Cancer surveillance in Italian army peacekeeping troops deployed in Bosnia and Kosovo, 1996–2007: Preliminary results

Abstract 

Objective: An excess of cancer cases was reported in 2000 among Italian troops involved in peacekeeping operations in Bosnia and Kosovo. A preliminary assessment of cancer risk in this cohort was done for the period 1996–2007, based on cancer surveillance activity, which was started in 2001. Methods: A retrospective cohort study was done among 27361 Italian Army soldiers deployed in Bosnia, 31052 deployed in Kosovo, and a control group of non-deployed soldiers, whose number varies from 130275 in 1996 to 40967 in 2007. Standardized incidence ratio and 95% confidence intervals (SIR [95% CI]) of the main types of tumours were computed as the ratio of the observed and expected cases. Results: 98 incident cancers were reported among soldiers deployed in Bosnia, 66 in those stationed in Kosovo and 388 in non-deployed personnel. Overall, cancer incidence was lower than expected in all groups. Annual SIR was significantly higher than expected in 2000 for Hodgkin's lymphoma only among troops deployed in Bosnia (4.34 [1.18–11.12]) and non-deployed personnel (3.48 [1.67–6.39]); and in 2001 for thyroid cancer only among troops deployed in Bosnia (5.28 [1.44–13.51]). Conclusion: Although further investigation is needed, these preliminary results give no indication of an increased risk of cancer for Italian soldiers who were stationed in Bosnia and Kosovo. The cluster of Hodgkin's lymphoma in 2000 and of thyroid cancer in 2001 were sporadic events, they did not specifically affect deployed personnel and are unlikely to be related to environmental exposures in the Balkans.

Keywords: Lymphoid malignancy, Thyroid neoplasms, Bosnia, Cancer epidemiology, Veterans studies