Abstract
BACKGROUND: Drinking water at US Marine Corps Base Camp Lejeune, North Carolina, was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985. METHODS: A cohort cancer incidence study was conducted of Marines/Navy personnel who began service and were stationed at Camp Lejeune (N = 154,821) or Camp Pendleton, California (N = 163,484) between 1975 and 1985 and civilian workers employed at Camp Lejeune (N = 6,494) or Camp Pendleton (N = 5,797) between October 1972 and December 1985. Camp Pendleton's drinking water was not contaminated with industrial solvents. Individual-level information on primary invasive cancers and in situ bladder cancer diagnosed between 1996 and 2017 was obtained from 54 US cancer registries. Proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) comparing cancer incidence between the Camp Lejeune and Camp Pendleton cohorts, adjusted for sex, race, education, and rank (or blue-collar work), with age as the time variable. Precision of aHRs was evaluated using the 95% confidence interval (CI) ratio (CIR). RESULTS: Cancers among Camp Lejeune Marines/Navy personnel and civilian workers totaled 12,083 and 1,563, respectively. Cancers among Camp Pendleton Marines/Navy personnel and civilian workers totaled 12,144 and 1,416, respectively. Compared with Camp Pendleton, Camp Lejeune Marines/Navy personnel had aHRs ≥ 1.20 with CIRs ≤ 3 for all myeloid cancers (HR = 1.24; 95% CI: 1.03, 1.49), acute myeloid leukemia (HR = 1.38; 95% CI: 1.03, 1.85), myelodysplastic and myeloproliferative syndromes (HR = 1.68; 95% CI: 1.07, 2.62), polycythemia vera (HR = 1.41; 95% CI: 0.94, 2.11), and cancers of the esophagus (HR = 1.27; 95% CI: 1.03, 1.56), larynx (HR = 1.21; 95% CI: 0.98, 1.50), soft tissue (HR = 1.21; 95% CI: 0.92, 1.59), and thyroid (HR = 1.22; 95% CI: 1.03, 1.45). Lymphoma subtypes mantle cell and marginal zone B-cell and lung cancer subtypes adenocarcinoma and non-small cell lung cancer also had aHRs ≥ 1.20 with CIRs ≤ 3. Compared with Camp Pendleton, Camp Lejeune civilian workers had aHRs ≥ 1.20 with CIRs ≤ 3 for all myeloid cancers (HR = 1.40; 95% CI: 0.83, 2.36), squamous cell lung cancer (HR = 1.63; 95% CI: 1.10, 2.41), and female breast (HR = 1.21; 95% CI: 0.97, 1.52) and ductal cancer (HR = 1.32; 95% CI: 1.02, 1.71). CONCLUSION: Increased risks of several cancers were observed among Marines/Navy personnel and civilian workers exposed to contaminated drinking water at Camp Lejeune compared with Camp Pendleton. https://doi.org/10.1289/EHP14966.