Serving Veterans with Gynecologic Cancer: An Update on Available Programs and New Partnerships | Haley Moss, MD, MBA

Haley Moss, MD, MBA

Women constitute the fastest growing population among veterans, with approximately two million women veterans currently, and women are projected to account for 18% of all living veterans by 2040.¹

According to the Veterans Health Administration, women account for 30% of all new patients. Female veterans differ from that their male veteran peers, as do their needs. The average female veteran is approximately fifteen years younger than male veterans, and women are more racially and ethnically diverse. Veterans with gynecologic cancers tend to be younger than civilian patients, and are more likely to be Black.

Historically, veterans with gynecologic and breast cancers were treated outside of the Veterans Health Administration due to lack of subspecialty expertise among VA oncologists. To address these disparities, VA’s National TeleOncology (NTO) connects veterans at smaller or rural facilities to increase access to care through satellite sites in areas that lack cancer providers, meet the same standard of care through telehealth appointments, and offer chemotherapy education, genetic testing and counseling. To address barriers to cancer care for women veterans, the VA’s National Oncology Program established the Breast & Gynecologic Oncology System of Excellence (BGSoE) to improve the quality of care for veterans diagnosed with breast and gynecologic malignancies. BGSoE has developed a collaborative network across the country, provides virtual tumor boards services to local oncologists, created a national navigation program for Veterans with gynecologic and breast cancer, and provides support groups tailors to veterans with cancer.

Further research is needed to understand the epidemiology of gynecologic cancers among veterans and novel treatment delivery modalities to address the unique risk factors and barriers to care that impact veterans. In alignment with the PACT Act, the VA and NCI have recently announced a new partnership with the Surveillance, Epidemiology and End Results (SEER) Program and the VA cancer registry to study cancer diagnosis and treatments within the veteran population. The collaboration will aim to further understand the impact of cancer on veterans and allow for more complete data exchange while maintaining privacy. COURAGE, or Center for Oncology oUtcomes Review And Gender Equity, is a newly funded center to evaluate the best evidence to support delivery of high quality and accessible care to women (broadly defined) veterans with cancer. COURAGE will seek to support capacity growth, quality improvement, and set future research agendas for women veterans with cancer.

References

1. Katon JG, Tartaglione EV, Eleazer JR, Frayne SM, Haeger KO, Luo S, Schule AKR, Offer C, Phibbs
   CS, Rose D, Saechao F, Shankar M, Shaw J, Vinekar KS, Yano EM, Christy AY, Johnson AM. State of Reproductive Health Volume II: VA Reproductive Health Diagnoses and Organization of Care. Office of Women’s Health, Veterans Health Administration, Department of Veterans Affairs, January 2023.

Haley Moss, MD, MBA, serves as the Director of the Breast and Gynecologic Oncology System of Excellence. She cares for patients at the Durham VA, as well as veterans across the country through the National TeleOncology. Please reach out to BGSOE@va.gov or haley.moss1@va.gov with any questions or concerns related to BGSOE or COURAGE.