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Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)

BACKGROUND: Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among U.S. service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom conflicts. METHODS: Cancer mortal...

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Autores principales: Sharifian, Neika, Carey, Felicia R., Seay, Julia S., Castañeda, Sheila F., Boyko, Edward J., Rull, Rudolph P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association for Cancer Research 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150238/
https://www.ncbi.nlm.nih.gov/pubmed/36880966
http://dx.doi.org/10.1158/1055-9965.EPI-22-0943
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author Sharifian, Neika
Carey, Felicia R.
Seay, Julia S.
Castañeda, Sheila F.
Boyko, Edward J.
Rull, Rudolph P.
author_facet Sharifian, Neika
Carey, Felicia R.
Seay, Julia S.
Castañeda, Sheila F.
Boyko, Edward J.
Rull, Rudolph P.
author_sort Sharifian, Neika
collection PubMed
description BACKGROUND: Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among U.S. service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom conflicts. METHODS: Cancer mortality between 2001 and 2018 was ascertained from the Department of Defense Medical Mortality Registry and National Death Index for 194,689 Millennium Cohort Study participants. Cause-specific Cox proportional hazard models were used to examine links between military characteristics and cancer mortality [overall, early (<45 years), and lung]. RESULTS: Compared with individuals who deployed with no combat experiences, non-deployers had a greater risk of overall [HR = 1.34; 95% confidence interval (CI) = 1.01–1.77] and early cancer mortality (HR = 1.80; 95% CI = 1.06–3.04). Enlisted individuals had a greater risk of lung cancer mortality compared with officers (HR = 2.65; 95% CI = 1.27–5.53). No associations by service component, branch, or military occupation and cancer mortality were observed. Higher education was associated with reduced overall, early and lung cancer mortality risk and smoking and life stressors were associated with elevated overall and lung cancer mortality risk. CONCLUSIONS: These findings are consistent with the healthy deployer effect in which military personnel who were deployed tend to be healthier than those who did not deploy. Further, these findings highlight the importance of considering socioeconomic factors, such as military rank, that may have long-term implications for health. IMPACT: These findings highlight military occupational factors that may predict long-term health outcomes. Additional work is necessary to investigate more nuanced environmental and occupational military exposures and cancer mortality.
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spelling pubmed-101502382023-05-02 Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018) Sharifian, Neika Carey, Felicia R. Seay, Julia S. Castañeda, Sheila F. Boyko, Edward J. Rull, Rudolph P. Cancer Epidemiol Biomarkers Prev Research Articles BACKGROUND: Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among U.S. service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom conflicts. METHODS: Cancer mortality between 2001 and 2018 was ascertained from the Department of Defense Medical Mortality Registry and National Death Index for 194,689 Millennium Cohort Study participants. Cause-specific Cox proportional hazard models were used to examine links between military characteristics and cancer mortality [overall, early (<45 years), and lung]. RESULTS: Compared with individuals who deployed with no combat experiences, non-deployers had a greater risk of overall [HR = 1.34; 95% confidence interval (CI) = 1.01–1.77] and early cancer mortality (HR = 1.80; 95% CI = 1.06–3.04). Enlisted individuals had a greater risk of lung cancer mortality compared with officers (HR = 2.65; 95% CI = 1.27–5.53). No associations by service component, branch, or military occupation and cancer mortality were observed. Higher education was associated with reduced overall, early and lung cancer mortality risk and smoking and life stressors were associated with elevated overall and lung cancer mortality risk. CONCLUSIONS: These findings are consistent with the healthy deployer effect in which military personnel who were deployed tend to be healthier than those who did not deploy. Further, these findings highlight the importance of considering socioeconomic factors, such as military rank, that may have long-term implications for health. IMPACT: These findings highlight military occupational factors that may predict long-term health outcomes. Additional work is necessary to investigate more nuanced environmental and occupational military exposures and cancer mortality. American Association for Cancer Research 2023-05-01 2023-03-07 /pmc/articles/PMC10150238/ /pubmed/36880966 http://dx.doi.org/10.1158/1055-9965.EPI-22-0943 Text en ©2023 The Authors; Published by the American Association for Cancer Research https://creativecommons.org/licenses/by-nc-nd/4.0/This open access article is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.
spellingShingle Research Articles
Sharifian, Neika
Carey, Felicia R.
Seay, Julia S.
Castañeda, Sheila F.
Boyko, Edward J.
Rull, Rudolph P.
Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title_full Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title_fullStr Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title_full_unstemmed Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title_short Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
title_sort risk and protective factors for cancer mortality among united states service members and veterans (2001–2018)
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150238/
https://www.ncbi.nlm.nih.gov/pubmed/36880966
http://dx.doi.org/10.1158/1055-9965.EPI-22-0943
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