Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, 2300 Eye Street, Washington, DC 20037, USA.
Ann Epidemiol. 2010 Apr;20(4):265-272.e1. doi: 10.1016/j.annepidem.2009.11.012. Epub 2010 Jan 29.
The purpose of this study was to determine whether proportional cancer incidence is greater among Gulf War veterans compared with non-Gulf War veterans.
Files obtained from the Defense Manpower Data Center included data for 621,902 veterans who were deployed to the Persian Gulf during the 1990 to 1991 Gulf War (August 2, 1990, to March 1, 1991) and 746,248 non-Gulf War veteran controls. Identification of veterans who received a cancer diagnosis between 1991 and 2006 was accomplished through record linkage of the Defense Manpower Data Center dataset with files from 28 state cancer registries and the Department of Veterans Affairs Central Cancer Registry. By the use of logistic regression, proportional incidence ratios adjusted for demographic and military characteristics were calculated by comparing the proportion of a specific cancer among all cancers in the Gulf War veterans to the proportion of that specific cancer among all cancers in the non-Gulf War veterans.
Only lung cancer showed a statistically significant relative excess among Gulf War veterans compared with non-Gulf War veterans (adjusted proportional incidence ratios, 1.15; 95% confidence interval, 1.03-1.29). When adjusted for race, age, and sex, the overall proportion of cancers among Gulf War and non-Gulf War veterans was similar (odds ratio, 0.99; 95% CI, 0.96-1.02).
With the exception of lung cancer, there is little evidence of excess risk of cancer associated with Gulf War deployment. A follow-up study is warranted to confirm this finding and to evaluate the role of greater smoking rates among deployed personnel.
本研究旨在确定与非海湾战争退伍军人相比，海湾战争退伍军人的癌症发病率是否呈比例增加。
从国防人力数据中心获得的档案包括在 1990 年至 1991 年海湾战争期间（1990 年 8 月 2 日至 1991 年 3 月 1 日）部署到波斯湾的 621902 名退伍军人和 746248 名非海湾战争退伍军人对照组的数据。通过将国防人力数据中心数据集与来自 28 个州癌症登记处和退伍军人事务部中央癌症登记处的文件进行记录链接，确定退伍军人在 1991 年至 2006 年期间被诊断患有癌症的情况。通过逻辑回归，比较海湾战争退伍军人中特定癌症在所有癌症中的比例与非海湾战争退伍军人中特定癌症在所有癌症中的比例，计算调整人口统计学和军事特征后的比例发病率比。
只有肺癌在海湾战争退伍军人中与非海湾战争退伍军人相比表现出统计学上显著的相对过量（调整后的比例发病率比，1.15；95%置信区间，1.03-1.29）。当按种族、年龄和性别调整时，海湾战争和非海湾战争退伍军人中癌症的总体比例相似（比值比，0.99；95%置信区间，0.96-1.02）。
除肺癌外，海湾战争部署与癌症风险增加几乎没有关联。需要进行后续研究以证实这一发现，并评估部署人员中更高吸烟率的作用。
