Military environmental exposures and risk of breast cancer in active-duty personnel and veterans: a scoping review

Dylan J Jester; Mehret T Assefa; Daya K Grewal; Abou M Ibrahim-Biangoro; Jennifer S Jennings; Maheen M Adamson

doi:10.3389/fonc.2024.1356001

Military environmental exposures and risk of breast cancer in active-duty personnel and veterans: a scoping review

Front Oncol. 2024 Mar 13:14:1356001. doi: 10.3389/fonc.2024.1356001. eCollection 2024.

Authors

Dylan J Jester¹, Mehret T Assefa¹, Daya K Grewal^#^{1

2}, Abou M Ibrahim-Biangoro^#^{1

3}, Jennifer S Jennings^{1

4}, Maheen M Adamson^{1

5}

Affiliations

¹ Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, CA, United States.
² Department of Psychology, Palo Alto University, Palo Alto, CA, United States.
³ Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
⁴ War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States.
⁵ Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States.

^# Contributed equally.

Abstract

Background: The effects of military environmental exposures (MEE) such as volatile organic compounds (VOCs), endocrine-disrupting chemicals (EDCs), tactile herbicides, airborne hazards and open burn pits (AHOBP), and depleted uranium on health are salient concerns for service members and Veterans. However, little work has been done to investigate the relationship between MEE and risk of breast cancer.

Data sources and methods: We conducted a scoping review on MEE, military deployment/service, and risk of breast cancer among active-duty service members and Veterans. PRISMA was used. PubMed, Embase, and citations of included articles were searched, resulting in 4,364 articles to screen: 28 articles were included.

Results: Most papers on military deployment and military service found a lower/equivalent risk of breast cancer when comparing rates to those without deployment or civilians. Exposure to VOCs due to military occupation or contaminated groundwater was associated with a slightly higher risk of breast cancer. Exposure to Agent Orange was not associated with an increased risk of breast cancer. Evidence regarding EDCs was limited. No paper directly measured exposure to AHOBP or depleted uranium, but deployments with known exposures to AHOBP or depleted uranium were associated with an equivalent/lower risk of breast cancer.

Conclusions: Women are the fastest growing population within the military, and breast cancer poses a unique risk to women Veterans who were affected by MEE during their service. Unfortunately, the literature on MEE and breast cancer is mixed and limited, in part due to the Healthy Soldier Paradox and poor classification of exposure(s).

Keywords: breast neoplasm; environmental epidemiology; female; war; women veterans.

Publication types

Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Women’s Operational Military Exposure Network Center of Excellence (WOMEN CoE). The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.