Brain tumors in United States military veterans

Abstract

BACKGROUND Comprehensive analysis of brain tumor incidence and survival in the Veteran population has been lacking. METHODS Veteran data was obtained from the Veterans Health Administration (VHA) Medical Centers via VHA Corporate Data Warehouse. Brain tumor statistics on the overall US population were generated from the Central Brain Tumor Registry of the US data. Cases were individuals (≥18 years) with a primary brain tumor, diagnosed between 2004-2018. The average annual age-adjusted incidence rates (AAIR) and 95% confidence intervals were estimated per 100,000 population and Kaplan-Meier survival curves evaluated overall survival outcomes among Veterans. RESULTS The Veteran population was primarily white (78%), male (93%), and between 60-64 years old (18%). Individuals with a primary brain tumor in the general US population were mainly female (59%) and between 18-49 years old (28%). The overall AAIR of primary brain tumors from 2004-2018 within the VA cancer registry was 11.6. Non-malignant tumors were more common than malignant tumors (AAIR:7.19 vs 4.42). The most diagnosed tumors in Veterans were non-malignant pituitary tumors (AAIR:2.96), non-malignant meningioma (AAIR:2.62), and glioblastoma (AAIR:1.96). In the Veteran population, survival outcomes became worse with age and were lowest among individuals diagnosed with glioblastoma. CONCLUSIONS Differences between Veteran and US populations can be broadly attributed to demographic composition differences of these groups. Prior to this, there have been no reports on national level incidence rates and survival outcomes for Veterans. These data provide vital information that can drive efforts to understand disease burden and improve outcomes for individuals with primary brain tumors.

Evolution of community outreach and engagement at National Cancer Institute‐Designated Cancer Centers, an evolving journey

“…data are yet to be collected nationally, including sexual and gender minorities (SGMs), veterans, and people with disabilities (PwDs). [134][135][136][137][138][139][140][141][142][143] The SGM community represents 7.2% of the US population and faces disparities in cancer care, with limited data available on their experiences and health outcomes. 134,135 The absence of SOGI data in major clinical databases limits research and inclusive care recommendations.…”

“…144 Similarly, veterans, who represent 7% of the adult population, face a lack of systematically included cancer data in state and national registries, compromising the accuracy and completeness of the national cancer burden estimates. [137][138][139] Legislative efforts aim to rectify this. These include the Veterans' Cancer Act of 2023, which would require Veterans Health…”

“…Until recently, NCI‐DCCs have not matched their scientific focus with an intense focus on the inclusion of historically marginalized patients in research trials, access to treatment advances, and development of innovative care‐delivery interventions to improve access in marginalized communities 133 . The newer emphasis on COE must be expanded to embrace the unaddressed communities whose data are yet to be collected nationally, including sexual and gender minorities (SGMs), veterans, and people with disabilities (PwDs) 134–143 . The SGM community represents 7.2% of the US population and faces disparities in cancer care, with limited data available on their experiences and health outcomes 134,135 .…”

“…SOGI data should be collected and reported as mandated by the US Bureau of Primary Health Care, the Health Resources, and Services Administration 144 . Similarly, veterans, who represent 7% of the adult population, face a lack of systematically included cancer data in state and national registries, compromising the accuracy and completeness of the national cancer burden estimates 137–139 . Legislative efforts aim to rectify this.…”