PALO ALTO, CA – A long list of health effects have been attributed to military environmental exposures (MEE) such as volatile organic compounds (VOCs), endocrine-disrupting chemicals (EDCs), tactile herbicides, airborne hazards and open burn pits (AHOBP), and depleted uranium.
Yet, even though women are the fastest growing group in the U.S. military, little research has investigated the relationship between MEE and the risk of breast cancer, according to a new VA study.
Researchers from the Women’s Operational Military Exposure Network Center of Excellence at the VA Palo Alto, CA, Healthcare System conducted a scoping review on MEE, military deployment/service, and risk of breast cancer among active-duty service members and veterans. The study team used PRISMA and searched PubMed, Embase. Ultimately, 4,364 articles were screened and 28 were included in the analysis.
“Most papers on military deployment and military service found a lower/equivalent risk of breast cancer when comparing rates to those without deployment or civilians,” the researchers reported in Frontiers in Oncology. “Exposure to VOCs due to military occupation or contaminated groundwater was associated with a slightly higher risk of breast cancer.”1
On the other hand, they pointed out that exposure to Agent Orange was not associated with an increased risk of breast cancer while evidence regarding EDCs was limited. While no paper directly measured exposure to AHOBP or depleted uranium, the authors added, deployments with known exposures to AHOBP or depleted uranium were associated with an equivalent/lower risk of breast cancer.
“Women are the fastest growing population within the military, and breast cancer poses a unique risk to women veterans who were affected by MEE during their service,” the researchers advised. “Unfortunately, the literature on MEE and breast cancer is mixed and limited, in part due to the Healthy Soldier Paradox and poor classification of exposure(s).”
Background information in the article noted that women veterans served by the VHA more than quintupled between 2000 and 2021 (159,810 to 870,000+), while the number of men grew substantially slower over the same period.
“In 2020, women comprised 19% of all military branches (2, 4), which highlights an ongoing need for the expansion of women-specific health services,” the study team wrote. “The 2023 Office of Women’s Health – State of Reproductive Health governmental report found that abnormal breast conditions were reported as one of the top five reproductive and sexual health concerns for women veterans aged 45+. As VA projects the resources needed to care for the expanding women Veteran population, clinical and educational efforts must consider the unique health concerns faced by women veterans.”
Breast cancer (BC) is the most prevalent cancer among women, with around 300,000 cases diagnosed in the United States (U.S.) annually, with one out of every eight women being diagnosed at least once in their lifetime. The incidence rate of BC has increased over the past two decades, but the mortality rate has lowered substantially following advancements in early detection and treatment, according to the report.
The authors described how, while less than 1% of all BC patients are men, the cancer is deadlier in men than women. “Military men with BC tend to present at a higher stage and with a larger tumor size than military women with BC, though demographics or tumor characteristics do not fully explain the higher rate of mortality in men with BC.”
As a result of all of that, they added, “BC is of great concern to VA and is a presumptive condition under The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022”. Presumptive conditions allow veterans to receive care for ongoing health concerns that are of unknown etiology and can be presumed to be related to service. Cancer of any kind remains an ongoing concern for veterans as they age, and especially among Veterans with military environmental exposures (MEE).
The study pointed out that, with combat exposure increasing from 7% to 24% when comparing pre-1990 to post-1990 women veterans, MEE concerns are expected to grow.
- Jester DJ, Assefa MT, Grewal DK, Ibrahim-Biangoro AM, Jennings JS, Adamson MM. Military environmental exposures and risk of breast cancer in active-duty personnel and veterans: a scoping review. Front Oncol. 2024 Mar 13;14:1356001. doi: 10.3389/fonc.2024.1356001. PMID: 38544835; PMCID: PMC10965704.
