3 juli 2014: Bron: BMJ Open 2014;4:e005245 doi:10.1136/bmjopen-2014-005245
Alcohol vergroot kans op overlijden met resp. 11% (niet rokers) en 18% (rokers) voor mannen en 5% (niet rokers) en 7% (rokers) voor vrouwen in vergelijking met mensen die weinig alcohol gebruikten. Dit blijkt uit de EPIC studie, een 12,5 jarig bevolkingsonderzoek in 23 landen onder totaal 380395 mannen en vrouwen, die bij de start van de studie vrij waren van ziektes als kanker, diabetes, hart- en vaatziektes.
Vooral de sterfte aan vormen van kanker die gerelateerd zijn aan alcohol, waaronder slokdarmkanker, borstkanker, leverkanker en darmkanker springt eruit. Ook overlijden door geweld of ongelukken is een factor van betekenis. Het risico te overlijden aan hart- en vaatziektes door alcoholgebruik bleek gering te zijn.
30 glazen per dag voor vrouwen en 60 glazen per dag voor mannen werd in deze studie gezien als extreme drinkers, matige drinkers dronken 0,1 glazen per dag voor vrouwen tot 4,9 glazen voor mannen per dag. En wie er ook nog bij rookt heeft een nog grotere kans te overlijden, vooral aan kanker in borst, slokdarm, en vormen van kanker in het spijsverteringssysteem zoals darmkanker en uiteraard primaire leverkanker.
Conclusie van de onderzoekers: alcoholgebruik wordt gerelateerd aan kans op overlijden aan alle oorzaken waarbij aan alcohol gerelateerde vormen van kanker, gewelddadige dood en verwondingen het grootste risico vormen. maar alcohol is in geringe mate gerelateerd aan overlijden aan hart- vaatziektes en aan een beroerte.(CVD / CHD). Absolute risico's op overlijden waargenomen in de EPIC studie suggereren dat alcohol een belangrijke determinant is van de totale sterfte.
Het volledige studierapport: Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study is gratis en volledig in te zien.
Hieronder het abstract van deze studie die gepubliceerd is in BMJ Open 2014;4:e005245 doi:10.1136/bmjopen-2014-005245
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.
BMJ Open 2014;4:e005245 doi:10.1136/bmjopen-2014-005245
Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study
- Pietro Ferrari1,
- Idlir Licaj1,
- David C Muller1,
- Per Kragh Andersen2,
- Mattias Johansson1,
- Heiner Boeing3,
- Elisabete Weiderpass4,5,6,7,
- Laure Dossus8,9,10,
- Laureen Dartois8,9,10,
- Guy Fagherazzi8,9,10,
- Kathryn E Bradbury11,
- Kay-Tee Khaw12,
- Nick Wareham13,
- Eric J Duell14,
- Aurelio Barricarte15,16,
- Esther Molina-Montes17,18,
- Carmen Navarro Sanchez18,19,20,
- Larraitz Arriola16,21,
- Peter Wallström22,
- Anne Tjønneland23,
- Anja Olsen23,
- Antonia Trichopoulou24,25,
- Vasiliki Benetou24,
- Dimitrios Trichopoulos25,26,27,
- Rosario Tumino28,
- Claudia Agnoli29,
- Carlotta Sacerdote30,31,
- Domenico Palli32,
- Kuanrong Li33,
- Rudolf Kaaks33,
- Petra Peeters34,
- Joline WJ Beulens34,
- Luciana Nunes1,35,
- Marc Gunter36,
- Teresa Norat36,
- Kim Overvad37,38,
- Paul Brennan1,
- Elio Riboli36,
- Isabelle Romieu1
+Author Affiliations
- 1International Agency for Research on Cancer, Lyon, France
- 2Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
- 3Potsdam-Rehbrücke Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
- 4Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromsø, Norway
- 5Department of Research, Cancer Registry of Norway, Oslo, Norway
- 6Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- 7Samfundet Folkhälsan, Helsinki, Finland
- 8Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, France
- 9Université Paris Sud, UMRS 1018, Villejuif, France
- 10IGR, Villejuif, France
- 11Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- 12Department of Public Health and Primary Care, University of Cambridge Addenbrooke's Hospital, Cambridge, UK
- 13Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
- 14Unit of Nutrition, Cancer Epidemiology Research Program, Environment and Cancer, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain
- 15Navarre Public Health Institute, Pamplona, Spain
- 16Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Murcia, Spain
- 17Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Granada, Spain
- 18CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- 19Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
- 20Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
- 21Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, Spain
- 22Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden
- 23Danish Cancer Society Research Center, Copenhagen, Denmark
- 24Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Food and Nutrition Policies, University of Athens Medical School, Athens, Greece
- 25Hellenic Health Foundation, Athens, Greece
- 26Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
- 27Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- 28Cancer Registry and Histopathology Unit, “Civic-MP Arezzo” Hospital, ASP Ragusa, Italy
- 29Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- 30Unit of Cancer Epidemiology, AO Citta’ della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Turin, Italy
- 31Human Genetics Foundation (HuGeF), Turin, Italy
- 32Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Florence, Italy
- 33Department of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
- 34Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
- 35Department of Statistics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- 36Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- 37Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
- 38Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- Correspondence toDr Pietro Ferrari; ferrarip@iarc.fr
- Received 11 March 2014
- Revised 23 April 2014
- Accepted 25 April 2014
- Published 3 July 2014
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.
EPIC studie, hart- en vaatziektes, overlijdensrisico, leverkanker, darmkanker, slokdarmkanker, borstkanker, preventie, alcohoil
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