Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, USA.
Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA.
J Gen Intern Med. 2024 Sep;39(12):2300-2316. doi: 10.1007/s11606-024-08903-7. Epub 2024 Jul 4.
Women are the fastest growing veteran group in the US and the number of women veterans (WVs) with cancer is rising; however, little is known about this population. Cancer care for WVs is complex and it is essential to understand their unique needs and care coordination challenges to provide evidence-based care. The purpose of this review is to map the quantity, distribution, and characteristics of literature describing cancer and its treatment among WVs.
We searched MEDLINE (via PubMed), Embase (Elsevier), and Web of Science Core Collection (Clarivate) from inception through January, 2024. Publications were eligible that reported gender-specific data on any aspect of cancer care among WVs. Data was abstracted by a single investigator with over-reading.
Forty-six reports were included; 44 were observational and 19 had a women-only sample. There were no interventional reports and no qualitative reports had a patient sample. Breast cancer was the most commonly addressed (n = 19). There were six additional reports on sex-specific cancers. Many reports used large VA databases or previous trial data, creating the potential for patient overlap between reports. Among VA-specific areas of interest, only three reports evaluated the potential implications of racial differences and only two included a transgender population. No reports examined the effects of toxic exposures on cancer. Within the NCI Cancer Control Continuum, crosscutting areas were more commonly represented; over half (25) of the reports addressed epidemiology. There were few reports on focus areas and little overlap between focus and crosscutting areas.
Existing literature provides an inadequate understanding of the population of WVs with cancer. There is scant information regarding the population of WVs with cancer, their care preferences or experiences, or how to best identify and address unmet healthcare needs. It is imperative to expand research to provide evidence-based care for this population.
女性是美国增长最快的退伍军人群体，癌症女性退伍军人（WVs）的数量正在增加；然而，人们对这一人群知之甚少。癌症对 WVs 的治疗很复杂，了解她们的独特需求和护理协调挑战对于提供基于证据的护理至关重要。本研究的目的是绘制描述 WVs 癌症及其治疗的文献的数量、分布和特征。
我们通过 PubMed 搜索了 MEDLINE、Embase（Elsevier）和 Web of Science Core Collection（Clarivate），检索时间从开始到 2024 年 1 月。符合条件的出版物报告了 WVs 癌症护理的任何方面的性别特定数据。一名调查员对数据进行了摘要，同时进行了多次阅读。
共纳入 46 项报告；44 项为观察性研究，19 项为仅女性样本研究。没有干预性报告，也没有定性报告有患者样本。乳腺癌是最常见的（n=19）。还有 6 项关于特定性别的癌症报告。许多报告使用了大型退伍军人事务部数据库或以前的试验数据，因此报告之间可能存在患者重叠。在退伍军人事务部感兴趣的特定领域中，只有 3 项报告评估了种族差异的潜在影响，只有 2 项报告包括跨性别群体。没有报告研究有毒物质暴露对癌症的影响。在 NCI 癌症控制连续体中，交叉领域更常见；超过一半（25 项）的报告涉及流行病学。很少有报告涉及重点领域，重点和交叉领域之间几乎没有重叠。
现有文献对癌症女性退伍军人人群的了解不足。关于癌症女性退伍军人人群、她们的护理偏好或经验，或者如何最好地识别和满足未满足的医疗保健需求的信息很少。扩大研究对于为这一人群提供基于证据的护理至关重要。
