Comparative Incidence of Breast Cancer Among Members of the Armed Forces Serving on Acitve Duty, Dates of Diagnosis 2000 to 2011

Background: The Department of Defense (DOD) Active Duty (AD) population may experience differential exposures to risk factors vice the U.S. population; therefore, comparisons of AD to the US population utilizing established North American Association of Central Cancer Registries (NAACCR) and Surveillance, Epidemiology, and End Results Program (SEER) methodologies for consolidation of malignant tumors and assessment of comparisons is imperative.  This analysis provides a comparison of female AD breast cancer rates to civilian rates across similar age groups.  The Health Analysis Department at the Navy and Marine Corps Public Health Center utilizing a similar method previously undertaken to compare prostate cancer age-adjusted rates within the DOD to civilian rates was tasked to compare female AD breast cancer standardized incidence rates to those generated from the US population.

Methods:  The population of interest includes AD female breast cancer cases diagnosed between January 1, 2000 and December 31, 2010 documented within the Automated Central Tumor Registry (ACTUR) for women 20-59 years of age, an approach taken previously.  Age-specific and age-adjusted rates were calculated and compared to the SEER-18 population utilizing 95% confidence intervals to test hypotheses of no differences in rates.

Findings: We found significantly lower age-adjusted malignant breast cancer rates among AD females (93.68 per 100,000 population (95%CI 91.63, 95.76)), relative to the SEER female population (107.76 per 100,000 population (95%CI 107.35, 108.18)).  When stratified by race, breast cancer age-adjusted rates for AD white females (82.36 per 100,000 population (95% CI 79.61, 85.16)) were significantly lower compared to the SEER female white population (108.35 per 100,000 population (95% CI 107.94, 108.77)).  In both African-Americans and Other/Unknown races, there were no significant differences in age-adjusted breast cancer rates.

Implications: Age-adjusted incidence rates are significantly lower over the study time period when compared with national incidence rates reported by the National Cancer Institute (NCI) for all AD females and AD white females, while for AD African-Americans and Other/Unknown races no significant differences in age-adjusted breast cancer rates were seen.  The results here are encouraging for the Armed Forces efforts to promote force readiness, population health, and effective preventive and treatment strategies.

Disclaimer
The views expressed in this abstract are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U. S. Government.