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
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.
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.
KW - Cause-specific mortality
KW - EPIC
KW - Lifetime alcohol use
KW - Prospective study
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
ER -
