the leading cause of death for Hispanics was motor vehicle injuries.

The 2006 rankings of all other causes of death in the state remained unchanged from 2005. The No. 3 cause of death in 2006 was stroke (4,551 deaths), followed by chronic lower respiratory diseases (4,004 deaths), unintentional injuries not including motor vehicle injuries (2,425), Alzheimer’s disease (2,258), diabetes (2,230), pneumonia and influenza (1,699), unintentional motor vehicle injuries (1,666) and kidney disease (1,631).