TY - JOUR
T1 - The association of pattern of lifetime alcohol use and cause of death in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
AU - Bergmann, Manuela M.
AU - Rehm, Jürgen
AU - Klipstein-Grobusch, Kerstin
AU - Boeing, Heiner
AU - Schütze, Madlen
AU - Drogan, Dagmar
AU - Overvad, Kim
AU - Tjønneland, Anne
AU - Halkjær, Jytte
AU - Fagherazzi, Guy
AU - Boutron-Ruault, Marie Christine
AU - Clavel-Chapelon, Françoise
AU - Teucher, Birgit
AU - Kaaks, Rudolph
AU - Trichopoulou, Antonia
AU - Benetou, Vassiliki
AU - Trichopoulos, Dimitrios
AU - Palli, Domenico
AU - Pala, Valeria
AU - Tumino, Rosario
AU - Vineis, Paolo
AU - Beulens, Joline W.J.
AU - Redondo, Maria Luisa
AU - Duell, Eric J.
AU - Molina-Montes, Esther
AU - Navarro, Carmen
AU - Barricarte, Aurelio
AU - Arriola, Larraitz
AU - Allen, Naomi E.
AU - Crowe, Francesca L.
AU - Khaw, Kay Tee
AU - Wareham, Nick
AU - Romaguera, Dora
AU - Wark, Petra A.
AU - Romieu, Isabelle
AU - Nunes, Luciana
AU - Riboli, Elio
AU - Ferrari, Pietro
N1 - Funding Information:
The work for the EPIC study on which this analysis is based was financially supported by the Europe Against Cancer Program of the European Commission (SANCO); Danish Cancer Society; German Institute of Human Nutrition, German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Dutch Ministry of Public Health, Welfare and Sports; National Cancer Registry and the Regional Cancer Registries Amsterdam, East and Maastricht of The Netherlands; Health Research Fund (FIS) of the Spanish Ministry of Health; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer; Health Research Fund (FIS) of the Spanish Ministry of Health; the ISCIII Network RCESP (C03/09) and RETICC C03/10, Spanish Regional Governments of Andalusia, Asturias, Basque Country, Granada, Murcia and Navarra and the Catalan Institute of Oncology; Cancer Research UK; Medical Research Council, UK; Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; Wellcome Trust, UK; Ligue Nationale contre le Cancer, 3M Company, INSERM. This work was also conducted on behalf of the mortality working group for the EPIC-elderly Nah project (contract no. 2004 126) that aims to understand specific health problems of the elderly population in Europe. Part of this work was also supported by la Direction Générale de la Santé(French Ministry of Health) with contract (GR-IARC-2003-09-12-01).
PY - 2013/12
Y1 - 2013/12
N2 - Background There is limited evidence for an association between the pattern of lifetime alcohol use and cause-specific risk of death.Methods Multivariable hazard ratios were estimated for different causes of death according to patterns of lifetime alcohol consumption using a competing risks approach: 111 953 men and 268 442 women from eight countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included. Self-reported alcohol consumption at ages 20, 30, 40 or 50 years and at enrolment were used for the analysis; 26 411 deaths were observed during an average of 12.6 years of follow-up.Results The association between lifetime alcohol use and death from cardiovascular diseases was different from the association seen for alcohol-related cancers, digestive, respiratory, external and other causes. Heavy users (>5 drinks/day for men and >2.5 drinks/day for women), regardless of time of cessation, had a 2- to 5-times higher risk of dying due to alcohol-related cancers, compared with subjects with lifetime light use (≤1 and ≤0.5 drink/week for men and women, respectively). Compared with lifetime light users, men who used <5 drinks/day throughout their lifetime had a 24% lower cardiovascular disease mortality (95% confidence interval 2-41). The risk of death from coronary heart disease was also found to be 34-46% lower among women who were moderate to occasionally heavy alcohol users compared with light users. However, this relationship was only evident among men and women who had no chronic disease at enrolment.Conclusions Limiting alcohol use throughout life is associated with a lower risk of death, largely due to cardiovascular disease but also other causes. However, the potential health benefits of alcohol use are difficult to establish due to the possibility of selection bias and competing risks related to diseases occurring later in life. Published by Oxford University Press on behalf of the International Epidemiological Association.
AB - Background There is limited evidence for an association between the pattern of lifetime alcohol use and cause-specific risk of death.Methods Multivariable hazard ratios were estimated for different causes of death according to patterns of lifetime alcohol consumption using a competing risks approach: 111 953 men and 268 442 women from eight countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included. Self-reported alcohol consumption at ages 20, 30, 40 or 50 years and at enrolment were used for the analysis; 26 411 deaths were observed during an average of 12.6 years of follow-up.Results The association between lifetime alcohol use and death from cardiovascular diseases was different from the association seen for alcohol-related cancers, digestive, respiratory, external and other causes. Heavy users (>5 drinks/day for men and >2.5 drinks/day for women), regardless of time of cessation, had a 2- to 5-times higher risk of dying due to alcohol-related cancers, compared with subjects with lifetime light use (≤1 and ≤0.5 drink/week for men and women, respectively). Compared with lifetime light users, men who used <5 drinks/day throughout their lifetime had a 24% lower cardiovascular disease mortality (95% confidence interval 2-41). The risk of death from coronary heart disease was also found to be 34-46% lower among women who were moderate to occasionally heavy alcohol users compared with light users. However, this relationship was only evident among men and women who had no chronic disease at enrolment.Conclusions Limiting alcohol use throughout life is associated with a lower risk of death, largely due to cardiovascular disease but also other causes. However, the potential health benefits of alcohol use are difficult to establish due to the possibility of selection bias and competing risks related to diseases occurring later in life. Published by Oxford University Press on behalf of the International Epidemiological Association.
KW - Cause-specific mortality
KW - EPIC
KW - Lifetime alcohol use
KW - Prospective study
UR - http://www.scopus.com/inward/record.url?scp=84892447326&partnerID=8YFLogxK
U2 - 10.1093/ije/dyt154
DO - 10.1093/ije/dyt154
M3 - Article
C2 - 24415611
AN - SCOPUS:84892447326
SN - 0300-5771
VL - 42
SP - 1772
EP - 1790
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 6
M1 - dyt154
ER -