John P. Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, United States of America.
PLoS One. 2021 Sep 3;16(9):e0257087. doi: 10.1371/journal.pone.0257087. eCollection 2021.
Digestive cancers greatly contribute to the cancer burden in the United States. These cancers are more common among men and some are increasing among adults under age 50. Military population, which is dominantly male and young, and general populations differ in exposure to risk factors for these cancers. However, no studies have systematically investigated whether the incidence rates of these cancers differ between the two populations. This study aimed to compare incidence rates and trends of select digestive cancers between active-duty military and general populations in men aged 20-59 years.
Data were from the Department of Defenses' Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results 9 (SEER-9) registries. Age-adjusted incidence rates of colorectal, stomach, liver, and pancreatic cancers among men aged 20-59 years during 1990-2013 were compared between the two populations. Stratified analyses by age were done for colorectal and stomach cancers. The joinpoint regression analysis was conducted to examine temporal trends for colorectal cancer.
The age-adjusted incidence rates of colorectal, stomach, liver, and pancreatic cancers were overall lower among active-duty than SEER (IRR = 0.86, 95% CI = 0.81-0.92; IRR = 0.65, 95% CI = 0.55-0.76; IRR = 0.39, 95% CI = 0.30-0.49; IRR = 0.51, 95% CI = 0.41-0.62, respectively). This was observed in the groups of both ages 20-39 and 40-59 years for stomach cancer, and in the group of ages 40-59 years for colorectal cancer. The incidence rates of colorectal cancer tended to decrease since 2008 in ACTUR.
The incidence rates for selected digestive cancers overall were lower in the active-duty military population than the U.S. general population. This study highlights the need for more research enhancing our understanding of variations in these cancers between the two populations.
在美国，消化道癌症极大地加重了癌症负担。这些癌症在男性中更为常见，并且在 50 岁以下的成年人中某些癌症的发病率正在上升。军队人口以男性和年轻人为主，与一般人群在这些癌症的危险因素暴露方面存在差异。但是，尚无研究系统地调查这两种人群中这些癌症的发病率是否存在差异。本研究旨在比较现役军人和一般人群中 20-59 岁男性中某些消化道癌症的发病率和趋势。
数据来自国防部的自动中央肿瘤登记处（ACTUR）和美国国家癌症研究所的监测、流行病学和最终结果 9（SEER-9）登记处。比较了 1990-2013 年间，20-59 岁男性中结直肠癌、胃癌、肝癌和胰腺癌的年龄调整发病率，比较了这两种人群之间的发病率。对结直肠癌和胃癌进行了分层分析。使用 Joinpoint 回归分析来检查结直肠癌的时间趋势。
与 SEER 相比，现役军人的结直肠癌、胃癌、肝癌和胰腺癌的年龄调整发病率总体较低（IRR=0.86，95%CI=0.81-0.92；IRR=0.65，95%CI=0.55-0.76；IRR=0.39，95%CI=0.30-0.49；IRR=0.51，95%CI=0.41-0.62）。在年龄分别为 20-39 岁和 40-59 岁的胃癌组以及年龄为 40-59 岁的结直肠癌组中观察到了这种情况。ACTUR 中的结直肠癌发病率自 2008 年以来呈下降趋势。
总体而言，现役军人中某些消化道癌症的发病率低于美国一般人群。本研究强调了需要更多的研究来增强我们对这两种人群中这些癌症差异的理解。
