Background/Objective:US military personnel deployed to the Middle East were potentially subjected to harmful exposures, such as carcinogens from burn pits, which may increase the risk of lymphoid malignancies. Our objective was to determine the association between deployment and the risk of developing lymphoid malignancies.Methods:This was a retrospective nested matched case-control study from a cohort of 3.5 million veterans who enlisted in the military after September 2001 and were followed until death or last follow up through September 2024. Cases of lymphoid malignancies were identified by the VA Central Cancer Registry and controls were randomly selected from the same base cohort, matched by year of birth, year of enlistment, sex, race, and ethnicity. Exposure was defined as deployment to the Middle East as determined by identification on the VA Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) roster with confirmed dates of deployment or paystubs.Results:There were 1037 cases of lymphoid malignancies and 3572 matched controls. Deployment was not associated with a higher risk of developing lymphoid malignancies compared to non-deployment. Exposure to OEF/OIF was not associated with a higher risk of developing certain types of lymphoid malignancies.Conclusions:In this large, matched case-control study of US veterans, deployment to the Middle East was not associated with increased risk of developing lymphoid malignancies. While these findings do not support an increased lymphoid malignancy risk, important limitations remain, including the absence of detailed exposure and potential confounding variables. Prospective monitoring of specific types and doses of exposures during military deployment, development of lymphoid and other malignancies, and their underlying pathophysiology is indicated.
背景/目的：部署至中东地区的美军人员可能接触有害物质（如露天燃烧坑释放的致癌物），这可能增加淋巴系统恶性肿瘤的发病风险。本研究旨在明确军事部署与淋巴系统恶性肿瘤发病风险之间的关联。 方法：本研究采用回顾性巢式匹配病例对照设计，研究对象为2001年9月后入伍的350万退伍军人队列，随访截止至2024年9月死亡或末次随访。淋巴系统恶性肿瘤病例通过退伍军人事务部中央癌症登记系统确认，对照组从同一基础队列中随机选取，并根据出生年份、入伍年份、性别、种族和民族进行匹配。暴露定义为通过退伍军人事务部"持久自由行动/伊拉克自由行动"（OEF/OIF）名册确认部署日期或工资单记录证实的赴中东部署经历。 结果：研究共纳入1037例淋巴系统恶性肿瘤病例及3572例匹配对照。与非部署人员相比，军事部署并未导致淋巴系统恶性肿瘤发病风险显著升高。参与OEF/OIF行动与特定类型淋巴系统恶性肿瘤的风险增加无显著关联。 结论：在这项针对美国退伍军人的大规模匹配病例对照研究中，中东地区部署与淋巴系统恶性肿瘤发病风险增加无关。虽然这些发现不支持部署会增加淋巴系统恶性肿瘤风险，但研究仍存在重要局限，包括缺乏详细的暴露数据及潜在混杂变量。未来需对军事部署期间特定类型和剂量的暴露、淋巴系统及其他恶性肿瘤的发生发展及其潜在病理生理机制进行前瞻性监测。
Middle East Deployment and Lymphoid Malignancies in US Veterans: A Matched Case-Control Analysis
肿瘤(癌症)患者之家