Bergman Beverly P, Mackay Daniel F, Pell Jill P
Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK.
Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK.
Cancer Epidemiol. 2017 Apr;47:100-105. doi: 10.1016/j.canep.2017.02.001. Epub 2017 Feb 23.
Lymphohaematopoietic malignancies are common in the general population. There have been concerns that military service may be associated with increased risk as a result of occupational exposures. To date, few studies have demonstrated an increased risk, although a disability pension is payable to veterans who were present at nuclear tests and who develop leukaemia (other than chronic lymphocytic leukaemia). The aim of the study was to utilise data from the Scottish Veterans Health Study to examine the risk of lymphohaematopoietic malignancy following military service in a large national cohort of veterans.
Retrospective cohort study of 57,000 veterans and 173,000 non-veterans born between 1945 and 1985 matched for age, sex and area of residence, adjusted for areal deprivation and followed up for up to 30 years, using Cox proportional hazard models to compare the risk of lymphohaematopoietic malignancy overall, by diagnosis and by sex and birth cohort.
We found no statistically significant difference in risk between veterans and non-veterans either for all leukaemias (Cox proportional hazard ratio 1.03, 95% confidence intervals 0.84-1.27, p=0.773), Hodgkin lymphoma (hazard ratio 1.19, 95% confidence intervals 0.87-1.61, p=0.272) or for non-Hodgkin lymphoma (hazard ratio 0.86, 95% confidence intervals 0.71-1.04, p=0.110).
Our findings provide reassurance that service in the UK Armed Forces is not associated with increased risk of lymphohaematopoietic malignancy.
淋巴造血系统恶性肿瘤在普通人群中很常见。有人担心，由于职业暴露，服兵役可能会增加患病风险。迄今为止，很少有研究表明风险增加，尽管对于参加过核试验并患上白血病（慢性淋巴细胞白血病除外）的退伍军人可支付残疾抚恤金。本研究的目的是利用苏格兰退伍军人健康研究的数据，在一个大型全国退伍军人队列中研究服兵役后患淋巴造血系统恶性肿瘤的风险。
对57000名退伍军人和173000名1945年至1985年出生的非退伍军人进行回顾性队列研究，根据年龄、性别和居住地区进行匹配，对地区贫困程度进行调整，并随访长达30年，使用Cox比例风险模型比较总体、按诊断、性别和出生队列划分的淋巴造血系统恶性肿瘤风险。
我们发现，退伍军人和非退伍军人在所有白血病（Cox比例风险比1.03，95%置信区间0.84-1.27，p=0.773）、霍奇金淋巴瘤（风险比1.19，95%置信区间0.87-1.61，p=0.272）或非霍奇金淋巴瘤（风险比0.86，95%置信区间0.71-1.04，p=0.110）方面的风险没有统计学上的显著差异。
我们的研究结果表明，在英国武装部队服役与淋巴造血系统恶性肿瘤风险增加无关，这让人放心。
