Investigating the Risk of Cancer in 1990–1991 US Gulf War Veterans With the Use of State Cancer Registry Data

Young, Heather A.; Maillard, Jessica D.; Levine, Paul H.; Simmens, Samuel J.; Mahan, Clare M.; Kang, Han K.

doi:10.1016/j.annepidem.2009.11.012

« Previous Next »Annals of Epidemiology
Volume 20, Issue 4 , Pages 265-272.e1, April 2010

Investigating the Risk of Cancer in 1990–1991 US Gulf War Veterans With the Use of State Cancer Registry Data

Heather A. Young, PhD
- Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
- Address correspondence to: Heather A. Young, Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, 2300 Eye Street, NW, Ross Hall 120, Washington, DC, 20037. Tel.: 202 994 6518; Fax: 202 994 0082.
Jessica D. Maillard, MPH
- Veterans Health Administration, Department of Veterans Affairs, Environmental Epidemiology Service, Washington, DC
Paul H. Levine, MD
- Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
Samuel J. Simmens, PhD
- Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
Clare M. Mahan, PhD
- Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
- Veterans Health Administration, Department of Veterans Affairs, Environmental Epidemiology Service, Washington, DC
Han K. Kang, DRPH
- Department of Epidemiology and Biostatistics, George Washington University School of Public Health and Health Services, Washington, DC
- Veterans Health Administration, Department of Veterans Affairs, Environmental Epidemiology Service, Washington, DC

Received 24 July 2009; accepted 19 November 2009. published online 29 January 2010.

Purpose

The purpose of this study was to determine whether proportional cancer incidence is greater among Gulf War veterans compared with non-Gulf War veterans.

Methods

Files obtained from the Defense Manpower Data Center included data for 621,902 veterans who were deployed to the Persian Gulf during the 1990 to 1991 Gulf War (August 2, 1990, to March 1, 1991) and 746,248 non-Gulf War veteran controls. Identification of veterans who received a cancer diagnosis between 1991 and 2006 was accomplished through record linkage of the Defense Manpower Data Center dataset with files from 28 state cancer registries and the Department of Veterans Affairs Central Cancer Registry. By the use of logistic regression, proportional incidence ratios adjusted for demographic and military characteristics were calculated by comparing the proportion of a specific cancer among all cancers in the Gulf War veterans to the proportion of that specific cancer among all cancers in the non-Gulf War veterans.

Results

Only lung cancer showed a statistically significant relative excess among Gulf War veterans compared with non-Gulf War veterans (adjusted proportional incidence ratios, 1.15; 95% confidence interval, 1.03−1.29). When adjusted for race, age, and sex, the overall proportion of cancers among Gulf War and non-Gulf War veterans was similar (odds ratio, 0.99; 95% CI, 0.96−1.02).

Conclusions

With the exception of lung cancer, there is little evidence of excess risk of cancer associated with Gulf War deployment. A follow-up study is warranted to confirm this finding and to evaluate the role of greater smoking rates among deployed personnel.

Key Words: Gulf War, Neoplasms, Veterans

Selected Abbreviations and Acronyms: DOD, Department of Defense, DMDC, Defense Manpower Data Center, SEER, Surveillance, Epidemiology, and End Results, PIR, proportional incidence ratio, 95% CI, 95% confidence interval, SIR, standardized incidence ratio, VACCR, Veterans Affairs Central Cancer Registry, VA, Veterans Affairs