A Cancer Study Among Female Veterans in Texas, 1979-2001

描述（由申请人提供）： 这项以人群为基础的职业队列研究将研究德克萨斯州美国女性退伍军人中兵役与癌症风险的关联。与退伍军人身份有关的特征可能使这一群体易患性别特异性健康问题。潜在的危险因素包括战时服役期间的环境暴露、与兵役相关的创伤事件以及与生殖史相关的依赖性因素。先前的研究报告称，妇科癌症是女性退伍军人的主要癌症类型。主要研究目的是调查居住在得克萨斯州的女性退伍军人的乳腺癌、子宫癌、宫颈癌和卵巢癌发病率（1995年至2001年）和死亡率（1979年至2001年）。退伍军人事务部的国家女退伍军人登记处（NRVW）是一个包含1946年至1995年期间服役的超过140万女退伍军人的数据库，将使用概率链接技术与德克萨斯州生命统计数据（死亡率研究）和德克萨斯州癌症登记处（发病率研究）进行交叉链接。第二项研究的目的是检查所有其他癌症的死亡率和发病率。潜在的解释变量进行检查的等级，分支的服务，服务年限，军事工资等级，在越南或波斯湾战区，军事职业地位和军事时代服务。将使用德克萨斯州女性人群的癌症发生率作为比较的外部标准，计算年龄和种族标准化发病率（SIR）、死亡率（SMR）和比例死亡率（SPMR）。将使用泊松回归同时考虑所有潜在的解释变量。将使用当前年龄、州和军队特定分母数据计算SIR和比例死亡率。拟议的研究人群具有种族多样性，代表了多代人和多个时代的兵役。这项研究将提供试点数据，作为针对退伍军人妇女的更广泛的分析性、基于人群的癌症研究的基础。联系方法使用现有的和未充分利用的数据库，提供新的信息稀疏机构的研究女退伍军人，并作为一个潜在的模式，为未来的性别特定的退伍军人健康研究。这项研究将进一步了解女退伍军人的保健需求，有助于确定所需的保健服务和指导保健政策，并将为针对这一不断增长的职业群体的研究议程提供基础。

DESCRIPTION (provided by applicant): This population-based, occupational cohort study will examine the association of military service with cancer risk in the U.S. female veteran population in Texas. Characteristics related to veteran status may predispose this cohort to gender-specific health problems. Potential risk factors include environmental exposures during wartime service, traumatic events associated with military service, and hormone-dependent factors associated with reproductive history. Previous research reports gynecologic cancers as the leading type of cancer among women veterans. The primary study aim is to examine breast, uterine corpus, cervical and ovarian cancer incidence (1995 to 2001) and mortality (1979 to 2001) rates among female veterans residing in Texas. The Department of Veterans Affairs' National Registry of Women Veterans (NRVW), a database of over 1.4 million women veterans who served during the period 1946 to 1995 will be cross-linked using probabilistic linking techniques with Texas vital statistics (mortality study) and Texas Cancer Registry (incidence study). A secondary study aim is to examine mortality and incidence of all other cancers. Potential explanatory variables to be examined are rank, branch of service, length of service, military pay grade, service in the Vietnam or Persian Gulf War theaters, military occupational status and military era served. Age- and race- standardized incidence ratios (SIRs), mortality ratios (SMRs), and proportional mortality ratios (SPMRs) will be computed using cancer rates in the Texas female population as the external standard for comparison. All potential explanatory variables will be considered simultaneously using Poisson regression. SIRs and proportional mortality ratios will be calculated using current age-, state-, and military-specific denominator data. The proposed study population is racially diverse and represents multiple generations and eras of military service. This study will provide pilot data as a basis for more extensive analytic, population-based cancer research aimed at veteran women. The linkage methodology uses an existing and underused database, contributing new information to the sparse body of research on women veterans and serving as a potential model for future gender-specific veteran health research. This research will further knowledge of the health needs of women veterans, serving to identify needed health services and to guide health policy, and will provide a basis for research agendas aimed at this growing occupational cohort.