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ABSTRACT: Objectives
To investigate the role of factors that modulate the association between alcohol and mortality, and to provide estimates of absolute risk of death.Design
The European Prospective Investigation into Cancer and nutrition (EPIC).Setting
23 centres in 10 countries.Participants
380 395 men and women, free of cancer, diabetes, heart attack or stroke at enrolment, followed up for 12.6 years on average.Main outcome measures
20 453 fatal events, of which 2053 alcohol-related cancers (ARC, including cancers of upper aerodigestive tract, liver, colorectal and female breast), 4187 cardiovascular diseases/coronary heart disease (CVD/CHD), 856 violent deaths and injuries. Lifetime alcohol use was assessed at recruitment.Results
HRs comparing extreme drinkers (≥30 g/day in women and ≥60 g/day in men) to moderate drinkers (0.1-4.9 g/day) were 1.27 (95% CI 1.13 to 1.43) in women and 1.53 (1.39 to 1.68) in men. Strong associations were observed for ARC mortality, in men particularly, and for violent deaths and injuries, in men only. No associations were observed for CVD/CHD mortality among drinkers, whereby HRs were higher in never compared to moderate drinkers. Overall mortality seemed to be more strongly related to beer than wine use, particularly in men. The 10-year risks of overall death for women aged 60 years, drinking more than 30 g/day was 5% and 7%, for never and current smokers, respectively. Corresponding figures in men consuming more than 60 g/day were 11% and 18%, in never and current smokers, respectively. In competing risks analyses, mortality due to CVD/CHD was more pronounced than ARC in men, while CVD/CHD and ARC mortality were of similar magnitude in women.Conclusions
In this large European cohort, alcohol use was positively associated with overall mortality, ARC and violent death and injuries, but marginally to CVD/CHD. Absolute risks of death observed in EPIC suggest that alcohol is an important determinant of total mortality.
SUBMITTER: Ferrari P
PROVIDER: S-EPMC4091394 | biostudies-literature | 2014 Jul
REPOSITORIES: biostudies-literature
Ferrari Pietro P Licaj Idlir I Muller David C DC Kragh Andersen Per P Johansson Mattias M Boeing Heiner H Weiderpass Elisabete E Dossus Laure L Dartois Laureen L Fagherazzi Guy G Bradbury Kathryn E KE Khaw Kay-Tee KT Wareham Nick N Duell Eric J EJ Barricarte Aurelio A Molina-Montes Esther E Sanchez Carmen Navarro CN Arriola Larraitz L Wallström Peter P Tjønneland Anne A Olsen Anja A Trichopoulou Antonia A Benetou Vasiliki V Trichopoulos Dimitrios D Tumino Rosario R Agnoli Claudia C Sacerdote Carlotta C Palli Domenico D Li Kuanrong K Kaaks Rudolf R Peeters Petra P Beulens Joline Wj JW Nunes Luciana L Gunter Marc M Norat Teresa T Overvad Kim K Brennan Paul P Riboli Elio E Romieu Isabelle I
BMJ open 20140703 7
<h4>Objectives</h4>To investigate the role of factors that modulate the association between alcohol and mortality, and to provide estimates of absolute risk of death.<h4>Design</h4>The European Prospective Investigation into Cancer and nutrition (EPIC).<h4>Setting</h4>23 centres in 10 countries.<h4>Participants</h4>380 395 men and women, free of cancer, diabetes, heart attack or stroke at enrolment, followed up for 12.6 years on average.<h4>Main outcome measures</h4>20 453 fatal events, of which ...[more]