On the risk of death

ToBeOrNotToBe_diegoperez74Risk of death is a strange concept, and risk factors for death — characteristics that may elevate or diminish risk — are even stranger. After all, we’re all going to die. It’s only a matter of time. And time is the crucial element here. None of us will avoid death, but most of us would like to evade it for as long as possible. At the very least it would be preferable to not die before the age of 70 years. This is the goal of the World Health Organisation’s 25 by 25 Framework, which aims to reduce premature deaths from non-communicable diseases, such as cancer, cardiovascular diseases, and diabetes, by 25% before the year 2025.

Is 25 by 25 achievable, or is it just a catchy slogan?

Many factors are known to contribute to the risk of premature death. In Europe, the six chief causes are tobacco smoking, poor diet, high blood pressure, overweight and obesity, physical inactivity, and high alcohol consumption. But what proportion of premature deaths could we avoid if we removed these factors? Myself and colleagues at IARC and Imperial College London conducted a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to find out. Among 265,000 participants in the EPIC cohort, 12,000 people died before the age of 70 years. We studied the six main factors associated with risk, and found that they jointly accounted for 57% of premature deaths in this group. Smoking was responsible for the biggest proportion of deaths (31%), and more than one-third of premature deaths in people who had never smoked could be explained by the remaining five factors. You can read the full story in the journal article, which was just published in BMC Medicine.

The results of this study suggest that the goal of reducing premature deaths by 25% is achievable if these six risk factors could be eliminated or tightly controlled, at least in Europe. It also supports current NICE and NHS recommendations on healthy diet, weight control, physical activity, and blood pressure control aimed at promoting population health and preventing chronic diseases. Whether the reduction could occur before 2025 will largely depend on the investment that will be made on disease prevention nationally and internationally.

David Muller

David Muller

David Muller is a research associate in the Department of Epidemiology and Biostatistics at Imperial College London. He is a biostatistician and molecular epidemiologist, and works primarily to model the risk of several common cancers with the goal of identifying causes of the disease, understanding disparities in cancer incidence in populations, and as a means to evaluate cancer risk for individuals and population health programmes.

Research Interests:Cancer aetiology and prevention. Cancer survival. Biostatistics.
David Muller

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1 comment to On the risk of death

  • Eloquent as ever. Nevertheless, a rather sobering thought / conclusion regarding longevity! Playing the devil’s advocate, and given the current state of affairs (economically) as well as past performance by successive governments, what would be your advice to policy makers, if a budget allowed for only one risk factor to be targeted? Which one would you choose? Are there indications (within EPIC) that tackling physical inactivity (meaning actively taking part in sports) will have a knock-on effect on most, if not all other chief causes of premature death?

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