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Cancer

The Military Aviators Cancer Study (MACS) cancers data were collected from three sources:

  • Defense Medical Surveillance System (DMSS)
  • Department of Defense Cancer Registry (DODCR)
  • Veteran's Affairs Central Cancer Registry (VACCR)

The DMSS records include inpatient hospital records starting in 1990, outpatient medical records beginning in 1996, as well as Theater Medical Data Store (TMDS) records from 2008 onward. The DMSS claims were then processed together into incidence cancers using the Health.mil surveillance case definitions. Further information on the DMSS medical encounter data can be found on the [Data Collected / Medical Encounter Data page (link)].

Cancers from each of the registries (DODCR, VACCR) were reported using ICD-O-2 or ICD-O-3, while the DMSS medical claims provide ICD-9/10 codes. The codes from all data sources were classified using SEER cancer recodes. Both the ICD codes and the SEER recodes are available in the cancer dataset.

Table: Number of Cancer Diagnoses by source

*Reported cancers are limited to sites listed in Appendix A below which were included in cancer registries or DMSS claims that meet Health.mil surveillance case definitions.
Cancer Data Source Number of Cancers* Collection Years
DMSS 33,159 1990*-2023
DODCR 5,760 1990-2017
VACCR 3005 1990-2020

Summary

  • Data covers cancers from:
    • DoD registry: 1990-2017
    • VACCR: 1990-2020
    • DMSS inpatient records: 1990-2024
    • DMSS outpatient records: 1996-2024
    • DMSS TMDS records: 2008-2024
  • Records were de-duplicated by recoding cancers into SEER sites and then combining all information for that SEER site. Diagnosis dates, data sources, and ICD 9/10 and/or ICD-O-2/3 codes are retained.

Variables

  • DMSS Cancers:
    • ICD-9/10 codes recoded to SEER site codes
    • Does not include topography, morphology, or behavior
  • DODCR:
    • ICD-O-2/3 codes recoded to SEER site codes.
    • Topography, Morphology, and Behavior are included
  • VACCR:
    • ICD-O-3 codes recoded to SEER site codes
    • Topography, Morphology, and Behavior are included

Supplemental Table 1: Cancer Diagnoses over Time

The histogram shows few cancer diagnoses before 1990. The graph shows a steady number of cancer diagnoses for those in service between the 1990s and 2023, while the number of cancers occurring after military service steadily increases over time.
The histogram shows few cancer diagnoses before 1990. The graph shows a steady number of cancer diagnoses for those in service between the 1990s and 2023, while the number of cancers occurring after military service steadily increases over time.

Appendix A: Cancer Sites

  • Brain
  • Breast Cancer (Female)
  • Breast Cancer (Male)
  • Cervical
  • Colorectal
  • Gastric
  • Hodgkin Lymphoma
  • Leukemia
  • Liver
  • Lung
  • Melanoma
  • Non-Hodgkin Lymphoma
  • Ovarian
  • Pancreatic
  • Prostate
  • Renal
  • Testicular
  • Thyroid
  • Urinary
  • Uterine