期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 42, 期 6, 页码 1772-1790出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyt154
关键词
Prospective study; lifetime alcohol use; cause-specific mortality; EPIC
资金
- Europe Against Cancer Program of the European Commission (SANCO)
- Danish Cancer Society
- German Institute of Human Nutrition
- German Cancer Research Center
- German Federal Ministry of Education and Research
- Dutch Ministry of Public Health, Welfare and Sports
- National Cancer Registry 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
- ISCIII Network RCESP [C03/09]
- RETICC [C03/10]
- 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
- EPIC-elderly Nah project [2004 126]
- Direction Generale de la Sante (French Ministry of Health) [GR-IARC-2003-09-12-01]
- German Cancer Aid
- Regional Cancer Registry Amsterdam of The Netherlands
- Regional Cancer Registry East of The Netherlands
- Regional Cancer Registry Maastricht of The Netherlands
- Catalan Institute of Oncology
- Spanish Regional Government of Andalusia
- Spanish Regional Government of Asturias
- Spanish Regional Government of Basque Country
- Spanish Regional Government of Granada
- Spanish Regional Government of Murcia
- Spanish Regional Government of Navarra
- Cancer Research UK [14136] Funding Source: researchfish
- Medical Research Council [G1000143, G0401527] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
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.
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