Female veterans deployed post-9/11 have lower breast cancer rates

2020 11 11 18 28 0190 Military 400

Female veterans deployed post-9/11 have a lower incidence of breast cancer than female veterans without deployment history, a study published December 5 in the Annals of Epidemiology found.

A team led by Allison Gaffey, PhD, from the VA Connecticut Healthcare System and Yale University in New Haven found that women who deployed for Operations Enduring Freedom/Iraqi Freedom were 23% less likely to be diagnosed with breast cancer versus nondeployed veterans. Possible contributors to this trend were a "healthy soldier effect" -- that is, the benefits soldiers reap from having to maintain a high level of health to deploy -- and screening differences, researchers wrote.

"This finding adds to earlier evidence that military deployment does not increase women veterans' risk of cancer or of disease-related mortality," Gaffey et al wrote.

Previous reports suggest that breast cancer is the most prevalent type among younger female veterans. The effects of deployment on health are not well known, but one study reported that breast cancer diagnoses tripled among this population between 1995 and 2012. This is likely due to the increase in the number of women receiving Veterans Affairs care, the investigators noted.

Gaffey and colleagues investigated whether breast cancer incidence was higher for female veterans who deployed in support of post-9/11 conflicts versus those who did not deploy at all. They also explored whether deployment history and breast cancer incidence differed by age, race, or healthcare resource use. Their study included data from a national outpatient sample of electronic health records from 2001 to 2021.

Out of the data analyzed from 576,601 women, 24.6% deployed during post-9/11 conflicts. On median follow-up (8.2 years), 1.2% of these women were diagnosed with breast cancer.

The researchers found that women deployed post-9/11 had a breast cancer incidence rate of 0.034 per 100 person-years, compared with 0.044 seen in women without a deployment history.

Women who deployed post-9/11 were 58% less likely to be diagnosed with breast cancer versus nondeployed veterans, the researchers found. Smoking, obesity, and hormone replacement therapy use were each linked to a greater risk of incident breast cancer, while hormonal contraceptive use was tied to a lower risk. The researchers also found that ethnicity and alcohol use disorder were not independently associated with the likelihood of a cancer diagnosis.

Results like these can help researchers improve risk stratification and better allocate resources for more timely and cost-effective breast cancer prevention, the authors concluded.

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