Bethesda, MD — Even though a previous study found higher papillary thyroid cancer incidence in the U.S. military than the general population—with larger differences among Black than white individuals—it did not provide an explanation for why that might be the case.
Researchers from the Murtha Cancer Center Research Program, the Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., all in Bethesda, MD, compared the two populations in the incidence by sex, race, tumor stage and size to assess possible factors related to identified differences.
Adult patients up to age 59 with papillary thyroid cancer diagnosed during 1990-2013 were identified from the DoD’s Automated Central Tumor Registry (ACTUR) and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The study team calculated age-adjusted rates and incidence rate ratios (IRR) comparing ACTUR to SEER for the report in Cancer Epidemiology.1
The results showed that higher incidence rates in ACTUR than SEER were more obvious for Black (IRR=2.07, 95%CI=1.56-2.70) than white men (IRR=1.17, 95%CI=1.07-1.26) and for Black (IRR=2.30, 95%CI=1.91-2.71) than white women (IRR=1.50, 95%CI=1.38-1.64). “Population differences by race were observed for localized tumors among both men and women and were larger for Black individuals,” according to the researchers. “Differences were observed regardless of tumor size among Black men and white women, and in smaller tumors among Black women.”
The authors posited that the incidence in the military than general population primarily in localized tumors suggested that universal healthcare in the military may lead to earlier detection. “The differences were larger among Blacks than whites, suggesting universal access in the military may be more impactful among Black persons, who are less likely to have timely care than white persons in the general population. Nevertheless, observed differences for tumors >2 cm suggest other factors may also play a role.”
- Bytnar JA, Enewold L, Shriver CD, Zhu K. Incidence of papillary thyroid cancer: Comparison of the military and the general population by race and tumor stage/size. Cancer Epidemiol. 2024 Apr;89:102539. doi: 10.1016/j.canep.2024.102539. Epub 2024 Feb 9. PMID: 38340498.