Gynecologic Cancer Diagnoses Rising Among Women Veterans

PHILADELPHIA — The number of gynecologic cancer diagnoses among women veterans and military servicemembers has nearly tripled over the past two decades, reflecting both the growing population of women who have served in the military and an increasing need to address cancer prevention, treatment and survivorship in this population, according to a new study.

The findings, published in Gynecologic Oncology Reports, provided one of the most comprehensive looks to date at gynecologic cancer trends among women veterans and active-duty servicemembers.¹

“We know uterine cancer incidence and mortality are increasing in the general population, with uterine cancer rates on pace to outnumber colon cancer in women by 2030,” said lead author Anna Jo Bodurtha Smith, MD, a gynecologic oncologist and health services researcher with the University of Pennsylvania Health System. “Little was known about gynecologic cancer trends in women servicemembers and veterans.”

Using data from the National Cancer Database, Bodurtha Smith and her colleagues compared gynecologic cancer diagnoses among veterans and active-duty servicemembers covered by military or VA insurance with diagnoses among nonveterans between 2004 and 2021.¹

During that period, the investigators identified 13,359 gynecologic cancer diagnoses among veterans. Uterine cancer was the most common gynecologic cancer in both veterans and nonveterans, accounting for 55% of new diagnoses in 2021.

The study also found important differences between the two groups: Veterans were diagnosed with gynecologic cancers at a younger median age than nonveterans—58 years vs. 62 years—and were more likely to be diagnosed with early-stage disease. Researchers also found differences in tumor types, with veterans more likely to develop endometrioid uterine cancer, germ cell ovarian cancer and cervical adenocarcinoma. Overall survival was similar between veterans and nonveterans after adjusting for age, cancer stage and tumor characteristics.

One of the most encouraging findings, according to Bodurtha Smith, was the tendency toward earlier diagnosis among veterans. “We were excited to see earlier-stage diagnoses in veterans, as most gynecologic cancers are curable when diagnosed at an early stage,” she said.

The reasons for the difference are not entirely clear, but access to healthcare may play an important role, she said. “Servicemembers and veterans are more likely to be insured and have primary care clinicians, which facilitates access to care and diagnoses if and when cancer symptoms develop,” Bodurtha Smith explained.

For cervical cancer, the only gynecologic cancer for which routine screening is available, veterans also appear to have an advantage. “We know that veterans have higher rates of cervical cancer screening than nonveterans,” she said. “Further research, including work with veterans, will help us understand how we can help more veterans intercept and treat gynecologic cancer and pre-cancers.”

The study identified notable differences in cancer histology between veterans and nonveterans, but researchers say more work is needed to understand why.

Veterans had higher rates of endometrioid uterine cancer, germ cell ovarian cancer and cervical adenocarcinoma than nonveterans. While military-related exposures, lifestyle factors and environmental influences have been suggested as possible contributors, the researchers were cautious about drawing conclusions.

“We hope to explore this in further research,” Bodurtha Smith said when asked why military populations might differ biologically or environmentally from civilians.

Similarly, the potential impact of military-related exposures—including deployment environments, chronic stress, burn pits, smoking patterns and reproductive health factors—remains an open question. “This could be explored in future research,” Bodurtha Smith told U.S. Medicine.

The researchers also noted challenges in fully understanding the cancer burden among veterans. Although the National Cancer Database captures many veterans who receive cancer care outside the VA while using VA or military insurance, it does not identify veterans who are not using those benefits.

“In this study, we were able to capture individuals using VA or military insurance getting care outside the VA system,” Bodurtha Smith said. “This misses veterans not using VA insurance, and there is ongoing work to characterize cancer burden in veterans across the country.”

The findings may become increasingly important as more women enter and use the VA healthcare system. The study noted that recent expansions in VA eligibility are expected to increase the number of veterans receiving cancer-related care through VA programs in the coming years.

Bodurtha Smith said she believes prevention efforts should remain a priority. “Cervical cancer is the only gynecologic cancer with a screening test, so we should continue to work to increase cervical cancer screening in veterans and nonveterans,” she said.

She also emphasized the importance of vaccination against human papillomavirus (HPV), which is linked to several cancers. “The HPV vaccine also prevents cervical, vaginal, vulvar, rectal and ENT cancers, so I would strongly encourage individuals not yet vaccinated to get the HPV vaccine,” she said. “Even individuals who have had HPV in the past or had cervical dysplasia will benefit from getting the vaccine because it protects against nine strains of HPV.”

As the number of women serving in the military and receiving care through the VA continues to grow, understanding gynecologic cancer risks, prevention strategies, treatment patterns and survivorship needs will become increasingly important, Bodurtha Smith said.

 

1. Smith AJB, Dean D, Wang X, Zullig LL, Moss HA. Gynecologic cancers in veterans and military service members compared to non-veterans, 2004-2021: A National cancer database study. Gynecol Oncol Rep. 2026 May 6;65:102100. doi: 10.1016/j.gore.2026.102100. PMID: 42170348; PMCID: PMC13187539.