Zhu Kangmin, Devesa Susan S, Wu Hongyu, Zahm Shelia Hoar, Jatoi Ismail, Anderson William F, Peoples George E, Maxwell Larry G, Granger Elder, Potter John F, McGlynn Katherine A
US Military Cancer Institute, Walter Reed Army Medical Center,Washington, DC 20307-5001, USA.
Cancer Epidemiol Biomarkers Prev. 2009 Jun;18(6):1740-5. doi: 10.1158/1055-9965.EPI-09-0041.
The U.S. active-duty military population may differ from the U.S. general population in its exposure to cancer risk factors and access to medical care. Yet, it is not known if cancer incidence rates differ between these two populations. We therefore compared the incidence of four cancers common in U.S. adults (lung, colorectal, prostate, and breast cancers) and two cancers more common in U.S. young adults (testicular and cervical cancers) in the military and general populations. Data from the Automated Central Tumor Registry (ACTUR) of the Department of Defense and the nine cancer registries of the Surveillance, Epidemiology and End Results (SEER) of the National Cancer Institute for the years 1990 to 2004 for persons with ages 20 to 59 years were analyzed. Incidence rates were significantly lower in the military population for colorectal cancer in White men, lung cancer in White and Black men and White women, and cervical cancer in Black women. In contrast, incidence rates of breast and prostate cancers were significantly higher in the military among Whites and Blacks. Incidence rates of testicular cancer did not differ between ACTUR and SEER. Although the numbers of diagnoses among military personnel were relatively small for temporal trend analysis, we found a more prominent increase in prostate cancer in ACTUR than in SEER. Overall, these results suggest that cancer patterns may differ between military and nonmilitary populations. Further studies are needed to confirm these findings and explore contributing factors.
美国现役军人在接触癌症风险因素和获得医疗保健方面可能与美国普通人群有所不同。然而,尚不清楚这两个人群的癌症发病率是否存在差异。因此,我们比较了美国成年人中常见的四种癌症(肺癌、结直肠癌、前列腺癌和乳腺癌)以及美国年轻人中更常见的两种癌症(睾丸癌和宫颈癌)在军人和普通人群中的发病率。分析了国防部自动中央肿瘤登记处(ACTUR)以及美国国立癌症研究所监测、流行病学和最终结果(SEER)项目的九个癌症登记处1990年至2004年期间20至59岁人群的数据。在军人人群中,白人男性的结直肠癌、白人和黑人男性及白人女性的肺癌以及黑人女性的宫颈癌发病率显著较低。相比之下,白人和黑人军人中乳腺癌和前列腺癌的发病率显著较高。ACTUR和SEER中睾丸癌的发病率没有差异。尽管军人中的诊断病例数相对较少,无法进行时间趋势分析,但我们发现ACTUR中前列腺癌的增长比SEER中更为显著。总体而言,这些结果表明军人和非军人人群的癌症模式可能不同。需要进一步的研究来证实这些发现并探索相关因素。