Rolland-Harris Elizabeth, VanTil Linda, Zamorski Mark A, Boulos David, Reicker Alexander, Masoud Huda, Trudeau Richard, Weeks Murray, Simkus Kristen
Directorate of Force Health Protection (Rolland-Harris, Weeks, Simkus) and Directorate Mental Health (Zamorski, Boulos), Department of National Defence, Ottawa, Ont.; Research Directorate (VanTil, Simkus), Veterans Affairs Canada, Charlottetown, PEI; Statistics Canada (Reicker, Masoud, Trudeau), Ottawa, Ont.
CMAJ Open. 2018 Dec 10;6(4):E619-E627. doi: 10.9778/cmajo.20170125. Print 2018 Oct-Dec.
Military service exposes personnel to unusual situations with unclear health-related implications, and to identify both immediate and delayed risks, part of health surveillance includes examination of mortality and cancer rates that extends beyond periods of military service. The main aim of the Canadian Forces Cancer and Mortality Study II (CFCAMS II) is to describe the mortality and cancer experience of Canadian Armed Forces personnel (serving and released; about 230 000 people), with the further aim of informing health promotion and prevention programs for serving personnel and services for veterans after they leave the military.
This protocol is for a retrospective cohort study of serving and released Canadian Armed Forces personnel who enrolled on or after Jan. 1, 1976 in the Regular Force or Class C of the Reserve Force. To create our cohort, we identified record-linkage methods as the most appropriate mechanism to study mortality and cancer in those with a history of Canadian military service. Statistics Canada will link the CFCAMS II cohort file to the Canadian Vital Statistics (Mortality) and Canadian Cancer Registry databases for outcomes up to Dec. 31, 2014. The linkage will be stored in their highly secure linkage environment. Statistical analyses will be broadly divided into mortality and cancer incidence.
We will quantify mortality and cancer morbidity incidence and survival using multiple established methods, as well as age-period-cohort regression models to describe the relation between military service and mortality and cancer outcomes.
The findings will represent novel and sound evidence on the risks and protective factors of military life.
兵役使人员面临健康影响不明的特殊情况，为了识别即时和延迟风险，健康监测的一部分包括对死亡率和癌症发病率的检查，该检查会延伸至兵役期之后。加拿大军队癌症与死亡率研究II（CFCAMS II）的主要目的是描述加拿大武装部队人员（现役和退役；约23万人）的死亡率和患癌经历，进一步目的是为现役人员的健康促进和预防计划以及退伍军人退役后的服务提供信息。
本方案是一项针对1976年1月1日及以后在正规部队或预备役部队C类入伍的现役和退役加拿大武装部队人员的回顾性队列研究。为了创建我们的队列，我们确定记录链接方法是研究有加拿大军事服役史人员死亡率和癌症情况的最合适机制。加拿大统计局将把CFCAMS II队列文件与加拿大生命统计（死亡率）和加拿大癌症登记数据库相链接，以获取截至2014年12月31日的结果。链接将存储在其高度安全的链接环境中。统计分析将大致分为死亡率和癌症发病率分析。
我们将使用多种既定方法以及年龄-时期-队列回归模型来量化死亡率、癌症发病率和生存率，以描述军事服役与死亡率和癌症结果之间的关系。
这些发现将为军事生活的风险和保护因素提供新颖且可靠的证据。
