Abstract 4208: Incidence of papillary thyroid cancer: comparison of the military with the general population by race, gender, and tumor stage/size
Authors: Bytnar Julie A. , Enewold Lindsey , Shriver Craig D. , Zhu Kangmin 
Published: April 2023

Abstract
Background: A previous study found that the incidence of papillary thyroid cancer was higher in the US military than in the general population and the difference was larger among Black than White patients for both men and women. This study compared the military to the general population in thyroid cancer incidence by not only race and gender but also tumor stage and size to assess possible factors related to the identified differences.
Methods: The study subjects were men and women aged 18-59 histologically diagnosed with papillary thyroid cancer from 1990-2013 in the military and the general population. The data were from the Department of Defense’s Automated Central Tumor Registry (ACTUR) and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. Age adjusted rates and incidence rate ratios (IRR) and 95% confidence intervals (95% CI) comparing ACTUR to SEER were calculated. Comparisons were made by race (Black, White), gender, cancer stage (local, regional, distant), and tumor size (0-2 cm, &gt;2 cm).
Results: Higher age-adjusted incidence rates in ACTUR than SEER were more obvious for Black (IRR=2.07, 95% CI=1.56-2.70) than White (IRR=1.17, 95% CI=1.07-1.26) men and for Black (IRR=2.30, 95% CI=1.91-2.71) than White (IRR=1.50, 95% CI=1.38-1.64) women, respectively. In further analysis by tumor stage, the difference between the two populations was observed only for localized tumors, which was larger for Blacks for both men and women. The analysis by tumor size showed that the difference between the populations existed in both 0-2 cm and &gt;2 cm tumors, but only in Blacks among men and was larger for Blacks than Whites among women.
Conclusion: The observations that a higher incidence in the military than the general population primarily existed in localized tumors suggest that universal care in the military may lead to earlier detection of the cancer. The larger differences for Blacks than Whites suggest that such impact may be larger for Blacks, who are less likely to have timely care in the general population. Nevertheless, the observed differences between the populations for tumors larger than 2cm suggest that other factors may also play a role.
Disclaimer: The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, opinions or policies of NCI, USUHS, HJF, the DoD or the Departments of the Army, Navy or Air Force. Mention of trade names, commercial products or organizations does not imply endorsement by the US Government.
Citation Format: Julie A. Bytnar, Lindsey Enewold, Craig D. Shriver, Kangmin Zhu. Incidence of papillary thyroid cancer: comparison of the military with the general population by race, gender, and tumor stage/size. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4208.