Camp Lejeune Cancer Incidence Study (CIS): - PowerPoint Presentation

Camp Lejeune Cancer Incidence Study (CIS):A retrospective cohort study Frank J. Bove, Sc.D, MS Agency for Toxic Substances and Disease Registry (ATSDR)/Centers for Disease Control and Prevention (CDC)NAACCR/IACR Combined Annual Conference, June 13, 2019 Agency for Toxic Substances and Disease Registry

ResearchersPrincipal Investigator:Frank J. Bove, ScD, MS Agency for Toxic Substances and Disease Registry (ATSDR) / Centers for Disease Control and Prevention (CDC) Contractor:Battelle Memorial Institute Project Director: April Greek, PhDProject Manager: Ruth Gatiba, MPH

ResearchersSubcontractors:North American Association of Central Cancer RegistriesAssistant Project Director: Betsy Kohler, MPH, CTR Recinda Sherman, MPH, PhD, CTRCastine Clerkin, MS, CTRInformation Management Services, Inc. (IMS) Donald Green, BSWilliam Howe, BS, BAUniversity of Southern California –Los AngelesRich Pinder, BADennis Deapen, PhD

ObjectivesDetermine if exposures of marines and civilian workers to contaminated drinking water at Camp Lejeune were associated with increased risks of cancers.Did Camp Lejeune marines and workers have higher incidence rates for cancers than comparison cohorts of marines and workers? Within the Camp Lejeune cohorts, were there exposure-response relationships between cumulative exposures to the drinking water contaminants and increased incidence rates of cancers?

CohortsMarine/Navy personnel, 1975 - 1987 (N=521,154)Camp Lejeune = 241,513Camp Pendleton = 256,697New River Air Station = 22,944 Civilian employees, 1972 – 1987 (N=15,447)Camp Lejeune = 8,024 Camp Pendleton = 7,423

Information SourcesDefense Manpower Data Center personnel recordsSocial security number, name, date of birth, sex, race, unit code, base location Camp Lejeune base family housing dataLocator firm (TransUnion), Social Security Administration (SSA) data, and the National Death Index (NDI) Vital status, current address, state and date of death

Cancer registry data Primary site SEER summary stage-1977 Histologic type Derived summary stage Laterality Sequence number Behavior code State of diagnosis Grade Age at diagnosis Diagnostic confirmation Date of diagnosis SEER summary stage-2000 “DCO” case (y/n) Veterans Affairs Central Cancer Registry, Department of Defense Automated Central Tumor Registry, state and territorial cancer registries Cancer incidence data linked to personal identifier information

Why national data?Camp Lejeune and Camp Pendleton cohorts reside in all 50 states and U.S. territoriesTo minimize bias, registry data must be available for a high percentage (e.g., >90%) of both cohorts Comprehensive case ascertainment necessary for adequate statistical power since many cohort members will be <65 years old at end of follow-up

AnalysesComparisons between Camp Lejeune and Camp Pendleton cohortsJanuary 1996 – December 2017 Comparisons internal to Camp Lejeune cohortsAs far back as registry has complete data or January 1973, whichever is later, through December 2017

Progress to dateApplications submitted to 51 cancer registriesFull approval received from 49 registries: 45 state registriesVACCR, D.C., Puerto Rico, Pacific Island Jurisdiction

Next stepsObtain study approvals from remaining registriesObtain data security agreements and other materials from each registry prior to participation in the linkage Finalize agreements with TransUnion, SSA, and NDI to obtain current address and vital status informationEach cancer registry performs linkage with cohort data

Questions?