PT  - JOURNAL ARTICLE
AU  - Pietro Ferrari
AU  - Idlir Licaj
AU  - David C Muller
AU  - Per Kragh Andersen
AU  - Mattias Johansson
AU  - Heiner Boeing
AU  - Elisabete Weiderpass
AU  - Laure Dossus
AU  - Laureen Dartois
AU  - Guy Fagherazzi
AU  - Kathryn E Bradbury
AU  - Kay-Tee Khaw
AU  - Nick Wareham
AU  - Eric J Duell
AU  - Aurelio Barricarte
AU  - Esther Molina-Montes
AU  - Carmen Navarro Sanchez
AU  - Larraitz Arriola
AU  - Peter Wallström
AU  - Anne Tjønneland
AU  - Anja Olsen
AU  - Antonia Trichopoulou
AU  - Vasiliki Benetou
AU  - Dimitrios Trichopoulos
AU  - Rosario Tumino
AU  - Claudia Agnoli
AU  - Carlotta Sacerdote
AU  - Domenico Palli
AU  - Kuanrong Li
AU  - Rudolf Kaaks
AU  - Petra Peeters
AU  - Joline WJ Beulens
AU  - Luciana Nunes
AU  - Marc Gunter
AU  - Teresa Norat
AU  - Kim Overvad
AU  - Paul Brennan
AU  - Elio Riboli
AU  - Isabelle Romieu
TI  - Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study
AID  - 10.1136/bmjopen-2014-005245
DP  - 2014 Jul 01
TA  - BMJ Open
PG  - e005245
VI  - 4
IP  - 7
4099  - http://bmjopen.bmj.com/content/4/7/e005245.short
4100  - http://bmjopen.bmj.com/content/4/7/e005245.full
SO  - BMJ Open2014 Jul 01; 4
AB  - 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.