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.