Norwegian Armed Forces Joint Medical Services, Institute of Military Medicine and Epidemiology, Sessvollmoen Garnison, N-2018 Sessvollmoen, Norway.
Cancer Registry of Norway, Box 5313 N-0304 Oslo, Norway.
Mil Med. 2020 Feb 12;185(1-2):e239-e243. doi: 10.1093/milmed/usz179.
In 2012, Norwegian news media reported on cases of brain cancer among Norwegian peacekeeping troops who served in Kosovo, allegedly caused by exposure to depleted uranium fired during airstrikes before the peacekeepers arrived in 1999. A first study followed 6076 military men and women with peacekeeping service in Kosovo during 1999-2011 for cancers and deaths throughout 2011. The study did not support to the idea that peacekeeping service in Kosovo could lead to increased risk of brain cancer or other cancers. However, the average time of follow-up (10.6 years) was rather short for cancer development; therefore the aim of the present study was to evaluate cancer risk and general mortality in an updated cohort after 5 years of additional follow-up.
The updated cohort consisted of 6,159 peacekeepers (5,884 men and 275 women) who served in Kosovo during 1999-2016 and were followed for cancer incidence and mortality from all causes combined throughout 2016. We calculated standardized incidence ratios (SIR) for cancer and standardized mortality ratios (SMR) from national population rates. Poisson regression was used to assess the effect of length of service (<1 year vs. ≥1 year) on cancer risk.
We observed 149 cancer cases and 75 deaths in the updated cohort. Observed cancer incidence did not exceed national rates. In men, the SIR for brain cancer was 0.73 (95% confidence interval (CI) 0.32-1.44), based on eight cases, while the risk of colon cancer was lowered (SIR = 0.14, 95% CI 0.00-0.79). The Poisson regression showed no effect of service duration on all-site cancer incidence. Mortality from all causes combined was lower than expected (SMR = 0.62, 95% CI 0.49-0.78) and in accordance with a "healthy soldier effect".
The extended follow-up did not give support to the suggestion that peacekeeping service in Kosovo could lead to increased risk of cancer.
2012 年，挪威新闻媒体报道了在科索沃执行维和任务的挪威维和部队中出现脑癌病例，据称这些病例是由于维和部队在 1999 年抵达之前的空袭中接触贫铀所致。第一项研究对 1999 年至 2011 年期间在科索沃执行维和任务的 6076 名男女军人进行了癌症和 2011 年全年死亡情况的跟踪调查。该研究并未支持维和服务可能导致脑癌或其他癌症风险增加的观点。然而，癌症发展的平均随访时间（10.6 年）相对较短；因此，本研究的目的是在 5 年的额外随访后，对更新队列中的癌症风险和一般死亡率进行评估。
更新后的队列由 6159 名在 1999 年至 2016 年期间在科索沃执行维和任务的维和人员（5884 名男性和 275 名女性）组成，在 2016 年期间，他们的癌症发病率和所有原因导致的死亡率均进行了跟踪调查。我们计算了癌症的标准化发病比（SIR）和全国人口发病率的标准化死亡率比（SMR）。泊松回归用于评估服务年限（<1 年与≥1 年）对癌症风险的影响。
我们在更新后的队列中观察到 149 例癌症病例和 75 例死亡病例。观察到的癌症发病率并未超过全国水平。在男性中，基于 8 例病例，脑癌的 SIR 为 0.73（95%置信区间（CI）0.32-1.44），而结肠癌的风险降低（SIR=0.14，95%CI0.00-0.79）。泊松回归显示，服务年限对所有部位癌症发病率无影响。所有原因导致的死亡率均低于预期（SMR=0.62，95%CI0.49-0.78），与“健康士兵效应”一致。
延长随访时间并未支持在科索沃执行维和任务可能会增加癌症风险的说法。
