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Committee Examines Veterans Health Issues, Breast Cancer Research

On March 25, the House Veterans’ Affairs Committee held a legislative hearing on several health issues affecting veterans, including breast cancer research.

Speaking on behalf of his bill, the Armed Forces Breast Cancer Research Act (H.R. 3926), Rep. Leonard Boswell (D-IA) said, “Women are currently the fastest-growing veteran population, representing eight percent of the population. As the demographics of the military continue to change, we find our VA [Department of Veterans Affairs] system is struggling to serve the unique needs of this growing population. By 2020, 15 percent of veterans using the VA for health care will be women. What this means is that veterans’ health care, which is now primarily tailored to men, needs to undergo significant changes and fast.” He continued, “Particularly, one health concern that has been largely ignored is the prevalence of breast cancer in our servicewomen and women veterans. That is why I have introduced H.R. 3926, the Armed Forces Breast Cancer Research Act. This legislation would require the secretary of Defense and the secretary of Veterans’ Affairs to collaboratively study the incidence rate of breast cancer in service members and veterans. This study would focus on the number of service members who have deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom, the demographic information of those service members and veterans, an analysis of the clinical characteristics of breast cancer diagnosed, and possible exposures to cancer risk factors.”

Rep Boswell added, “In recent years, the U.S. medical and research communities have stepped up their efforts on breast cancer detection, research, and treatment in the country’s civilian population. However, women who serve or have served in our nation’s armed forces have largely been excluded from these studies, despite their exposure to cancer risk factors and access to medical care. A recent study [by the] Department of Defense (DoD) and National Cancer Institute (NCI) compares the prevalence of certain types of cancer among active-duty military personnel with the general public. The study found that breast cancer among women is more common in the military than in the general population and that further studies are needed to confirm these findings and explore contributing factors. That is my goal for this legislation: to find out if our servicewomen do have a higher risk of breast cancer than the rest of women in the country, and why that might be, so that, ultimately, we can determine if breast cancer is a service-connected disability which I truly believe it is. At this moment in history it is particularly important to consider what we can do to better serve the brave individuals who fight for our security and liberty once they return home.”

Gerald Cross, MD, deputy chief of Patient Care Services and chief consultant for Primary Care at the Veterans Health Administration in the Department of Veterans Affairs, said, “H.R. 3926 would direct the Department of Defense (DoD) and VA to conduct a joint study on the incidence of breast cancer within the armed forces and among veterans. VA supports the objective of H.R. 3926, but cannot support the bill as proposed. H.R. 3926 would provide only an estimate of incidence of one disease at one point in time. A broader study of health care outcomes would be much more cost effective and useful. A broader study would provide information regarding the frequency of occurrence of breast cancer as well as other illnesses and chronic disease outcomes of interest to veterans. For less than the costs required to conduct such a study we could support a longitudinal study that considers breast cancer as one condition among many. This would be accomplished by collecting information on a representative sample of veterans, including demographic variables such as age, gender, era of service, and frequency of occurrence of various health outcomes of concern to veterans. Establishing a survey mechanism of this type would allow VA to repeat the study and identify trends over time, such as increases or decreases in the occurrence of various diseases, such as breast cancer. In order to satisfy the complex requirements of H.R. 3926, the study requirements currently proposed in the bill would demand much more time than the 18-month time frame envisioned. We estimate it would take three to five years to accomplish this work. The total cost of this study is estimated to be $6.34 million.”

Joy Ilem, deputy national legislative director for Disabled American Veterans (DAV) spoke in support of H.R. 3926. She said, “This act would direct the secretaries of DoD and VA to jointly conduct a study on the incidence of breast cancer among members of the armed forces, including National Guard and Reserve components, and veterans and report those study results to Congress. H.R. 3926 would also require demographic information on study participants, including information on possible exposure to hazardous elements or chemical or biological agents (including vaccines), locations in which the service members or veterans were deployed, and analysis of breast cancer treatments received by armed forces members and veterans.” She added, “DAV Resolution No. 252 urges greater collaboration between DoD and VA to share necessary deployment, health, and exposure data from military operations and deployments, in order to timely and adequately address the subsequent health concerns of disabled veterans, whatever the causes of those disabilities. Additionally, this resolution urges Congress to provide adequate funding for research to identify all disabling conditions and effective treatment for such disabilities that may have been caused by exposure to environmental hazards and man-made toxins while serving in the armed forces of the United States. DAV is committed to ensuring [that] veterans disabled by exposure to environmental hazards and toxins receive effective high-quality health care and that the biomedical research and development programs of the department are fully addressing their needs. For these reasons we are pleased to support H.R. 3926, the Armed Forces Breast Cancer Research Act, and urge its passage.”

Reps. Bob Filner (D-CA), Steve Scalise (R-LA), Gabrielle Giffords (D-AZ), Ann Kirkpatrick (D-AZ), and Ginny Brown-Waite (R-FL) testified at the hearing regarding other legislation.

Denise Williams, assistant director of the Veterans Affairs and Rehabilitation Commission at the American Legion; Blake Ortner, senior associate legislative director for the Paralyzed Veterans of America; and Eric Hilleman, director of the National Veterans Service at the Veterans of Foreign Wars of the United States, also testified.

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