COVID-19 dramatically reshaped mortality across Europe. This study aimed to assess its impact on total mortality in European countries taking into consideration the relationship with selected country-level socioeconomic indicators, non-pharmaceutical interventions, and vaccine uptake. We obtained weekly mortality data from 2010 to 2023 from the Short-term Mortality Fluctuations data series, the annual population data from the United Nations archives, selected sociodemographic and economic indicators from the World Bank’s database, the stringency index and the percentage of the population fully vaccinated from Our World in Data. A quasi-Poisson regression model trained on pre-pandemic years was used to estimate expected number of deaths in 2020–2023 in 29 European countries. Excess mortality was estimated using three different metrics: excess deaths (number), relative excess mortality (% different from expected deaths) and age-standardized excess death rate per 10,000 population. The relationship between socioeconomic indicators and excess mortality was evaluated using linear regression models, which included both linear and quadratic terms for the predictors to account for possible non-linear relationships. We estimated 1,642,586 excess deaths (95% confidence interval, CI: 1,607,161–1,678,010) across all countries over the four years (+8.0% compared to the expected number of deaths). Excess mortality was mainly concentrated in 2020–2022 (0.52 million excess deaths in 2020, 0.57 million in 2021 and 0.44 million in 2022), with no substantial excess (0.11 million) estimated for 2023. Over the period 2020–23, the highest number of excess deaths was estimated for Italy (227,736 deaths, +8.7%), Poland (223,735 deaths, +13.7%), and Germany (218,111 deaths, +5.6%), while the highest excesses in relative terms were in Bulgaria (72,328 deaths, +17.2%), Lithuania (23,813 deaths, +16.1%), and Slovakia (31,984 deaths, +14.9%). The age-standardised death rates ranged from 1.8 per 10,000 population in Sweden to 24.7 in Bulgaria. The percentage of the population living below the poverty line and the Gini index were significantly associated with an increased excess death rate, with p-values for the linear and quadratic terms being 0.003 and 0.003 for the Gini index, and 0.024 and 0.017 for the population living below the poverty line. Conversely, gross domestic product per capita (p-values for the linear and quadratic terms: <0.001, 0.003), health expenditure (0.001, 0.273) and the percentage of people fully vaccinated by the end of 2021 (<0.001, 0.989) or 2022 (0.001, 0.890) were inversely associated with excess death rate. No significant association was observed with population density and stringency index. The observed geographic disparities in total mortality excess across Europe can be related to differences in socioeconomic contexts, as well as to suboptimal vaccine uptakes in some countries. This research was supported by European Union (EU) funding within the NextGeneration EU-MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT). The funding source had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

We reviewed available evidence on coffee drinking and the risk of all cancers and selected cancers updated to May 2016. Coffee consumption is not associated with overall cancer risk. A meta-analysis reported a pooled relative risk (RR) for an increment of 1 cup of coffee/day of 1.00 [95% confidence interval (CI): 0.99–1.01] for all cancers. Coffee drinking is associated with a reduced risk of liver cancer. A meta-analysis of cohort studies found an RR for an increment of consumption of 1 cup/day of 0.85 (95% CI: 0.81–0.90) for liver cancer and a favorable effect on liver enzymes and cirrhosis. Another meta-analysis showed an inverse relation for endometrial cancer risk, with an RR of 0.92 (95% CI: 0.88–0.96) for an increment of 1 cup/day. A possible decreased risk was found in some studies for oral/pharyngeal cancer and for advanced prostate cancer. Although data are mixed, overall, there seems to be some favorable effect of coffee drinking on colorectal cancer in case–control studies, in the absence of a consistent relation in cohort studies. For bladder cancer, the results are not consistent; however, any possible direct association is not dose and duration related, and might depend on a residual confounding effect of smoking. A few studies suggest an increased risk of childhood leukemia after maternal coffee drinking during pregnancy, but data are limited and inconsistent. Although the results of studies are mixed, the overall evidence suggests no association of coffee intake with cancers of the stomach, pancreas, lung, breast, ovary, and prostate overall. Data are limited, with RR close to unity for other neoplasms, including those of the esophagus, small intestine, gallbladder and biliary tract, skin, kidney, brain, thyroid, as well as for soft tissue sarcoma and lymphohematopoietic cancer.

Objectives: We aimed at describing the attitudes towards influenza vaccination and a potential COVID-19 vaccine in Italy. Methods: A nationally representative survey based on 1055 Italians aged 15-85 years was conducted in September 16-28, 2020. Results: We found that 40.8% of the population reported the intention to be vaccinated against influenza next winter and 53.7% would accept to receive a potential COVID-19 vaccine. The percentages were higher among individuals aged 55 and over (58.8% for influenza vaccine and 58.2% for a potential COVID-19 vaccine) and among professionals, managers and teachers as compared to manual workers and farmers (36.1% vs. 27.6% for influenza vaccine and 51.6% vs. 44.8% for a potential COVID-19 vaccine). Discussion: These data confirm a certain degree of vaccine mistrust in Italy, especially among less qualified workers.