Cancer in veterans: no problem

In the last five years the Veterans Administration has figured out a way to decrease cancer cases amongst veterans by a lot: 40,000 to 70,000 are the estimates. The breakthrough was initiated by the Bush administration, which has used the same technique to make an impact on other problems, from military casualties to the environment: they just don't bother to tell anyone about the cases. Presto: they disappear:

Stonewalling by the Veterans Administration is putting U.S. cancer surveillance and research in jeopardy, according to many of the researchers involved in those fields.

After decades of sharing data freely and allowing researchers to get in touch with its patients, the agency has been blocking such activity for the past several years, according to Dennis Deapen, Dr.PH., of the Los Angeles Cancer Surveillance Program and the University of Southern California.

The result, Dr. Deapen said, is that California state data on cancer incidence rates are being skewed. And that, he said, is likely to have serious effects on national data.

The California Cancer Surveillance Program has seen a sharp drop in the agency's reporting of new cases to Californian cancer registries beginning in late 2004 -- from 3,000 cases in 2003 to almost none by the end of 2005, according to an article in the September issue of Lancet Oncology. (MedPageToday)

It's not just California, either. Florida has had the same problem and probably other states as well. Florida and California are most concerned because they have so many veterans. But according to CDC data, VA centers in seven states are not reporting their cases to state cancer registries and at least some VA hospitals aren't reporting in six more states. It's not as if the states haven't been complaining. And not just the states: the North American Association of Central Cancer Registries, the American Cancer Society, the CDC and the National Cancer Institute have been meeting to try to figure out what to do. The loss of the VA data can seriously bias cancer national cancer data and make certain kinds of cancer research difficult or impossible.

The story gets worse:

But even when states get VA data, some cases may slip through the cracks under a related VA policy that forbids interstate data-sharing, he said.

For instance, he said, it's common for veterans in some eastern states to seek treatment in neighboring states.

The host state doesn't count them, because they live next door. And the VA refuses to notify the home state or let the host state do so, so that some cases are simply never counted, Dr. Deapen said.

No one seems to know the reason for the Bush VA policy. Stupidity and incompetence are the most plausible explanation for this administration, but it is also true that the friends of this administration have no strong incentive to make cancer surveillance work. After all, finding out who gets cancer, where and when are some of the most important clues to occupational and environmentally caused cancer, not to mention service-related cancer.

So stupidity and incompetence have their virtues. If you don't mind a few tens of thousands of cancers.

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My experience with the VA healthcare, and cancer is, the VA chooses to ignore signs, sypmtoms, and reality when it comes to cancer. For 2 yrs my late husband was a patient in a VA hospital, he was diagnosed with esophageal cancer, operated on and we were told he was ''cancer free'' and offered no treatment to prevent a reoccurence. His weight declined, from 221 lbs to 70 lbs, and days he would scream with pain, with severe diarreah, and all along, the VA believed he was faking this and it was all in his head.
He died in 2000 4 days after finding he was a total mass of cancer, and 8 days after his last appointment with the VA, diagnosis was done at an outside hospital.
So maybe this is VA's answer, to ignore signs and symptoms of cancer, where there is no record of patient having it.
Doctors at this VA openly admitted later that they did not believe my husband was even sick. How sad is this?

By Denise Soles (not verified) on 10 Sep 2007 #permalink

Bush science. Bush numbers. Bush obfuscations ::

Climate, energy, disease / health, unemployment, the economy in general, pollution, US deaths in Iraq, wildlife, agriculture (preserved somewhat at the USDA as nobody really looks at the numbers and draws conclusions), US Gvmt. aid to other countries; and the beat goes on..

Lies, and dismantling of one of the sockets of rational decisions, basic numbers, properly gathered, acknowledged, acted upon in various ways....no more. Gone. Finito!

Bush = the US Gvmt, it s agencies, etc.

Denise: Sigh. Very sad. I am a cancer epidemiologist by trade (bird flu is a sideline) and these stories are dismaing. I also know the VA system well. Enough said.


He died in 2000 4 days after finding he was a total mass of cancer, and 8 days after his last appointment with the VA, diagnosis was done at an outside hospital.

Our condolences, Denise.

We have had to deal with cancer in our own family, and the advice we invariably give is this: if your doctor offers up a dismissive diagnosis, and if you have the smallest doubt about that, run -- do not walk -- to get a second opinion.

This goes double for the VA. There are some very competent physicians working for the VA. I should know: a former doctor of mine left a prestigious university teaching hospital to enter VA service. But there are also a pretty impressive contingent of fools and quacks on the other side of the balance. And it's hard to know just who you will end up with.

--

Considering how many kilotons of depleted uranium our current madness has sprayed across the landscape and atmosphere of Iraq, and how many milligrams of DU hundreds of thousands of veterans (and mercenaries and other contractors) are bringing back in their lungs and livers, it's hard to think that this particular "fog of war" is not a preemptive smoke and mirrors attack.

By Pierce R. Butler (not verified) on 12 Sep 2007 #permalink