Cancer incidence among Canadian Veterans: A matched cohort study |
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| Affiliation: | 1. ICES, Toronto, Canada;2. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada;3. Faculty of Health, Dalhousie University, Halifax, Canada;4. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;5. School of Rehabilitation Therapy, Queen’s University, Kingston, Canada;6. Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada;1. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;2. Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landspitali University Hospital of Iceland, Reykjavik, Iceland;1. Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan;2. Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan;3. Pharmacy Student, University of Jordan, Amman 11972, Jordan;4. Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan;5. Medical Student, University of Jordan, Amman 11972, Jordan;1. Cancer Surveillance and Data Analysis Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil;2. Early Detection and Cancer Care Network Division, National Cancer Institute INCA, Rio de Janeiro, Brazil;3. Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France;1. Department of Cancer Strategy, Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka Prefecture 541-8567, Japan;2. Inequalities in Cancer Outcome Network, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom;1. Maccabi Institute for Research and Innovation (Maccabitech), Maccabi Healthcare Services, HaMered 27, Tel Aviv, 68125, Israel;2. MSD Israel, Merck Sharp & Dohme (Israel-1996) Company Ltd. 34 Hacharash St. P.O.B 7340, Hod Hasharon 45240, Israel;3. Institute of Oncology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel;4. Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel;5. Sackler Faculty of Medicine, Tel Aviv University, Israel |
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| Abstract: | IntroductionOccupational exposures related to military service may increase the risk of cancer for military Veterans, while high levels of fitness during service may decrease risk. However, few studies have compared this post-career cancer risk directly to the employed general population.MethodsThis retrospective cohort study used linked administrative data. Canadian Armed Forces and Royal Canadian Mounted Police Veterans in Ontario, Canada were matched 1:4 on age, sex, geography, and community-level income to a group of non-Veterans most likely to have been employed during a period similar to the Veterans’ military service. Cancer diagnoses were identified using the Ontario Cancer Registry.ResultsDuring the study period, 642 of 30 576 included Veterans (2.1%) and 3408 of the 122 293 matched general population cohort (2.8%) experienced at least one cancer diagnosis. The crude rate of cancer was 153.5 per 100 000 person-years among Veterans vs. 205.9 per 100 000 person-years for the general population cohort. After adjusting for rurality and matching variables, Veterans had an 27% lower risk of developing any cancer than their matched comparators [hazard ratio = 0.73 (95% CI: 0.67–0.80)]. Among specific cancer types, the risk of lung and colorectal cancer was significantly lower for Veterans relative to the general population cohort; the risk of breast and prostate cancer was similar.DiscussionThis study adds to the growing international evidence suggesting that risk of many cancers among Veterans is lower or similar to the general population. Further understanding of the complex relationships among occupational exposures, environmental factors, and lifestyle factors is needed. |
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| Keywords: | Military personnel Military health Veterans Occupational groups Neoplasms |
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