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Cancer is a disease in which the normal process of cell growth and death is disrupted. Cancerous cells grow abnormally and spread to other parts of the body, eventually destroying healthy tissue. There are more than 100 different types of cancer.

There are two main types of cancer. Hematologic cancers are diseases that affect blood cells. Leukemia and lymphoma fall in this group. Solid tumor cancers involve tissues in the body or organs, like the stomach, breast, or colon.

Nearly 50,000 cases of cancer are reported annually in the VA Central Cancer Registry. In 2010, the three most frequently diagnosed cancers in the VA health care system were prostate, lung/bronchus, and colon/rectum cancer according to a 2017 study. This list is similar to cancers observed in American men.

In 2021, bladder cancer was added to the list of presumptive conditions related to Agent Orange exposure, joining chronic B-cell leukemia, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, respiratory cancers (including lung cancer), and some soft tissue sarcomas.

VA’s National TeleOncology Program provides cancer care virtually, connecting patients and providers across great distances. The program delivers cancer screenings, diagnoses, and treatment for Veterans through telemedicine technology.

Code to Catch Cancer

As the largest integrated healthcare system in the nation, the VA has a proud history of innovation regarding the maintenance of medical records. Starting with the Internet's infancy, VA revised and improved the earliest electronic record keeping software for ease of access to VA providers. Today, where research on targeted algorithms works to make sure no Veteran is left behind, the VA is dedicated to harnessing the power of technology for the wellbeing of the Veteran community.

Problem-solving is at the heart of VA research. In the case of Dr. Singh, he solved patient follow-up issues for varying cancer screening results; the solution was an algorithm. Utilizing the most modern technologies available, the VA continues to look out for its Veteran community.


Selected Major Accomplishments

  • 1932: Establisheda VA tumor research laboratory in Hines, Illinois
  • 1950: Found there was "strong circumstantial evidence" linking cigarette smoking with respiratory tract cancers
  • 1962: Developed the “Gleason score” to predict the aggressiveness of prostate cancer
  • 1984:Developed a transdermal nicotine patch to reduce the cravings for cigarettes
  • 2000:Showedthe superiority of colonoscopy to sigmoidoscopy
  • 2016: Established VA National Precision Oncology Program (NPOP) to implement precision oncology treatment for Veterans
  • 2017: Determined prostate cancer surgery does not significantly reduce all-cause deaths for men who are in early-stage disease
  • 2018: Partnered with the National Cancer Institute to help Veterans with cancer enroll in NCI-funded clinical trials
  • 2020:
    • Partnered with the GO2 Foundation to increase awareness about lung cancer screenings and improve outcomes for Veterans with lung cancer
    • Created the National Women Veterans Oncology System of Excellence to provide cutting edge cancer care and access to clinical trials for women


New, Ongoing, and Published Research

VA researchers are working hard to understand the mechanisms that cause cancer, evaluate existing treatments, and find new drugs and therapies for Veterans and others with cancer. In 1930, the year the Veterans Administration was established, the Edward Hines, Jr. VA Hospital in Illinois established a cancer treatment center in which surgeons, radiologists, and specialists worked together to provide the latest treatments for cancer patients. In 1932, the Hines VA established a tumor research laboratory to complement the work of its cancer treatment center.

In 2018, VA established a collaboration with the National Cancer Institute (NCI) to address barriers to cancer clinical trial recruitment across VA—the NCI and VA Interagency Group to Accelerate Trial Enrollment (NAVIGATE). The group is working to increase the number and variety of clinical trials available to VA patients, and has created a national network of VA clinical trial sites that will work together to solve common problems and help create best practices.

If you are interested in learning about joining a VA-sponsored clinical trial, visit our research study information page.

➤ Lung cancer

Every year, VA diagnoses 7,700 Veterans with lung cancer. Veterans at risk of developing lung cancer include those with a history of smoking, who are older, and who have been exposed to environmental hazards during or after military service. VA has partnered with the GO2 Foundation to increase awareness about the importance of lung cancer screening and improve outcomes for Veterans with lung cancer. VA is working to ensure access to early detection and treatment for Veterans with lung cancer.

Early pioneers—The Hines VA tumor research lab was the first VA laboratory to receive funds specifically for research. VA researcher Dr. Robert Schrek was the first to discover the connection between sunlight and skin cancer. He also conducted pioneering studies on how skin cancers develop and the effects of cigarette smoking on lung, throat, and mouth cancers.

Dr. Oscar Auerbach worked at the East Orange VA Medical Center, now part of the VA New Jersey Health Care System. Auerbach's landmark study found that long-term smoking caused major changes in the lungs of animals—many developed cancer. Auerbach was later a participant in the first surgeon general's report, published in 1964, that explained the harmful effects of smoking.

Nicotine patch—In 1984, VA researchers developed the nicotine patch—a major contribution toward helping Veterans quit smoking. The patch was developed by Drs. Jed Rose, Daniel Rose, and Murray Jarvik. The patch, which Jed Rose first tested on himself, transfers small amounts of nicotine into the bloodstream to reduce cravings for tobacco products.

Delaying surgery associated with a higher risk of death—Timely treatment is essential when treating lung cancer, the country’s leading cause of cancer deaths. A 2021 VA study found that patients with early-stage non-small cell lung cancer who delay surgery for more than 12 weeks after radiological diagnosis have a higher risk of recurrence and death, compared with those who do not.

Researchers at the VA St. Louis Health Care System and colleagues examined data for 9,904 Veterans diagnosed with stage 1 non-small cell lung cancer and treated with surgery, between 2006 and 2016. The team detected recurrence of cancer in 4,158 (42%) patients during the study’s follow-up period, six years after surgery. Patients whose surgical treatment was delayed by more than 12 weeks were at increased risk of their cancer returning. Every week of delay after 12 weeks increased the hazard of recurrence by 0.4%.

Being African American, living in a poorer area, being treated at a hospital with a lower caseload were all associated with delayed surgical treatment, according to the study. Year of diagnosis also affected surgery delays, with older cases being more likely have been delayed. Patients who were treated surgically within 12 weeks of their cancer diagnosis also had significantly better odds of overall survival than those whose treatment was delayed.

Rural Veterans may have less access to lung cancer screenings—Access to lung cancer screening varies widely based on location, finds a 2021 study by researchers at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Massachusetts.

Researchers looked at data for nearly 72,000 Veterans who received a lung cancer screening at a VA health care facility across 44 states, between 2013 and 2019. They found lung cancer screenings were particularly low in rural locations. Nine of the 12 states with the highest proportions of rural Veterans had three or fewer lung cancer screening facilities. While partnering with the GO2 Foundation expands capacity and access, disparities still exist between rural and urban locations.

Artificial intelligence diagnoses lung cancer—A team of researchers with the Palo Alto VA Medical Center, Google, Northwestern University, and New York University, found that AI computer programs can diagnose lung cancer better than physicians who specialize in the disease.

The 2019 study used computer software to review nearly 8,000 computed tomography (CT) scans, and compared the findings with the work of six lung cancer specialists. The AI accurately detected cancer in 5% more cases than the specialists and reduced false positives by 11%. The research team hopes AI can one day help clinicians detect lung cancer earlier and reduce the number of false positive findings.

Evaluating effectiveness of lung cancer treatments—The VA Lung Cancer Surgery or Stereotactic Radiotherapy (VALOR) clinical trial is currently evaluating the effectiveness of surgery compared to targeted radiation therapy for stage 1 non-small cell lung cancer (NSCLC).

The study hopes to find out which treatment results in a better five-year survival rate for Veterans with stage 1 NSCLC. Study locations currently include VA medical centers in Long Beach, California; Bay Pines, Florida; Atlanta, Georgia; Hines, Illinois; Indianapolis, Indiana; Minneapolis, Minnesota; Durham, North Carolina; Pittsburgh, Pennsylvania; Houston, Texas; and Richmond, Virginia. In total, the research team hopes to enroll 670 participants. The study is scheduled to be completed in 2027.

Lung cancer clinical program—The VA New England Healthcare System and the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) instituted a clinical program in 2015 to help Veterans newly diagnosed with non-small cell lung cancer.

VA physicians collected tumor samples and sent them to laboratories for genomic sequencing, a process that determines DNA characteristics within tumors, which are important for treating lung cancer. Genetic sequencing allows Veterans to benefit from individualized drug therapy that is targeted to tumor mutations, and to take part in clinical trials for new drugs. In 2017, the researchers created an online system to match patients with non-small cell lung cancer with the most relevant clinical trials.


➤ Prostate cancer

Prostate cancer is the most common malignancy affecting men in the United States. It is also the most commonly diagnosed solid tumor in VA. In 2016, VA and the Prostate Cancer Foundation established a partnership to promote prevention, screening, and research to find new treatments for prostate cancer in Veterans. They established a network of VA centers to help develop best practices for the treatment of Veterans with advanced prostate cancer. A list of PCF-VA centers of excellence in prostate cancer can be found here.

The VA Precision Oncology Program for Cancer of the Prostate (POPCaP) uses next-generation DNA sequencing to identify specific tumor mutations in Veterans with metastatic prostate cancer. That information can then be used to customize drug treatments for these patients.

VA early pioneer in prostate cancer pathology—Every year, approximately 15,000 Veterans are diagnosed with prostate cancer. The “Gleason score” is a staging system for prostate cancer developed in the 1960s by Dr. Donald Gleason at the Minneapolis VA Health Care System. Today, it is used almost universally to predict the aggressiveness of prostate cancer.

Surgery risks outweigh potential benefits—In a 2021 study, researchers at the Minneapolis VA Healthcare System and the University of Minnesota found that watchful waiting may be the best approach to treating prostate cancer. "Watchful waiting" involves monitoring a man's prostate specific antigen (PSA) to assess his disease progression without performing more active treatment such as surgery.

The research team conducted a systematic review of 67 studies to compare the effectiveness of various treatments for prostate cancer. They found watchful waiting may slightly increase the risk of death for men who were clinically diagnosed with prostate cancer. However, it reduced overall harm compared to surgery in this group.

Their results also suggested that surgery for prostate cancer may be necessary only for younger patients (those under age 65) and those with more aggressive forms of the cancer. Surgery, the investigators found, did not reduce death in men 65 or older.

PTSD raises suicide risk in prostate cancer patients—A 2021 study led by researchers at the White River Junction VA Medical Center in Vermont and Dartmouth University found that Veterans with prostate cancer and posttraumatic stress disorder (PTSD) were at greater risk of suicide than prostate cancer patients without PTSD. The results were consistent after adjusting for factors like depression, substance use disorder, and prostate cancer treatment.

The study looked at 200,000 Veterans with prostate cancer. About 6% of this group had a PTSD diagnosis in the year before their cancer diagnosis. The team found that almost twice as many patients with PTSD died by suicide, while half as many died from circumstances not related to suicide.

The investigators also found that men with prostate cancer and PTSD may be at lower risk of death from non-suicidal causes because of greater health care use and early diagnosis of localized, or low-risk, cancer.

Smoking linked to higher prostate cancer death—A 2020 VA study found that smoking is linked to a higher rate of dying from prostate cancer. Researchers at the San Diego VA Health Care System and the University of California looked at more than 73,000 VA patients diagnosed with prostate cancer. Within 10 years of diagnosis, current smokers had a 5.2% rate of death from prostate cancer. Former smokers had a 4.8% mortality rate, while those who never smoked had a 4.5% mortality rate. According to the researchers, a prostate cancer diagnosis may be an important opportunity to discuss quitting smoking.

Disparities in prostate cancer outcomes linked to care access—In a 2020 study, researchers at the VA San Diego Health Care system and the University of California found that African American men who received care through VA were not more likely to die of prostate cancer than non-Hispanic white men. In the general U.S. population, African American men are more than twice as likely to die of prostate cancer than non-Hispanic white men.

The research team followed 18,201 Black men and 41,834 non-Hispanic white men who were diagnosed with prostate cancer between 2000 and 2015. They found Black Veterans had a slightly lower rate of death, and were no more likely to present with advanced disease, than their non-Hispanic white counterparts. The investigators believe that disparities in health care may explain racial differences in prostate cancer mortality in the general population.

Drug could delay prostate cancer spread—In 2018, the Food and Drug Administration approved the use of apalutamide for castration-resistant prostate cancer that has not spread to other parts of the body. The approval followed a 2018 international study—which included a VA Portland researcher—that found patients who took the drug survived longer without cancer spread than those who took a placebo. Patients taking daily apalutamide lived a median of 40.5 months before their cancer spread, compared to a median of 16.2 months in the control group.

New polygenic hazard score can predict prostate cancer—A large research team including VA researchers has developed and validated a genetic tool to predict the age at which men may develop aggressive prostate cancer. The tool, which is more precise than the existing prostate-specific antigen (PSA) test, may potentially be used to help guide decisions about who to screen for prostate cancer and at what age. A study describing the tool was published in 2018.

PIVOT trial—The Prostate Cancer Intervention Versus Observation Trial (PIVOT) was a large VA-led clinical trial that lasted nearly 20 years. In a 2017 follow up, researchers found that surgery does not significantly reduce deaths from all causes or prostate cancer in men who are diagnosed with early-stage disease. The cooperative study found no difference in survival between men with early-stage prostate cancer who had surgery and men who underwent observation for disease progression.

Surgery to remove the prostate was associated with a greater frequency of adverse events, like urinary incontinence. The team concluded that the benefits of surgery were unclear for men with prostate cancer that had no symptoms. The researchers suggested these men could be regularly monitored using a PSA blood test and offered surgery to reduce symptoms if they develop.


➤ Skin Cancer

Drug lowers skin cancer risk and costs—Fluorouracil is a medication used on the skin to treat pre-cancerous and cancerous skin growths. Two 2018 papers by VA researchers found that treatment with fluorouracil cream can lower the risk for squamous cell carcinoma, a form of skin cancer, and provide cost savings for the VA health care system.

The first paper reported that patients treated with fluorouracil had a 75% lower risk of developing squamous cell carcinoma in the year following treatment than those treated with placebo. Patients receiving fluorouracil were also significantly less likely to undergo Mohs surgery for squamous and basal cell carcinoma. The second paper showed that patients in the fluorouracil group incurred $771 less in treatment costs over a three-year period compared with the placebo group.

New England shows reduced skin cancer rates—A 2017 study by researchers at the Denver VA Medical Center examined regional and state differences for melanoma rates across the United States between 2003 and 2013. More than 9,000 people die from melanoma, a serious type of skin cancer, each year in the United States.

The team found that New England was the only region to show an overall drop in both death and incidence rates for melanoma. The study authors believe strong public-awareness programs in New England may have driven the reduction in disease rates.


➤ Colorectal (colon) cancer

Colorectal cancer begins in the colon or rectum, and is often referred to as colon cancer. More than 100,000 new cases of colorectal cancer are diagnosed each year in the United States. If caught early, colon cancer can be cured—there are now more than 1.5 million survivors living in the United States. However, one-third of patients who develop colon cancer will die from the disease. VA diagnoses 4,000 cases of colon cancer every year among Veterans.

Seminal colonoscopy study—In 2000, VA Cooperative Study 380 found that colon screenings using a colonoscope—a flexible instrument that can inspect the entire colon—could detect abnormal growths called neoplasms, that could become cancerous. The researchers suggested colonoscopy is better than sigmoidoscopy, which inspects only the lower colon.

CONFIRM trial—VA is currently conducting a clinical trial, involving more than 50,000 Veterans, to compare the effectiveness of colonoscopy screenings versus fecal occult blood testing (FIT), a laboratory test that checks for the presence of blood in the stool. Enrolled Veterans will either receive a one-time colonoscopy or an annual FIT test for 10 years. If a FIT test is positive, a follow-up colonoscopy will be recommended. The trial is the largest VA clinical trial in history. It is currently scheduled to be completed in 2028.

Screening delay increases cancer risk—A 2021 study by researchers at the VA Greater Los Angeles Healthcare System and colleagues found that delaying colonoscopy following an abnormal stool test increases the risk of a colorectal cancer diagnosis, as well as cancer-related death. The investigators looked at the medical records of more than 200,000 patients with a mean age of 61 years.

Patients who received a colonoscopy 13 to 15 months after an abnormal stool test were 1.3 times more likely to be diagnosed with colorectal cancer compared with patients who were screened one to three months after an abnormal stool test. The odds for advanced colorectal cancer increased when a colonoscopy was delayed beyond 16 months. The risk for colorectal cancer-related death was 1.5 times greater when colonoscopy was delayed more than 19 months.

Racial disparities in colorectal cancer—A 2021 study led by researchers at the Richard L. Roudebush VA Medical Center in Indianapolis and Indiana University found that Black people may have a higher risk of colorectal cancer than white people, but that the risk was likely not due to genetics.

The investigators looked at more than 90,000 Veterans who underwent a colonoscopy at 18 VA facilities during a seven-year period. In the overall group, Black Veterans had a higher risk of colorectal cancer. However, in a subgroup of people who got routine screenings, the risk was equal for both Black and white patients, suggesting the difference is not biological. Non-biological factors, such as access and acceptance of health services or cultural differences in response to early cancer symptoms, may explain the differences in risk, according to the researchers.


➤ Liver cancer

Liver cancer begins in the cells of the liver. The most common type of liver cancer is called hepatocellular carcinoma (HCC), which originates in cells called hepatocytes. More often, cancer begins in other areas of the body and spreads to the liver. In that case it is called metastatic cancer, not liver cancer.

Liver disease and cancer—A team including researchers from the Harry S. Truman Veterans Hospital in Columbia, Missouri, has identified a possible connection between liver cancer and nonalcoholic fatty liver disease (NAFLD). A 2020 study found that patients with HCC liver cancer had reduced activity in the HADHA gene. The researchers studied a type of mice that were deficient in an enzyme called LCHAD. The mice developed NAFLD starting when they were 3 months old, and progressed to HCC cancer once they were 13 months or older. Impairment of the HADHA gene has been associated with LCHAD deficiency, and could cause NAFLD to progress to liver cancer, say the researchers.


➤ Breast cancer

VA researchers are looking closely at breast cancer, its causes, and treatments for the disease. In 2020, VA launched a strategic partnership with Duke University and Baylor College of Medicine to build VA’s National Women Veterans Oncology System of Excellence. VA hopes to integrate best practices in the public and private sectors to improve health outcomes for women Veterans with cancer. The partnership will also launch new collaborative research programs.

When you eat may reduce the risk of breast cancer—In a 2021 study, researchers with the VA San Diego Health Care System and the University of California found that time-restricted feeding reduced the risk of breast cancer and improved insulin levels in laboratory mice.

Restricting eating to an eight-hour window when the mice's activity was highest decreased the risk of development and growth of breast cancer in mouse models, according to researchers. They found that time-restricted feeding—which is a form of intermittent fasting aligned with circadian rhythms—also improved metabolic health in mice with obesity-driven, postmenopausal breast cancer.

CCN5 protein may suppress breast cancer growth—In 2017, researchers at the Kansas City VA Medical Center showed that the CCN5 protein delays cell growth in triple-negative breast cancer (TNBC). Epithelial cells in the body transition into mesenchymal cells (a type of stem cell) during a number of different processes, like wound healing. Epithelial to mesenchymal transition (EMT) is also a hallmark of aggressive cancer. The researchers found that CCN5 can reverse signaling that begins EMT, thereby blocking cancer cell formation. Increasing CCN5 protein levels may be able to control breast cancer growth, and possibly other cancers, according to the researchers. TNBC is a hard-to-treat form of breast cancer because different subtypes of cancer cells are present. This makes the cancer resistant to chemotherapy.

Shrinking aggressive breast tumors—In 2016, a team of researchers at the Washington, D.C. VA Medical Center found that blocking overexpression of a protein called annexin A2 can inhibit aggressive breast cancer growth in a mouse model. The team treated mice with implanted human breast tumors with an antibody called anti-ANX A2 mAb. The team followed the mice for nearly six months and found that the tumors, on average, shrank 67%. Tumors in untreated mice, however, continued to grow rapidly. The results suggest that annexin A2 plays an important role in breast cancer growth, and that it may be a target for new breast cancer treatments, according to the researchers.


➤ Genomics and cancer

VA has partnered with the U.S. Department of Energy and IBM to harness some of the world’s most powerful computing assets to benefit Veterans and others with cancer. IBM’s Watson for Genomics technology provides genetic information to help VA physicians find customized treatment options for Veterans with cancer. VA is also using artificial intelligence (AI) computer programs to distinguish images of cancerous cells from those of healthy tissue.

VA’s National Precision Oncology Program (NPOP) was established in 2016 to implement and standardize precision oncology throughout VA. Physicians use precision oncology approaches to identify unique DNA signatures within cancerous tumors that can be used to select targeted therapy. The program aims to increase collaboration among VA researchers and clinicians to find optimal cancer treatments for Veterans. In addition, VA’s coordinated learning network will ensure that all Veterans have equal access to the most advanced and effective cancer treatments.

In precision oncology, or personalized medicine, physicians take samples of a patient's tumor or blood and send it to the lab to sequence the DNA. The results can identify genes known to play a role in cancer and find specific mutations that effect how the cancer responds to treatment. This information allows physicians to choose the right drug or therapy to help a Veteran fight their cancer.

NPOP shown to be effective—A 2019 study by researchers at the Durham VA Health Care System has shown that, since its implementation, VA NPOP has been effective in delivering personalized cancer care.

The research team sequenced genetic samples from 3,000 Veterans with advanced solid tumors, mostly men with lung, prostate, or colorectal cancers. Overall, researchers found 70% of patients had at least one actionable mutation, meaning a specific drug or treatment could be used to directly target the cancer mutation. About 9% of Veterans had mutations for which there was already an FDA-approved drug available.

The researchers concluded that this approach is feasible for patients across VA, including those in rural areas with more limited access to health care.

APOLLO network launched—In 2016, VA announced a partnership with DOD and the National Cancer Institute (NCI) to tailor cancer care for patients based on the genes and proteins associated with their tumors. The program is called the Applied Proteogenomics Organizational Learning and Outcomes Consortium (APOLLO). The tri-agency program created the nation’s first system in which cancer patients’ tumors are routinely screened for genetic information, with the goal of finding targeted therapies for each individual patient. The process will also generate new information to improve clinicians’ ability to treat the disease.

Two RNA molecules may suppress tumor growth—A 2016 study of the RNA of cancer patients was published by researchers at the VA Palo Alto Healthcare System and Stanford University School of Medicine. RNA is a nucleic acid essential in the regulation and expression of genes.

The researchers found that two RNA molecules, SNORD50A and SNORD50B, are missing in 10% to 40% of tumors in patients with 12 common cancers. They found patients who do not have these molecules in their tumors have poorer survival rates than those who do. The two RNA molecules directly inhibit a cancer-associated protein called K-Ras. In the absence of those molecules, K-Ras becomes hyperactive and emits continued signals telling cancer cells to divide.

According to the research team, this is the first time an RNA molecule of this kind has been shown to act as a powerful tumor suppressor. The K-Ras mutation is an essential step in the development of nearly all human cancers. Understanding how the two molecules block K-Ras activation may open new doors to blocking its function in cancer.


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Selected Scientific Articles by Our Researchers


Tobacco smoking as an etiologic factor in disease; cancer. Schrek R, Baker LA, et al. This seminal VA study linked smoking to cancer. Cancer Res. 1950 Jan; 10(1):49-58.

The effect of direct cigarette smoke inhalation on the respiratory tree of dogs. Auerbach O, Hammond, EC, Kirman D, Garfinkel L, Stout AP. This important paper explores the effects of smoking on the lungs. Natl Cancer Inst Monogr 1968 Jun;28:65-67

Transdermal administration of nicotine. Rose JE, Jarvik ME, Rose KD. This paper describes the value of the nicotine patch. Drug Alcohol Depend. 1984 May;13(3):209-13

Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. This VA study demonstrated the value of colonoscopies compared to sigmoidoscopy. N Engl J Med 2000 Jul 20.

The Prostate Cancer Intervention Versus Observation Trial: VA/NCI/AHRQ Cooperative Studies Program #407 (PIVOT): design and baseline results of a randomized controlled trial comparing radical prostatectomy with watchful waiting for men with clinically localized prostate cancer. Wilt TJ. The PIVOT trial is a multicenter randomized controlled trial comparing radical prostatectomy with watchful waiting in men with prostate cancer. J Natl Cancer Inst Monogr, 2012 Dec; 2012(45):184-90


Prevalence of advanced colorectal neoplasia in Veterans: effects of age, sex, and race/ethnicity. Imperiale TF, Daggy JK, Imler TD, Sherer EA, Kahi CJ, Larson J, Cardwell et al. Age and race were associated with advanced neoplasia and colorectal cancer prevalence. Blacks had a higher overall prevalence of both, but not among screenings. J Clin Gastroenterol. 2021 Nov-Dec 01;55(10):876-883.

Analysis of delayed surgical treatment and oncologic outcomes in clinical stage I non-small cell lung cancer. Heiden BT, Eaton DB Jr, Engelhart KE, Chang SH, Yan Y, Patel MR, Kreisel D et al. Surgical procedures delayed more than 12 weeks are associated with increased risk of recurrence and worse survival. JAMA Netw Open. 2021 May 3;4(5):e2111613.

Time to colonoscopy after abnormal stool-based screening and risk for colorectal cancer incidence and mortality. San Miguel Y, Demb J, Martinez ME, Gupta S, May FP. Increased time to colonoscopy is associated with higher risk of colorectal cancer incidence, death, and late-stage colorectal cancer after abnormal fecal occult blood test or fecal immunochemical test. Gastroenterology. 2021 May;160(6): 1997-2005.

Posttraumatic stress disorder and suicide among Veterans with prostate cancer. Aboumrad M, Shiner B, Mucci L, Neupane N, Schroeck FR, Klaassen Z, Freedland SJ, Young-Xu Y. Patients with PTSD experienced greater suicide risk even after adjusting for important mediators. Psychooncology. 2021 Apr;30(4):581-590.

Therapies for clinically localized prostate cancer: a comparative effectiveness review. Wilt TJ, Ullman KE, Linskens EJ, MacDonald R, Brasure M, Ester E, Nelson VA, Saha J, Sultan S, Dahm P. Radical prostatectomy reduces mortality versus watchful waiting in clinically detected localized prostate cancer but causes more harms. J Urol. 2021 Apr;205(4):967-976.

Access to lung cancer screening in the Veterans Health Administration: does geographic distribution match need in the population? Boudreau JH, Miller DR, Qian S, Nunez ER, Caverly TJ, Wiener RS. Disparities in lung cancer screening access exist based on where Veterans live, particularly for rural Veterans. Chest. 2021 Feb. 19; S0012-3692(21)00280-4.

Time-restricted feeding normalizes hyperinsulinemia to inhibit breast cancer in obese postmenopausal mouse models. Das M, Ellies LG, Kumar D, Sauceda C, Oberg A, Gross E, Mandt T et al. Time-restricted feeding is likely to be effective in breast cancer prevention and therapy. Nat Commun. 2021 Jan 25;12(1):565.

pH-sensitive nanodrug carriers for codelivery of ERK inhibitor and gemcitabine enhance the inhibition of tumor growth in pancreatic cancer. Ray P, Dutta D, Haque I, Nair G, Mohammed J, Parmer M, Kale N et al. Findings reveal simple, yet efficient, drug delivery approaches to overcome resistance often developed to pancreatic cancer. Mol Pharm. 2021 Jan 4;18(1):87-100.

African-American men with low-risk prostate cancer treated with radical prostatectomy in an equal-access health care system: implications for active surveillance. Deka R, Parsons JK, Simpson DR, Riviere P, Nalawade V, Vitzthum KL, Kader AK ert al. There was no significant difference in most adverse pathologic outcomes between African American and white patients. Prostate Cancer Prostatic Dis. 2020 Dec;23(4):581-588.

Defects in long-chain 3-hydroxy acyl-CoA dehydrogenase lead to hepatocellular carcinoma: A novel etiology of hepatocellular carcinoma. Khare T, Khare S, Angdisen JJ, Zhang Q, Stuckel A, Mooney BP, Ridenhour SE et al. Mice with a deficiency of a protein analogous to HADHA were likely to develop nonalcoholic fatty liver disease when young. Older mice with the protein deficiency developed hepatocellular carcinoma. Int J Cancer. 2020 Sep 1;147(5):1461-1473.

Tobacco smoking and death from prostate cancer in US Veterans. Riviere P, Kumar A, Luterstein E, Vitzthum LK, Nalawade V, Sarkar RR, Bryant AK et al. Smoking at the time of diagnosis is associated with a higher risk of dying from prostate cancer as well as other causes of death. Prostate Cancer Prostatic Dis. 2020 Jun;23(2):252-259.

Survival of African American and non-Hispanic white men with prostate cancer in an equal-access health care system. Riviere P, Luterstein E, Kumar A, Vitzthum LK, Deka R, Sarkar RR, Bryant AK et al. African American men diagnosed with prostate cancer in the VA health system do not appear to present with more advanced disease or experience worse outcomes compared to non-Hispanic white men, in contrast to national trends, suggesting that access to care is an important determinant of racial equity. Cancer. 2020 Apr 15;126(8):1683-1690.

Metformin is associated with reduced odds for colorectal cancer among persons with diabetes. Demb J, Yaseyyedi A, Liu L, Bustamante R, Earles A, Ghosh P, Gutkind JS et al. Metformin was associated with reduced colorectal cancer odds—particularly rectal cancer—in a large sample of persons with diabetes undergoing colonoscopy. Clin Transl Gastroenterol. 2019 Nov;10(11):e00092.

Genomic analysis of metastatic solid tumors in Veterans: findings from the VHA National Precision Oncology Program. Poonen PJ, Duffy JE, Hintze B, Shukla M, Brettin TS, Conrad NR, Yoo H et al. Clinical implementation of precision oncology is feasible across the VHA health care system, including rural sites. JCO Precis Oncol. 2019 Aug 8:3:PO.19.00075.

End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography. Ardila D, Kiraly AP, Bharadwaj S, Choi B, Reicher JJ, Peng L, Tse D et al. Artificial intelligence can outperform radiologists at diagnosing lung cancer. Nat Med. 2019 Jun;25(6):954-961.

Impact of topical fluorouracil cream on costs of treating keratinocyte carcinoma (nonmelanoma skin cancer) and actinic keratosis. Yoon J, Phibbs CS, Chow A, Weinstock MA; Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial Group. Significant cost savings were found for patients treated with topical fluorouracil cream. J Am Acad Dermatol. 2018 Sep;79(3):501-507.e2.

Apalutamide treatment and metastasis-free survival in prostate cancer. Smith MR, Saad F, Chowdhury S, Oudard S, Hadaschick BA, Graff JN, Olmos D et al. Among men with nonmetastatic castration-resistant prostate cancer, metastasis-free survival and time to symptomatic progression were significantly longer with apalutamide than with placebo. N Engl J Med. 2018 Apr 12;378(15):1408-1418.

Delivering end-of-life cancer care: perspectives of providers. Patel MI, Periyakoll VA, Moore D, Nevedal A, Coker TR. Specific strategies for cancer care redesign endorsed by health care providers may be used to create interventions that can more efficiently and effectively address gaps in end-of-life cancer care. Am J Hosp Palliat Care. 2018 Mar;35(3):497-504

Chemoprevention of basal and squamous cell carcinoma with a single course of fluorouracil, 5% cream: a randomized clinical trial. Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial Group et al. A conventional course of fluorouracil to the face and ears substantially reduces surgery for squamous cell carcinoma for 1 year. JAMA Dermatol. 2018 Feb 1;154(2):167-174.

Polygenic hazard score to guide screening for aggressive prostate cancer: development and validation in large scale cohorts. Seibert TM, Fan CC, Wang Y, Zuber V, Karunamuni R, Parsons JK, Eeles RA et al. Polygenic hazard scores can be used for personalized genetic risk estimates that can predict for age at onset of aggressive prostate cancer. BMJ. 2018 Jan 10;360:j5757


Cancer Fact Sheet

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VA and other U.S. Government Online Resources

Immunotherapy treatment for Veteran battling leukemia, VA VAntage Point blog, July 21, 2021

Expanding cancer clinical trial access at VA, VA VAntage Point blog, July 20, 2021

Expanding access to specialty cancer care through TeleOncology, VA VAntage Point blog, June 23, 2021

VA Research Week: VHA’s National Oncology Program delivers world-class cancer care, VA VAntage Point Blog, May 17, 2021

Partnership to enhance breast cancer treatment for Veterans, VA VAntage Point blog, Nov. 17, 2020

Lung Precision Oncology Program (LPOP), Department of Veterans Affairs

Quality of Care: Cancer, Department of Veterans Affairs

Prostate Cancer and Agent Orange, Department of Veterans Affairs

Health Awareness Campaigns: Breast Cancer, Department of Veterans Affairs

Tobacco and Health, Department of Veterans Affairs

National Oncology Program Office, Department of Veterans Affairs

Cancer Genomics Research, National Cancer Institute, National Institutes of Health

Pain control: support for people with cancer, National Cancer Institute, National Institutes of Health

Comprehensive Cancer Information, National Cancer Institute (Spanish version  here)

Cancer: In Depth, National Center for Complementary and Integrative Health

Cancer, Centers for Disease Control and Prevention

Cancer, Medline Plus



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