Study red-flags rising cases of cancer in military, stresses on measures to cope with situation

Vijay Mohan

Chandigarh, April 18

A new study by Army medical specialists has red-flagged the rising number of cancer cases in the armed forces fraternity and has stressed upon the need for undertaking measures to deal effectively with the situation.

New cases registered were 2,023 in the year 2017, 2,856 in 2018 and 3,057 in 2019, with Haryana, Uttar Pradesh and Rajasthan representing 55 percent of all cases, the study revealed. “Seven per cent rise per year of new cases in this cohort is alarming,” the researchers observed.

The study, titled ‘Cancer Trends and Burden Among Armed Forces Personnel, Veterans and their Families’, was undertaken by nine specialists posted at different military hospitals and has been published in the latest edition of the Medical Journal Armed Forces India.

A retrospective analysis was performed of all patients registered at a tertiary care hospital cancer registry between January 1, 2017 and December 31, 2019. Baseline demographics and cancer subtype data were retrieved. Patients with histopathologically proven diagnosis and age above 18 years were studied. Patients with acute and chronic leukemia were excluded.

Among cancer cases, serving armed forces personnel, veterans and dependents accounted for 9.6 percent, 17.8 percent and 72.6 percent, respectively, with the male to female ratio being 1.14:1. The median age among serving personnel was 39 years.

The study observed that the prevalence of tobacco-related cancers was the highest. Amongst serving personnel and veterans, head and neck cancer was the most common malignancy. Lymphomas, brain tumors and colorectal cancers were also common. Cancer incidence was significantly higher in adults above the age of 40.

“There is an unmet need to establish a prospective centralised cancer registry to better understand the risk factors, outcomes of treatment and strengthen the policy matters,” the authors said while pointing out that the incidence and patterns of various cancers among armed forces personnel and veterans is not well known and limited literature is available on overall cancer incidence, morbidity and mortality in the military.

Observing that cancer incidence is rising across the globe, the study adds that by 2035, the estimated rate of annual incidence would be two million new cases in India and as the population is going to be more aged, 60 percent of the cancers will be seen in people above the age of 65 years. “This rise in cancer cases is worrisome in all aspects namely cost of treatment, limited outcomes, morbidity, and loss of human lives,” the authors state.

According to the study, military personnel, as a special population, are at increased risk of gliomas and skin cancers. “The lifestyle related diseases are increasing in the military population and risk factors like tobacco (smoking and smokeless) consumption makes them more vulnerable to cancer,” the authors further observe.

The study also brings out that presently the Armed Forces Medical Services does not have a central cancer registry and none of its hospitals are contributing to the National Cancer Registry.

Data from the central disease registry in the armed forces would be useful for prioritising the use of resources and policy making decisions. There is a need to address this special population which may help in policy making on cancer prevention and treatment, the study stresses.

The study also pointed out that the US military population and veterans had similar cancer incidence as compared to the US population. Similarly, a study of peacekeeping Norwegian forces did not differ for cancer incidence from their fellow countrymen.