美国军人软组织肉瘤的发病率：与美国普通人群发病率的比较。

Incidence rates of soft tissue sarcoma among U.S. military servicemen: Comparison with the rates in the general U.S. population.

作者信息

Bytnar Julie A, Anderson Ashley B, Potter Benjamin K, Shriver Craig D, Zhu Kangmin

机构信息

Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.

出版信息

Cancer. 2025 Jan 1;131(1):e35607. doi: 10.1002/cncr.35607. Epub 2024 Dec 9.

DOI:10.1002/cncr.35607

PMID:39648716

Abstract

BACKGROUND

Soft tissue sarcoma (STS) is one of the most frequently diagnosed cancers among men younger than age 30 years and a leading cause of cancer death in men younger than age 40 years. The military may be more exposed to STS risk factors and have generally better health and health care access than the general population, which may relate to lower cancer risk and/or early detection. This study compared STS incidence between servicemen and men in the general U.S.

METHODS

Data were from the Department of Defense's Automated Central Tumor Registry (ACTUR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. Subjects were active-duty servicemen in ACTUR and men in SEER aged 18-59 years diagnosed with STS from 1990 to 2013. Age-adjusted rates, incidence rate ratios (IRR), and 95% CIs were calculated.

RESULTS

STS incidence rates were lower in ACTUR than SEER overall (IRR = 0.86 [0.78-0.93]), for 18- to 39-year-old men (IRR = 0.78 [0.70-0.86]), by race (White: IRR = 0.85 [0.77-0.95]; Black: IRR = 0.77 [0.63-0.94]), for sites other than skin/connective/soft tissue (IRR = 0.49 [0.37-0.63]), other specified histologies (IRR = 0.84 [0.71-0.98]), and unspecified histology (IRR = 0.57 [0.38-0.82]). Rates were lower in ACTUR for regional (IRR = 0.37 [0.28-0.47]) and distant metastases (IRR = 0.58 [0.43-0.76]), even when race and age stratified. However, rates were higher in ACTUR for 40- to 59-year-old men (IRR = 1.25 [1.04-1.48]) and localized tumors (IRR = 1.16 [1.04-1.29]).

CONCLUSION

Lower STS rates among servicemen may relate to better health and early detection and treatment of STS-associated conditions within the military health system, which provides universal care. Higher rates among 40- to 59-year-old servicemen may result from greater cumulative military-related exposures.

摘要

背景

软组织肉瘤（STS）是30岁以下男性中最常被诊断出的癌症之一，也是40岁以下男性癌症死亡的主要原因。军人可能更多地暴露于STS风险因素中，并且总体上比普通人群拥有更好的健康状况和医疗保健机会，这可能与较低的癌症风险和/或早期发现有关。本研究比较了美国军人与普通男性之间的STS发病率。

方法

数据来自国防部的自动中央肿瘤登记处（ACTUR）和美国国立癌症研究所的监测、流行病学和最终结果（SEER）计划。研究对象为ACTUR中的现役军人以及SEER中1990年至2013年期间被诊断为STS的18至59岁男性。计算了年龄调整率、发病率比（IRR）和95%置信区间。

结果

总体上，ACTUR中的STS发病率低于SEER（IRR = 0.86 [0.78 - 0.93]）；18至39岁男性中也是如此（IRR = 0.78 [0.70 - 0.86]）；按种族划分，白人（IRR = 0.85 [0.77 - 0.95]）、黑人（IRR = 0.77 [0.63 - 0.94]）；皮肤/结缔组织/软组织以外部位（IRR = 0.49 [0.37 - 0.63]）、其他特定组织学类型（IRR = 0.84 [0.71 - 0.98]）以及未明确组织学类型（IRR = 0.57 [0.38 - 0.82]）的发病率均较低。ACTUR中区域转移（IRR = 0.37 [0.28 - 0.47]）和远处转移（IRR = 0.58 [0.43 - 0.76]）的发病率也较低，即使按种族和年龄分层后也是如此。然而，40至59岁男性（IRR = 1.25 [1.04 - 1.48]）和局限性肿瘤（IRR = 1.16 [1.04 - 1.29]）在ACTUR中的发病率较高。