Data Collected

Summary of Data Available

Service members who were selected for the Military Aviators Cancer Study (MACS) have data available through the Defense Medical Surveillance System (DMSS), which includes demographic personnel and medical encounter records from fixed military treatment facilities and civilian care when reimbursed through Tricare. Claims from retired service members insured through Tricare are also included in DMSS records. Cancer cases were identified from the Department of Defense Cancer Registry (DODCR), the Veteran's Affairs Central Cancer Registry (VACCR), as well as the North American Association of Central Cancer Registries (NAACCR) for individual state tumor registries.

Serum Specimens Collected

As part of its efforts to screen service members for Human Immunodeficiency Virus (HIV), the Department of Defense (DoD) began collecting serological samples in 1985. The DoD Serum Repository (DoDSR) was established in 1996 to consolidate specimens into a single storage location at the Armed Forces Health Surveillance Division (AFHSD), where the vials are stored at -30 °C. These specimens are collected approximately every 1-2 years for HIV screening and pre- and post-deployment requirements among service members.

For more information, on serum specimen availability, see the Serum Samples page.

Published materials for serum collection can be found on the Resources page.

Cancer

For the most comprehensive cancer information, cancer data are obtained from cancer registries and by summarizing service members' claims data (See Figure 1 below).

Figure 1: Cancer data sources available by calendar year

DODCR data only includes information on cancers identified in military treatment facilities. DMSS data are processed from ICD-9-CM and ICD-10-CM diagnoses in outsourced care facilities reimbursed by TRICARE. The VACCR data is available for cancers diagnosed or treated at one of the 132 Veterans Affairs Medical Centers.

For more information, see the Cancer Data Collected page.

Demographics

The earliest collection of occupational data began in 1985 for service members in the Army. Collection of demographic and occupational data for all service members, with monthly synchronization, began in 1990. Demographic data includes information on service member sex, race/ethnicity, age, marital status, military service branch, years of military service as well as Department of Defense Occupation Codes (DODOCC).

For more information about DMSS data, please visit the Defense Medical Surveillance System website or the Personnel page

Deployment

The DMSS provides linkage to data intended to describe service members' major deployments throughout their military career, starting with the Persian Gulf War (1990). The information provided includes time of deployment and the country/region of deployment. When able, these deployment records provide linkages to service members' pertinent pre-deployment, post-deployment, and post-deployment re-assessment surveys.

For more information, see the Deployment page

Health Surveys

In addition to the deployment data, DMSS data obtained from service members' pre- and post-deployment health assessment forms are available. Assessments are administered between 120 days prior to deployment up to 30 months upon return from deployment. These forms monitor service members' physical and mental health assessments, track environmental exposures, and life stressors.

Starting in 2016, a new protocol was introduced for all Armed Forces service members to complete a yearly Periodic Health Assessment (PHA). Due to the later introduction of this form, only approximately 25% of all service members in the MACS cohort have completed 1+ form. The self-assessment covers physical and mental health, as well as behavioral health. The form is reviewed for validity and health care providers interview the service members. Health providers then document referrals and recommendations for additional services as needed.

For more information, see the Deployment Assessments page and the Deployment Related Health Assessments website

Medical Encounters Data

Medical encounters included in the DMSS include three sources:

• Inpatient claims (starting in 1990)
• Outpatient/Ambulatory claims (starting in 1996)
• Theater Medical Data Store claims (starting in 2008)

All three sources of medical encounter data include a list of ICD-9-CM or ICD-10-CM codes. Each encounter includes all diagnosis codes recorded at that visit as well as any pertinent procedure codes for treatments performed. The diagnosis codes can include cancer and non-cancer conditions.

Summary Table