I'm not judging atheists, thats up to God! But the Bible states time and time again that those who die atheists are going to hell. So I beleive atheists are going to hell, not because I condemn them, but because Gods Word does. Because if evolution over millions of years is true then it would mean that God created the world with a violent, messy and cruel proccess. It would mean that animal suffering, earthquakes, death and disease would have been happening as part of Gods creative proccess and all this would have been happening a LONG time before humans were about. If death and suffering was around BEFORE the fall of man (or if in deed there was no fall) then all the evil in the world is not the result of Mans sin or Mans rebellion against God.
I beleive disease to be either Gods Wrath (in response to Sin) or Satan being allowed to attack the world with disease. But in both these cases evolution doesnt work! In the case of the first; How could God be judging and punishing the world before there is someone to punish? and in the case of the latter then it would be God who invited Satan into the world and not humanity through sin!!