Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system

Abstract

Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans’ health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes.

microRNA-342-5p and miR-608 inhibit colon cancer tumorigenesis by targeting NAA10

“…Colorectal cancer (CRC, including colon and rectal cancers) has a 5% overall incidence and is the third most common malignancy worldwide [ 1 ]. Although some progress has been achieved in the diagnosis and treatment of such diseases in the past decades, the 5-year survival rate remains at only 40-60% [ 2 , 3 ]. The high incidence and poor prognosis of CRC imply that more efforts are needed to understand the underlying mechanisms of its formation and progression.…”

Impact of Moderate versus Deep Sedation and Trainee Participation on Adenoma Detection Rate-Analysis of a Veteran Population

“…CRC is the second leading cause of cancer-related death, and monitoring quality metrics for screening colonoscopy is essential to reduce morbidity and mortality. [1][2][3][4] This is the first study, to the best of our knowledge, to evaluate the effect of moderate sedation compared with deep sedation on the ADR and PDR in the veteran population. Our results indicate that in veterans undergoing index screening colonoscopies, the quality metrics of the ADR, PDR, and withdrawal time are not influenced by deep sedation compared with moderate sedation.…”

“…3 Relative to the general population, veterans are older with multiple high-risk comorbidities, impacting CRC risk. 3,4 In ad-dition, certain lifestyle factors possibly impacting CRC risk include a higher smoking prevalence among veterans and poor diet. 5,6 Since, colonoscopy is a powerful tool in a gastroenterologist's armamentarium, a quality examination is essential to prevent and diagnose CRC.…”

Precision Medicine for CRC Patients in the Veteran Population: State-of-the-Art, Challenges and Research Directions

“…Specifically, the US Veteran population represents 3% of all cancer patients in the USA and CRC accounts for ~9% of all cancers among Veterans [ 4 ]. This is because a large proportion of Veterans receiving care under Veterans Health Administration (VHA) have poor health, multiple comorbidities, and lower income [ 3 ].…”

“…This is because a large proportion of Veterans receiving care under Veterans Health Administration (VHA) have poor health, multiple comorbidities, and lower income [ 3 ]. Further, the incidence of cancer among Veterans is likely to increase with the aging population, an increase in military personnel, and an increase in Veterans seeking health care in VHA [ 4 ]. VHA has supported a Precision Oncology Program (POP) that uses multi-gene, next-generation sequencing (NGS) panels for patients diagnosed with Stage III or IV CRC, with an intent to provide precision cancer treatment (PCTx).…”