Antero-Jacquemin · European journal of epidemiology 2018 · historical cohort study · n=2814

The heart of the matter: years-saved from cardiovascular and cancer deaths in an elite athlete cohort with over a century of follow-up.

Cited 48 times in the scientific literature.

Level 3 - non-randomized controlled study

Historical cohort study comparing Olympic athletes to general population registry data

PubMed 29730745 · doi:10.1007/s10654-018-0401-0 · record verified 2026-08-26

What was done

A historical cohort study evaluated 2,814 French Olympic athletes (455 deceased) who competed between 1912 and 2012, using national registries to identify vital status and cause of death. Athletes were classified into six effort categories: POWER (<45 s), INTERMEDIATE (45–600 s), ENDURANCE (≥600 s), POLYVALENT (multiple classifications), INTERMITTENT (e.g., team sports), and PRECISION (targeting events). A theoretical years-lost method adapted for competing risks was applied to calculate years of life saved from all-cause, cardiovascular disease (CVD), and cancer mortality relative to the general population.

What was found

Across all groups, athletes saved an average of 6.5 years of life (95% CI 5.8–7.2) compared to the general population. Lower cancer mortality contributed an average of 2.3 years saved (95% CI reported as 1.2–1.9) across groups. CVD-related mortality in the ENDURANCE and PRECISION groups was not significantly different from the general population, whereas other effort groups saved an average of 1.6 years of life (95% CI 1.2–1.9) from CVD death.

Why it matters

This study shows a significant overall lifespan extension in elite athletes driven predominantly by reduced cancer risk, while highlighting that cardiovascular survival benefits vary by physiological discipline.

Limits

The study is subject to healthy-worker/healthy-athlete selection bias, confounding from socioeconomic status, and unmeasured post-competition lifestyle factors. The cohort is restricted to French Olympians, and the abstract contains a typographical error in the reported 95% CI (1.2–1.9) for the 2.3 years saved from cancer.

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