Study Examines Characteristics and Needs of Veteran Cancer Survivors
The lifetime risk of receiving a diagnosis of cancer is about one in two (40.35%) for every man and woman born in the United States today. Survival rates are improving, but many cancer patients report that symptoms related to cancer treatment may linger for a long time, or even worsen. Cancer survivorship care involves medically addressing long-term and late-appearing adverse effects of cancer therapy, as well as the psychological and social complexities of cancer recovery. This article reports on the prevalence of cancer survivors within the VA healthcare system for FY07 and compares prevalence rates to the general U.S. population. Investigators also summarize common symptom concerns of cancer survivors and outline care models that show promise in meeting the unique challenges Veterans face following cancer treatment. For example, combat-exposed Veterans have high rates of PTSD, which has the potential to complicate psychosocial adjustment after cancer treatment as any cancer-related anxiety and depression interface with military-related PTSD. PTSD may also lead to higher rates of substance abuse, increasing the risk of developing some cancers.
Findings show that 11% (524,052) of the Veterans treated within the VA healthcare system in FY07 were cancer survivors. The most common cancer types were prostate, skin (non-melanoma), and colorectal. Compared to the general population, Veteran cancer survivors are older (84% are older than 60) and predominantly male (97%). Cancer site prevalence statistics vary between the VA and general U.S. cancer patient populations due to differences in age, gender, and risk factors. For instance, 41% of Veteran survivors had prostate cancer compared to 30% of the general population, and only 1% of Veteran survivors had breast cancer compared to 23% of the general population. Overall, the four common symptom concerns reported by cancer survivors are sexual dysfunction, fatigue, anxiety, and depression. The authors suggest that Veteran-specific research is needed on topics such as cancer survival among older Veterans, and the role of military exposures (physical, emotional, and psychological) in causing cancer and impacting recovery. The authors also suggest that four models of care may be relevant to improving care for Veterans who have survived cancer: 1) cancer survivorship clinics, 2) cancer care transition plans, 3) rehabilitation, and 4) chronic disease management. These models of care may help integrate the physical and mental health needs of cancer survivors.
Moye J, Schuster J, Latini D, and Naik A. The future of cancer survivorship care for Veterans. Federal Practitioner March 2010;27(3):36-43.
This study was partly supported by HSR&D. Drs. Latini and Naik are part of HSR&D's Houston Center for Quality of Care and Utilization Studies.