A Cancer Study Among Female Veterans in Texas, 1979-2001

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DESCRIPTION (provided by applicant): This population-based, occupational cohort study will examine the association of military service with cancer risk in the U.S. female veteran population in Texas. Characteristics related to veteran status may predispose this cohort to gender-specific health problems. Potential risk factors include environmental exposures during wartime service, traumatic events associated with military service, and hormone-dependent factors associated with reproductive history. Previous research reports gynecologic cancers as the leading type of cancer among women veterans. The primary study aim is to examine breast, uterine corpus, cervical and ovarian cancer incidence (1995 to 2001) and mortality (1979 to 2001) rates among female veterans residing in Texas. The Department of Veterans Affairs' National Registry of Women Veterans (NRVW), a database of over 1.4 million women veterans who served during the period 1946 to 1995 will be cross-linked using probabilistic linking techniques with Texas vital statistics (mortality study) and Texas Cancer Registry (incidence study). A secondary study aim is to examine mortality and incidence of all other cancers. Potential explanatory variables to be examined are rank, branch of service, length of service, military pay grade, service in the Vietnam or Persian Gulf War theaters, military occupational status and military era served. Age- and race- standardized incidence ratios (SIRs), mortality ratios (SMRs), and proportional mortality ratios (SPMRs) will be computed using cancer rates in the Texas female population as the external standard for comparison. All potential explanatory variables will be considered simultaneously using Poisson regression. SIRs and proportional mortality ratios will be calculated using current age-, state-, and military-specific denominator data. The proposed study population is racially diverse and represents multiple generations and eras of military service. This study will provide pilot data as a basis for more extensive analytic, population-based cancer research aimed at veteran women. The linkage methodology uses an existing and underused database, contributing new information to the sparse body of research on women veterans and serving as a potential model for future gender-specific veteran health research. This research will further knowledge of the health needs of women veterans, serving to identify needed health services and to guide health policy, and will provide a basis for research agendas aimed at this growing occupational cohort.