Cancer incidence in the U.S. Air Force: 1989-2002.
ABSTRACT Cancer incidence in U.S. Air Force active duty (AFAD) personnel is unknown. Defining the epidemiology may support more effective prevention and clinical services.
Standardized incidence ratios (SIRs) for invasive cancer in AFAD personnel during 1989-2002 were determined using U.S. national incidence rates as the reference. SIRs were adjusted for age and race. Cutaneous squamous and basal cell carcinomas (CAs) were excluded.
There were 2750 cases: 1986 in men and 764 in women. The all-cancers SIRs were for men, 0.50 (95% CI: 0.48-0.53), and for women, 0.96 (95% CI: 0.89-1.03). Among men, the 10 most frequent cancers (77.6% of total) were, in descending order: melanoma; testicular CA; prostate CA; non-Hodgkin lymphoma; follicular/papillary thyroid CA; Hodgkin's Disease; colorectal CA; brain neuroepithelial CA; and (tied) bladder CA and oral squamous cell CA. Among women, the 10 most frequent cancers (88.1% of total) were, in descending order: breast CA; cervical CA; follicular/papillary thyroid CA; melanoma; Hodgkin's Disease; colorectal CA; (tied) non-Hodgkin lymphoma and ovarian epithelial CA; vulvar CA; and (tied) brain neuroepithelial CA and oral squamous cell CA. Compared with the U.S. population, cancer type-specific SIRs were significantly increased for cervical CA, prostate CA, and vulvar CA (range, 1.44-3.54). SIRs were significantly decreased for bladder CA (men), brain neuroepithelial CA, colorectal CA (men), Hodgkin's Disease (men), non-Hodgkin lymphoma, oral squamous cell CA (men), and testicular CA (range, 0.31-0.68). The remaining SIRs were not significantly different from unity.
The cancer experience of the AFAD population differs substantially from that of the U.S. population.
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ABSTRACT: The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because the risk factors for the disease are poorly understood. Some research suggests that in utero exposures, or those in early childhood, are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolescence and adulthood is also linked to the development of testicular cancer. Of these, two adult occupational exposures-fire fighting and aircraft maintenance--and one environmental exposure (to organochlorine pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, seven of the identified factors--diet, types of physical activity, military service, police work as well as exposure to ionizing radiation, electricity and acrylamide--are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures--to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use--require further study to determine their association with testicular cancer.Nature Reviews Urology 04/2012; 9(6):339-49. · 4.79 Impact Factor
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ABSTRACT: Testicular germ cell tumours (TGCT) are the most common cancers in men aged between 15 and 44 years and the incidence has increased steeply over the past 30 years. The rapid increase in the incidence, the spatial variation and the evolution of incidence in migrants suggest that environmental risk factors play a role in TGCT aetiology. The purpose of our review is to summarise the current state of knowledge on occupational and environmental factors thought to be associated with TGCT. A systematic literature search of PubMed. All selected articles were quality appraised by two independent researchers using the 'Newcastle-Ottawa Quality Assessment Scale'. After exclusion of duplicate reports, 72 relevant articles were selected; 65 assessed exposure in adulthood, 7 assessed parental exposures and 2 assessed both. Associations with occupation was reported for agricultural workers, construction workers, firemen, policemen, military personnel, as well as workers in paper, plastic or metal industries. Electromagnetic fields, PCBs and pesticides were also suggested. However, results were inconsistent and studies showing positive associations tended to had lower quality ranking using the assessment scale (p=0.02). Current evidence does not allow concluding on existence of any clear association between TGCT and adulthood occupational or environmental exposure. The limitations of the studies may partly explain the inconsistencies observed. The lack of association with adulthood exposure is in line with current hypotheses supporting the prenatal origin of TGCT. Future research should focus on prenatal or early life exposure, as well as combined effect of prenatal and later life exposure. National and international collaborative studies should allow for more adequately powered epidemiological studies. More sophisticated methods for assessing exposure as well as evaluating gene-environment interactions will be necessary to establish clear conclusion.PLoS ONE 01/2013; 8(10):e77130. · 3.73 Impact Factor
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ABSTRACT: Colorectal cancer (CRC) is a major burden to healthcare systems worldwide accounting for approximately one million of new cancer cases worldwide. Even though, CRC mortality has decreased over the last 20 years, it remains the third most common cause of cancer-related mortality, accounting for approximately 600,000 deaths in 2008 worldwide. A multitude of risk factors have been linked to CRC, including hereditary factors, environmental factors and inflammatory syndromes affecting the gastrointestinal tract. Recently, various pathogens were added to the growing list of risk factors for a number of common epithelial cancers, but despite the multitude of correlative studies, only suggestions remain about the possible relationship between selected viruses and bacteria of interest and the CRC risk. United States military service members are exposed to various risk factors impacting the incidence of cancer development. These exposures are often different from that of many sectors of the civilian population. Thereby, cancer risk identification, screening and early detection are imperative for both the military health care beneficiaries and the population as a whole. In this review, we will focus on several pathogens and their potential roles in development of CRC, highlighting the clinical trials evaluating this correlation and provide our personal opinion about the importance of risk reduction, health promotion and disease prevention for military health care beneficiaries.Journal of Cancer. 01/2013; 4(3):227-40.