Incidence of hiatal hernia in service members, active component, U.S. Armed Forces, 2005-2014

From 2005 through 2014, a total of 27,276 active component service members had incident diagnoses of hiatal hernia documented in their medical records. The overall incidence rate was 19.7 cases per 10,000 person-years (p-yrs); annual incidence rates ranged from 16.5 to 22.2 cases per 10,000 p-yrs. Rates overall increased monotonically with increasing age and were higher among Air Force and Army members, officers, and healthcare workers than their respective counterparts. During the surveillance period, the 27,276 service members who had incident diagnoses of hiatal hernia accounted for 44,092 hiatal hernia-related encounters overall (1.6 encounters per case). Among all incident cases, 235 (0.86%) had surgical repairs documented during the period. The frequency of surgical treatment of hiatal hernias among military members mirrored the low frequency in U.S. civilian practice. During 2010-2014, most surgical procedures (79%) were accomplished via laparoscopic approaches. The incidence rates of hiatal hernia diagnoses reported here likely greatly underestimate the true incidence in U.S. military populations. Reasons for the underestimates and comparisons with other populations are discussed.