Prevalence of Toxic Exposures Among Women Veterans With Breast or Gynecologic Cancers Receiving Veterans Affairs (VA) Care.

INTRODUCTION: Toxic exposures have been linked to hormonal disruption and DNA damage, increasing risk for hormone-sensitive cancers, such as breast and gynecologic cancers. However, the effect of toxic exposure on women Veteran cancer risk is unknown, especially for Veterans who served in the recent Middle East conflict because of the latency with which cancer develops. This study assesses the prevalence of toxic exposures among women Veterans with diagnosed breast and gynecologic cancers. MATERIALS AND METHODS: This descriptive, cross-sectional study examines self-reported toxic exposures among Veterans diagnosed with breast or gynecologic cancers in the Veterans Health Administration and who participated in a clinical care survey with a nurse navigator. Data were obtained from Veteran Health Affairs (VA) electronic medical records and data from the Breast and Gynecologic Oncology System of Excellence (BGSoE) Program Dashboard. Exposure categories include air pollutants, occupational hazards, chemicals, physical agents, and biological risks. We compared demographic, health, and geographic factors between Veterans who reported hazardous exposure versus those who did not and described the characteristics of those hazards. RESULTS: Nearly 50% of women Veterans in the sample reported experiencing a hazardous exposure during military service. Over 80% reported feeling very or somewhat concerned about the exposure. Airborne exposures were the most frequently reported. CONCLUSIONS: Women Veterans with breast and/or gynecologic cancer frequently report hazardous exposures during military service, which may impact their actual and perceived cancer risk and subsequent health care utilization. Future research is needed to assess the relationship between perceived/reported and actual hazardous exposures and inform any needed cancer interception.

Duke Scholars

Author Megan E Shepherd-Banigan Population Health Sciences

Author Haley A Moss Obstetrics and Gynecology, Gynecologic Oncology

Author Karen M. Goldstein Medicine, General Internal Medicine

Author Leah L Zullig Population Health Sciences

Author Michael John Kelley Medicine, Medical Oncology