Cholangiocarcinoma (CCA) mortality in Vietnam war era veterans

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-02-01 DOI:10.1016/j.canep.2024.102721

T. Bullman , WJ Culpepper , YS Cypel , F. Akhtar , SW Morley , A. Schneiderman , JC Weitlauf , E. Garges , VJ Davey

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引用次数: 0

Abstract

Background

There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater. A variety of risk factors potentially related to Vietnam deployment may be associated with an increased risk of mortality from CCA. This study assessed the risk of CCA mortality among all Vietnam War era veterans, the first study to do so.

Methods

The Vietnam Era Veterans Mortality Study is a retrospective mortality study of all 2.5 million veterans who served in Vietnam and Southeast Asia (theater) and the 7.3 million veterans who served elsewhere during the Vietnam War (non-theater). Mortality was followed from 1979 to 2019. Hazard ratios (HRs) calculated from Cox proportional hazards models, adjusted for sex and age, compared CCA mortality risk between theater and non-theater veterans overall and by branch of service. Branch specific crude rates of CCA were also compared between theater and non-theater veterans.

Results

There were 2410 and 6502 CCA deaths among all theater and non-theater veterans respectively. Overall, there was no increased CCA mortality risk among theater versus non-theater veterans after adjusting for sex and age (hazard ratio, (HR: 1.00, 95 % CI: 0.95–1.04). When stratified by branch, the crude HRs for CCA were no different between branch-theater status groups except in non-theater Marines who had lower risk. A monotonic increase in crude rates for CCA mortality was observed in both theater and non-theater over forty years of follow-up.

Conclusion

There was no increased risk of CCA mortality in theater versus non-theater U.S. Vietnam War veterans, an important and new finding. This study lacked data on environmental exposures and behavioral factors that would further inform analyses of CCA risk. Identification of Vietnam era veterans’ specific risk factors for CCA would require alternate methods and data which do not exist.

查看原文本刊更多论文

越战老兵胆管癌（CCA）死亡率。

背景：在越战战场服役的美国退伍军人中存在胆管癌死亡率（CCA）的风险。各种可能与越南部署有关的风险因素可能与CCA死亡风险增加有关。这项研究评估了所有越南战争时期退伍军人的CCA死亡率风险，这是第一个这样做的研究。方法：越战时期退伍军人死亡率研究是一项回顾性死亡率研究，研究对象包括在越南和东南亚（战区）服役的所有250万退伍军人，以及在越南战争期间在其他地方（非战区）服役的730万退伍军人。从1979年到2019年跟踪了死亡率。根据Cox比例风险模型计算的风险比（hr），对性别和年龄进行了调整，比较了战区和非战区退伍军人总体和各服务部门之间的CCA死亡率风险。还比较了战区退伍军人和非战区退伍军人的分支特异性CCA粗率。结果：战区退伍军人和非战区退伍军人分别有2410例和6502例CCA死亡。总体而言，在调整性别和年龄后，战区退伍军人与非战区退伍军人的CCA死亡风险没有增加(风险比，（HR: 1.00, 95 % CI: 0.95-1.04）。当按军种分层时，除了非战区海军陆战队员的风险较低外，军种战区状态组之间CCA的粗hr没有差异。在40年的随访中，无论在战区还是非战区，CCA的粗死亡率均呈单调上升趋势。结论：战区与非战区美国越战老兵的CCA死亡风险没有增加，这是一个重要的新发现。这项研究缺乏环境暴露和行为因素的数据，这些数据将进一步为CCA风险分析提供信息。确定越南战争时期退伍军人的具体风险因素，需要替代的方法和数据不存在。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.