Is there an association between a history of military service and cancer diagnosis? Results from a US national-level study of self-reported outcomes

Cancer Causes Control. 2021 Jan;32(1):47-55. doi: 10.1007/s10552-020-01355-4. Epub 2020 Oct 16.

Abstract

Purpose: To examine cancer prevalence in men with and without military service history, using national-level self-reported outcomes.

Methods: A cross-sectional survey-based US study, including men aged 18 and above from the Health Information National Trends Survey database between 2011 and 2014. The primary endpoint was self-reported cancer prevalence. Multivariable logistic regression analyses assessed the association of various covariates with the prevalence of cancer.

Results: A total of 4,527 men were analyzed, with 1,352 (29.9%) reporting a history of military service. Compared to men with no military service history, men with a military service history were older (median of 65 [IQR 56, 74] vs. 53 [IQR 41, 62] years, p < 0.0001), more commonly Caucasian (71.4% vs. 61.4%, p < 0.0001), born in the US (95.6% vs. 79.5%, p < 0.0001), attained higher education level and annual household income (p < 0.0001), and consisted of more smokers(58.3% vs. 44.5%, p < 0.0001). The age-adjusted comparison demonstrated a higher cancer prevalence in men with military service history (20.5% vs. 7.6%, p < 0.0001). Specifically, genitourinary, dermatological, gastrointestinal, and hematological cancers were generally more prevalent. Adjusting for all available confounders, multivariable models showed that military service history was associated with 1.56 (95% CI 1.20-2.03), and 1.57 (95% CI 1.07-2.31) increased odds of having any cancer, and specifically genitourinary cancer, respectively.

Conclusions: Further research is needed to ascertain whether the association between military service and increased cancer diagnosis results from better screening programs or increased exposure to risk factors during military service.

Keywords: Cancer; Dermatological cancers; Genitourinary cancers; HINTS survey; Military service history.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Military Personnel / statistics & numerical data*
  • Neoplasms / diagnosis*
  • Patient Reported Outcome Measures
  • Prevalence
  • Risk Factors
  • Self Report
  • Surveys and Questionnaires
  • United States