Incidence of Colorectal Cancer Among Active Component Service Members, 2010-2022.

Colorectal cancer, which is more predominant among men than women, has been shown to be associated with environmental and occupational risk factors experienced by military members. The Defense Medical Surveillance System (DMSS) was used to determine the crude and age-adjusted incidence rates of colorectal cancer among active component service members from all military services from January 1, 2010 to December 31, 2022. Results from this analysis show higher crude incidence rates of colorectal cancer among those who are older and male. The overall age-adjusted incidence rate throughout the surveillance period ranged from 3.56 (95% CI: 2.54-4.58) to 7.92 (95% CI: 5.98-9.86) cases per 100,000 person-years. Age-adjusted colorectal cancer rates were similar for males and females (4.46 and 4.33 cases per 100,000 person-years, respectively) and rates were relatively similar by service as well as race and ethnicity. This finding could be attributed to the small number of cases in this study due to better screening practices in the Military Health System (MHS). Although non-Hispanic Black service members have historically had the highest incidence of colorectal cancer within the U.S. military, this study observed similar rates of colorectal cancer for all races and ethnicities after adjusting for age. Incident rates of colorectal cancer within the U.S. military increase monotonically with age, with service members over the age of 45 with the highest incidence, re-enforcing the need to promote wellness screening among military populations. The importance of the DHA guideline changes that decreased colorectal screenings to age 45 years is significant.

Trends in the Incidence of Eating Disorders Among Active Component Service Members, 2017 to 2021.

From 2017 through 2021, a total of 2,454 active component U.S. military service members received incident diagnoses for 1 of the following eating disorders: anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), or "other/unspecified eating disorder" (OUED). The incidence rate of any eating disorder was 3.6 cases per 10,000 person-years (p-yrs). The case defining diagnoses OUED, BN, and BED accounted for nearly 89% of total incident cases. The incidence rate of any eating disorder among women was more than 8 times the rate among men. Overall rates were highest among service members under 30 years of age. Crude annual incidence rates of total eating disorders increased in 2021, following the COVID-19 pandemic. Increased prevalence of major life stressors and mental health conditions were reported on Periodic Health Assessment (PHA) forms completed in the 1-year period after an eating disorder diagnosis. These data suggest the need for increased attention to eating disorder prevention. Additionally, treatment programs could be warranted as continued effects of the COVID-19 pandemic are elucidated within the military population.

Trends and disparities in systemic lupus erythematosus incidence among U.S. active component service members, 2000-2022.

Inpatient and outpatient encounter data retrieved from the Defense Medical Surveillance System (DMSS) were used to establish that there were 1,127 diagnoses of systemic lupus erythematosus (SLE) among active component U.S. service members (ACSM) from 2000 to 2022, with an overall incidence rate of 3.5 cases per 100,000 person-years. Annual incidence remained relatively constant over the 23-year surveillance period, peaking in 2009. Female ACSM accounted for 69.5% of incident cases, with a rate of incidence 12.3 times greater than males, while non-Hispanic Black ACSM accounted for 50.0% of incident cases, with a rate 6.7 times greater than among non-Hispanic Whites. This study further demonstrates greatest SLE incidence among non-Hispanic Black women, in all age groups.

Surveillance snapshot: mid-year populations by sex, age, and race and ethnicity of active component service members of the U.S. Armed Forces, 2018­2022

This Surveillance Snapshot describes the mid-year population for active component service members (ACSM) of the U.S. Army, Navy, Air Force, Marine Corps, and Coast Guard between 2018 and 2022, stratified by age, sex, and race and ethnicity.

Long-acting reversible contraceptive use, active component service women, U.S. Armed Forces, 2016-2020.

Long-acting reversible contraceptives (LARCs) are highly effective means of birth control that can improve service women's overall health and readiness. This report expands upon prior data and summarizes the annual prevalence (overall and by demographics) of LARC use from 2016 through 2020 among active component U.S. service women, compares LARC prevalence to the prevalence of short-acting reversible contraceptives (SARCs), and evaluates the probability of continued use of LARCs by type. LARC use increased from 21.9% to 23.9% from 2016 through 2019 while SARC use decreased from 28.3% to 24.9%. Both SARC and LARC use decreased in 2020 which may have been related to the coronavirus disease 2019 (COVID-19) pandemic. The prevalence of intrauterine devices (IUDs) was greater than implants, and IUDs also had a higher probability of continuation than implants. At 12 months, the continuation for IUDs was 81% compared to 73% for implants. At 24 months, the probabilities of continuation were 70% for IUDs and 54% for implants. Probabilities of continuation were similar across outsourced care and direct care settings. The increased use of LARCs along with their high frequency of continuation in U.S. service women may have a positive impact on overall health and readiness.

Sepsis hospitalizations among active component service members, U.S. Armed Forces, 2011-2020.

The objective of this study was to assess the incidence and trends of sepsis hospitalizations in the active component U.S. military over the past decade. Between 1 January 2011 and 31 December 2020, there were 5,278 sepsis hospitalizations of any severity recorded among the active component. The overall incidence was 39.8 hospitalizations per 100,000 person-years (p-yrs). Annual incidence increased 64% from 2011 through 2019, then dropped considerably in 2020. Compared to their respective counterparts, rates were highest among female service members, the oldest and youngest age groups, and recruits. The gap in sepsis hospitalization rates between female and male service members increased over the surveillance period. Pneumonia was the most commonly co-occurring infection, followed by genitourinary infections. Among female service members, genitourinary infections were more commonly diagnosed compared to pneumonia. The most common non-infection co-occurring diagnoses were acute kidney failure and acute respiratory failure. This study demonstrates an apparent sex disparity in sepsis rates and further study is recommended to understand its cause.