Some Sociodemographic and Diagnostic Characteristics of Military Patients Treated in the Department of Medical Oncology, Gülhane Military Medical Academy

Military Medicine, May 2006 by Acikel, Cengiz Han, Kir, Tayfun, Komurcu, Seref, Kilic, Selim, Et al

Today, chronic diseases have increased importance. Cancer, for which 10 million new cases are diagnosed around the world each year, is in the lead of such diseases. This study included military personnel with cancer who applied to the Department of Medical Oncology, Gülhane Military Medical Academy, in the period between 1998 and 2003, and it aims to describe some sociodemographic and diagnostic characteristics of the patients. The total number of cases was 938, which included both active duty and retired military personnel with diagnoses of cancer who were given medical care between 1998 and 2003 in the Department of Medical Oncology. For the study group, the five most common diagnoses were lung cancer, colorectal cancer, testicular cancer, non-Hodgkin's lymphoma, and Hodgkin's disease. Although the first three diagnoses among officers were lung cancer, testicular cancer, and Hodgkin's disease, those among retired officers were colorectal cancer, lung cancer, and prostate cancer. Among noncommissioned officers, the first three diagnoses were colorectal cancer, testicular cancer, and Hodgkin's disease for active duty patients and lung cancer, colorectal cancer, and gastric cancer for retired patients. In the group of privates, testicular cancer, Hodgkin's disease, and non-Hodgkin's lymphoma were the first three diagnoses. When we consider the characteristics of cancers, such as high costs of treatment, loss of manpower, and high mortality rates, prevention of cancers and early diagnosis are very important. Because the frequent types of cancers differed for groups according to age and occupation, those characteristics should be considered when cancer screening programs are being developed for the Armed Forces.

Introduction

Today, the average human life expectancy has increased, particularly as a result of successful outcomes in fighting infectious diseases, developments in diagnosis and treatment methods, and increases in access to health services; this has increased the importance of some health problems, such as cancer.1 At present, of a total of 10 million new cancer cases arising annually in the world, approximately 5.3 million cases (53%) involve male patients and 4.7 million cases (47%) involve female patients. It is anticipated that such figures will rise in the years to come and the total number of new cancer cases will reach 20 million annually.2 It has been estimated that 6 million deaths in the year 2000 were attributable to cancer, 1.6 million of which occurred in Europe.2,3

Although the annual anticipated number of cancer cases in Turkey was 70,000 to 100,000 in 1999, the number of cases reported was 25,942, and this figure never went beyond 40,000. The incidence determined in 1999 was 39.4 cases per 100,000.1 Although the proportion of deaths attributable to cancer among all deaths in Turkey in the year 1990 was 10.1%, it reached 12.4% and cancer ranked second among all causes of death.4 In the United States, the proportion of deaths attributable to cancer among all deaths was 23% in 2001, and cancer also ranked second.5

Some studies reported that the incidences of malignant melanoma, brain cancer, and prostate cancer among military personnel, especially among persons who are occupationally more exposed, and the mortality rates attributable to prostate cancer, brain cancer, and non-Hodgkin's lymphoma were higher than those for the general population.6-8 The purpose of this study was to determine the distribution of diagnoses according to sociodemographic features, age groups, and military status of the military patients who were diagnosed and treated for cancer in the 6-year period from January 1998 to December 2003, in the Department of Medical Oncology, Gülhane Military Medical Academy (GMMA) (Ankara, Turkey).

Methods

This was a descriptive study that investigated the distribution of diagnoses according to sociodemographic features, age groups, and military status of the military patients who were monitored with the diagnosis of pathologically demonstrated cancer in various organs or systems in the period between January 1998 and December 2003. The study population consisted of a total of 938 patients who were treated with cancer diagnoses in the given period.

The research data were collected from outpatient monitoring cards and inpatient files. Before commencement of data collection tasks, the staff members (n = 2) who participated in data collection were trained by a professor of the Department of Medical Oncology regarding data sheets and relevant sections and variables of interest in the files, and a preliminary trial was conducted with records for 100 patients. The data collection through examination of patient files was completed within 100 days. The data collected were recorded on the patient data sheets prepared for this study and were transferred from these sheets into computers. SPSS for Windows 10.0 (SPSS, Chicago, Illinois) was used to analyze the data. Frequencies for various variables were found as descriptive statistics.