Year of Publication

2021

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Public Health

Department/School/Program

Epidemiology and Biostatistics

First Advisor

Dr. Wayne T. Sanderson

Second Advisor

Dr. Steven Browning

Abstract

The incidence of melanoma and lung cancer has been gradually increasing in the United States over the past three decades with the reputed causes due to etiological and environmental exposures, and tobacco usage. There has been concern that melanoma and lung cancer incidence among military personnel may be associated with deployment to environments with intense sun exposure and increased smoking rates due to post-traumatic stress disorder. The aim of this study was to examine associations between deployment in support of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF), from 2001 through 2015, with subsequent melanoma and lung cancer incidence. We conducted an incidence-density matched case-control study with incident melanoma and lung cancer cases and their respective matched controls. Our cases were individuals in the Armed Forces who were serving in the Army, Navy, Air Force, or Marines during 2001 to 2015, and developed melanoma or lung cancer. For each case, 10 controls were randomly selected from others in the Armed Forces matched on age, sex, branch of service, time in military and year of matching. Conditional logistic regression was used to evaluate associations between deployment, number of deployments, and cumulative time deployed, and melanoma risk. After adjusting for covariates with a biological plausibility to either melanoma or lung cancer, we evaluated individuals who had deployed compared to those who had not deployed were significantly protective to odds of being diagnosed with melanoma or lung cancer. The dissertation further evaluated incidence rates of melanoma and lung cancer between the different branches of service, Army, Air Force, Marines and Navy, between the years 2002 to 2015. The dissertation supports previous research that service members in the Air Force and Navy are at an increased risk for melanoma.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2021.256

Available for download on Thursday, July 21, 2022

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