Survival and longevity in professional wrestlers: a retrospective cohort study

Objectives: This study aimed to quantify and compare survival and longevity among professional wrestlers, relative to sex-matched and age-matched referents from the US general population. Methods: Data on all male and female professional wrestlers who performed for World Wrestling Entertainment or its predecessor entities, from 7 January 1953 to 31 December 2024 (N=1012) were compiled. Non-parametric relative survival analysis was conducted to generate survival curves and estimate life years difference, and a multivariable Cox regression model was used to examine the association between survival probability and cohort characteristics. Results: The difference in life years for professional wrestlers was −2.91 (95% CI −4.54 to −1.28) years. The most common causes of death were cardiovascular disease, external causes of death (ie, drug overdose and suicide), cancer and neurodegenerative disease. Obesity (HR 3.12; 95% CI 1.59 to 6.13) and high match exposure intensity (HR 1.71; 95% CI 1.23 to 2.37) were significantly associated with survival probability. Conclusions: Professional wrestlers experience significantly worse survival compared with the general population, and the longevity deficit is predominantly driven by increased risk of mortality from cardiovascular disease, neurodegenerative disease and suicide.