National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands.
Cancer Epidemiol. 2013 Oct;37(5):550-5. doi: 10.1016/j.canep.2013.04.005. Epub 2013 May 22.
Suspicion has been raised about an increased cancer risk among Balkan veterans because of alleged exposure to depleted uranium. The authors conducted a historical cohort study to examine cancer incidence among Dutch Balkan veterans. Male military personnel (n=18,175, median follow-up 11 years) of the Army and Military Police who had been deployed to the Balkan region (1993-2001) was compared with their peers not deployed to the Balkans (n=135,355, median follow-up 15 years) and with the general Dutch population of comparable age and sex. The incidence of all cancers and 4 main cancer subgroups was studied in the period 1993-2008. The cancer incidence rate among Balkan deployed military men was 17% lower than among non-Balkan deployed military men (hazard ratio 0.83 (95% confidence interval 0.69, 1.00)). For the 4 main cancer subgroups, hazard ratios were statistically non-significantly below 1. Also compared to the general population cancer rates were lower in Balkan deployed personnel (standardised incidence rate ratio (SIR) 0.85 (0.73, 0.99). The SIR for leukaemia was 0.63 (0.20, 1.46). The authors conclude that earlier suggestions of increased cancer risks among veterans are not supported by empirical data. The lower risk of cancer might be explained by the 'healthy warrior effect'.
人们怀疑巴尔干半岛退伍军人的癌症风险增加，因为据称他们接触过贫铀。作者进行了一项历史队列研究，以检查荷兰巴尔干半岛退伍军人的癌症发病率。与未部署到巴尔干地区的同行（n=135355，中位随访时间为 15 年）相比，曾部署到巴尔干地区（1993-2001 年）的陆军和宪兵部队的男性军人（n=18175，中位随访时间为 11 年）以及年龄和性别相匹配的荷兰一般人群相比，研究了所有癌症和 4 个主要癌症亚组在 1993-2008 年期间的发病情况。与未部署到巴尔干地区的军人相比，部署到巴尔干地区的军人癌症发病率低 17%（风险比 0.83（95%置信区间 0.69，1.00））。对于 4 个主要癌症亚组，风险比低于 1，且无统计学意义。与一般人群相比，部署到巴尔干地区的军人癌症发病率也较低（标准化发病率比（SIR）0.85（0.73，0.99））。白血病的 SIR 为 0.63（0.20，1.46）。作者得出结论，早期关于退伍军人癌症风险增加的说法并没有得到实证数据的支持。癌症风险较低可能是由于“健康战士效应”。
