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dc.contributor.authorMuller, David C.
dc.contributor.authorMurphy, Neil
dc.contributor.authorJohansson, Mattias
dc.contributor.authorFerrari, Pietro
dc.contributor.authorTsilidis, Konstantinos K.
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorClavel, Francoise
dc.contributor.authorDartois, Laureen
dc.contributor.authorLi, Kuanrong
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorWeikert, Cornelia
dc.contributor.authorBergmann, Manuela
dc.contributor.authorBoeing, Heiner
dc.contributor.authorTjønneland, Anne
dc.contributor.authorOvervad, Kim
dc.contributor.authorRedondo, María-Luisa
dc.contributor.authorAgudo, Antonio
dc.contributor.authorMolina-Portillo, Elena
dc.contributor.authorAltzibar, Jone M.
dc.contributor.authorCirera, Lluis
dc.contributor.authorArdanaz, Eva
dc.contributor.authorKhaw, Kay-Tee
dc.contributor.authorWareham, Nicholas J.
dc.contributor.authorKey, Timothy J.
dc.contributor.authorTravis, Ruth C.
dc.contributor.authorBamia, Christina
dc.contributor.authorOrfanos, Philippos
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorPalli, Domenico
dc.contributor.authorPala, Valeria
dc.contributor.authorTumino, Rosario
dc.contributor.authorVineis, Paolo
dc.contributor.authorPanico, Salvatore
dc.contributor.authorBueno-de-Mesquita, H. Bas
dc.contributor.authorVerschuren, W.M. Monique
dc.contributor.authorStruijk, Ellen A.
dc.contributor.authorPeeters, Petra H.
dc.contributor.authorEngström, Gunnar
dc.contributor.authorMelander, Olle
dc.contributor.authorSund, Malin
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorSkeie, Guri
dc.contributor.authorLund, Eiliv
dc.contributor.authorNorat, Teresa
dc.contributor.authorGunter, Marc
dc.contributor.authorRiboli, Elio
dc.contributor.authorBrennan, Paul
dc.date.accessioned2017-02-24T12:31:24Z
dc.date.available2017-02-24T12:31:24Z
dc.date.issued2016-06-14
dc.description.abstractBackground<br> Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death.<br> Methods<br> We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models.<br> Results<br> We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31–32 %) and 14 % (95 % CI, 12–16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8–12 %) and high blood pressure (9 %; 95 % CI, 7–11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55–59 %), being 35 % (95 % CI, 32–37 %) among never smokers and 74 % (95 % CI, 73–75 %) among current smokers.<br> Conclusions<br> While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.<br> Keywords<br> Premature death Mortality Modifiable risk factors Attributable fraction Absolute risken_US
dc.description.sponsorshipThis work was supported by the French Social Affairs & Health Ministry, Department of Health (Direction Générale de la Santé). The work undertaken by David C Muller for this project was performed during the tenure of an IARC-Australia fellowship supported by Cancer Council Australia. Elio Riboli was supported by the Imperial College Biomedical Research Centre funded by the National Institute of Health Research of UK. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway); Health Research Fund (FIS), PI13/00061 to Granada, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk) (United Kingdom).en_US
dc.descriptionSource: <a href=http://dx.doi.org/10.1186/s12916-016-0630-6>doi: 10.1186/s12916-016-0630-6</a>en_US
dc.identifier.citationMuller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault M, Clavel, Dartois L, Li K, Kaaks R, Weikert C, Bergmann M, Boeing H, Tjønneland A, Overvad K, Redondo M, Agudo A, Molina-Portillo E, Altzibar, Cirera L, Ardanaz E, Khaw K, Wareham NJ, Key TJ, Travis RC, Bamia C, Orfanos P, Trichopoulou A, Palli D, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Verschuren WM, Struijk, Peeters PH, Engström G, Melander O, Sund M, Weiderpass E, Skeie G, Lund e, Norat T, Gunter M, Riboli E, Brennan P. Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study. BMC Medicine. 2016;14:87en_US
dc.identifier.doi10.1186/s12916-016-0630-6
dc.identifier.issn1741-7015
dc.identifier.urihttps://hdl.handle.net/10037/10360
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.relation.journalBMC Medicine
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.titleModifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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