18 July 2009

Study Reveals Differences Between Military and Civilian Cancer Rates

By David Loebsack Health.mil

A recent study of Department of Defense and National Cancer Institute statistics shows that active-duty military personnel may have lower risks of developing certain kinds of cancer compared with the general public.

These findings came to light after a group of researchers from the Military Health System and the National Institutes of Health compared cancer rates between members of the armed forces and the general U.S. population.

"Cancer risk may be affected by multiple factors. It is known that certain behaviors or exposures such as tobacco smoking, alcohol consumption, poor diet, obesity, radiation, and certain chemicals are associated with cancer," said Dr. Kangmin Zhu, a scientist at the U.S. Military Cancer Institute and the Uniformed Services University of the Health Sciences who led the research project.

"The military population may be different from the general population in its exposure to these factors and therefore cancer incidence rates may differ in the two groups," said Zhu.

Zhu’s team sought to take a broad picture of the effects of cancer on military members by comparing the frequency of six kinds of cancer—lung, colorectal, prostate, breast, testicular and cervical—between military and civilian populations. The study focused on adults aged 20 to 59 years old who were diagnosed with one of the six cancers between 1990 and 2004. Data was taken from two databases: the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute, and the Defense Department’s Automated Central Tumor Registry (ACTUR).

The research team found that certain cancers – colorectal, lung and cervical – appeared less frequently in the military population than in the general population. They also found that breast cancer among women and prostate cancer among men are more common in the military than in the general population. Testicular cancer appeared to affect both military and civilian populations equally.

Studies on cancer incidence in the U.S. Armed Forces are few and far between. Zhu’s team identified only two previous cancer studies in the military, and both were limited in size and scope. In 1999, a team of researchers conducted a study on the incidence of testicular cancer in the Defense Department. Then in 2006, another more general study was conducted, but only within Air Force personnel.

Although it is unclear why certain groups of military personnel demonstrated different rates, the research team offered some speculation in their article published last month in Cancer Epidemiology, Biomarkers and Prevention. According to their interpretation, differing cancer frequencies between military and civilian populations were most likely due to greater access to medical care and higher rates of cancer screening in the military. There also might be different levels of exposure to cancer risks such as smoking, alcohol use, and low physical activity. The differences between the two reporting systems could have also played a role in creating those disparities.

All in all, Zhu said, his team plans to continue this kind of analysis after more data has been collected. Descriptive epidemiological studies, he says, may provide clues for further research as well as provide evidence to support existing hypotheses

"Analysis of the frequency, distribution and pattern of various cancers can be the first step in understanding their etiology" said Zhu. "In the past, studies of cancer incidence rates in the U.S. military population have been very limited. One of the important research goals of the United States Military Cancer Institute, Uniformed Services University of the Health Sciences and its collaborator, the National Cancer Institute, is to understand cancer patterns in the military. We hoped that this descriptive study would provide basic information on cancer incidence in the military."

To read the full article in the June issue of Cancer, Epidemiology Biomarkers and Prevention click here.
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