Incidence rates of digestive cancers among U.S. military servicemen: Comparison with the rates in the general U.S. population.

Julie A Bytnar,Craig D Shriver,Kangmin Zhu,Scott M Langevin

doi:10.1371/journal.pone.0257087

Abstract

BackgroundDigestive 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.MethodsData 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.ResultsThe 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.ConclusionThe 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.

Highlights

Digestive cancers include cancers of the intestinal tract and the accessory digestive organs
The age-adjusted incidence rates of colorectal, stomach, liver, and pancreatic cancers were overall lower among active-duty than SEER (IRR = 0.86, 95% confidence intervals (CIs) = 0.81–0.92; Incidence rate ratio (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)
Digestive cancers in US the military compared to the US general population study are publicly available from the National Cancer Institute

Summary

Introduction

Digestive cancers include cancers of the intestinal tract (esophagus, stomach, small and large intestines, rectum, and anus) and the accessory digestive organs (liver, gallbladder, and pancreas). Most digestive cancers are more common among men with the incidence rates 2 to 3 times higher than those among women [1]. While the incidence of liver cancer has tripled [2] in the U.S since the 1970s and pancreatic cancer [4] has increased since 1994, the overall incidence rates of colorectal [3], and stomach [1] cancers have decreased over time. 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. 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

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Conclusion