This study aimed to perform a meta-analysis of cohort studies aimed at providing an accurate overview of mortality in elite athletes. English-language scientific articles available in Medline and Web of Science databases following the recommendations of the Meta-analyses Of Observational Studies in Epidemiology group were reviewed. A search was conducted for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014). Ten studies, including data from a total of 42,807 athletes (707 women), met all inclusion criteria. The all-cause pooled standard mortality ratio (SMR) was 0.67 (95% CI, 0.55-0.81; P<.001) with no evidence of publication bias (P=.24) but with significant heterogeneity among studies (I(2)=96%; Q=224.46; P<.001). Six studies provided data on cardiovascular disease (CVD) and 5 on cancer (in a total of 35,920 and 12,119 athletes, respectively). When only CVD was considered as a cause of mortality, the pooled SMR was 0.73 (95% CI, 0.65-0.82; P<.001) with no evidence of bias (P=.68) or heterogenity among studies (I(2)=38%; Q=8.07; P=.15). The SMR for cancer was 0.60 (95% CI, 0.38-0.94; P=.03) without andy evidence of bias (P=.20) despite a significant heterogeneity (I(2)=91%; Q=44.21; P<.001).
The evidence available suggests that top-level athletes live longer than the general population and have a lower risk of 2 major causes of mortality, namely, CVD and cancer.