Supporting the PACT Act: Top cancers diagnosed in young veterans who deployed to Iraq and Afghanistan

Introduction: In 2022, the PACT Act expanded Veterans Affairs healthcare benefits for Veterans with cancers related to toxic exposures encountered during their military service. However, evidence linking toxic exposures to cancer development remains incomplete. This study confronts this gap by identifying the most common cancers in young Veterans who served in Iraq and Afghanistan. Veteran cancer rates were compared to the National Cancer Institute's SEER database of cancers in young adults to uncover patterns that may reveal a hidden legacy of toxic exposure. Methods: The VA Informatics and Computing Infrastructure (VINCI) database was used to build a retrospective cohort of Veterans ages 18–39 who served in Iraq and Afghanistan and were diagnosed with cancer between 2017 and 22. The findings were compared to the 2024 SEER report on cancer incidence in young adults, ages 15–39. Data analysis was performed in Microsoft Excel. Results: Among young male Veterans, the most diagnosed cancers were testicular (20.8 %), melanoma (13.3 %), brain tumors (9.7 %), lymphoma (9.5 %), and thyroid (8.7 %). Among young female Veterans, the most common cancers were breast (25.3 %), cervical (18.8 %), thyroid (15.8 %), melanoma (10.5 %), and brain tumors (6.9 %). Male Veterans had double the relative incidence (RI) of melanoma (13.3 % vs 6.5 % in SEER, RI 2.1), and female Veterans had almost triple the relative incidence of cervical cancer (18.8 % vs 6.6 %, RI 2.8). Conclusions: Young Veterans who served in Iraq and Afghanistan face alarming rates of melanoma and cervical cancer. These findings may represent a broader, service-connected health crisis yet to be fully understood. Synopsis: This study defines the top cancers diagnosed in young (ages 18–39-year-old) Veterans who deployed to Iraq and/or Afghanistan. It finds double the relative incidence of melanoma in male Veterans and nearly triple the relative incidence of cervical cancer in female Veterans.