Sneaky Information About Fludarabine Exposed
The excess risk of melanoma may be due to the predominance of Caucasian men in the Australian DVA population, as Caucasian ethnicity is an Fludarabine established and strong risk factor for melanoma. It is also possible that DVA clients, with subsidised access to health care, were more pro-active than the general population in seeking medical advice for signs related to cancers. In mixed support of this theory, higher proportions of localised prostate (65% vs 58%; p=0.03), but not melanoma (79% vs 84%; p=0.15), were diagnosed in DVA clients aged 50�C69 years compared to the corresponding general NSW population 2000�C2007. Furthermore, Orange card holders, who do not have the same level of health care entitlements as Gold and White card holders, had decreased risk of prostate cancer and cutaneous melanoma. However, comprehensive health care access does not explain all the cancer incidence patterns. Subsidised health care with minimal co-payments may facilitate earlier presentation to a health practitioner, and reduce the risk of a diagnosis of cancer of unknown primary site. Thus, it would have been expected that Orange card holders would have an increased risk of cancer of unknown primary site, but the opposite was observed. We did not observe an excess risk of cancer overall or of any specific cancers in female DVA clients. This finding is to be expected as only 8% of females had a history of war service, thus they would be broadly representative of the general female population. The only prior study of Australian female veterans found an excess risk of self-reported breast cancer in Vietnam veterans.7 We did not find an increased risk of breast cancer in female DVA clients, except for women aged 50�C69 years, corresponding to the age range Australian women are eligible for free screening mammograms. This finding may indicate that female DVA clients are more likely to access this health service than the general population. There was a significantly reduced risk of death from cancer in our study. The ��healthy soldier effect�� is unlikely to have contributed on account of the age of our cohort and thus the period of time since recruitment into service.10 On the other hand, it is possible that a ��healthy-survivor�� effect was prevailing in men as they were survivors from a group who had died at a greater rate compared to their peers. The decreased risk of death from cancer in our cohort may also have been related to continued risk of dying from these other causes, and possibly to their unrestricted access to health care services. Prior cancer mortality studies have investigated younger cohorts (mean age