Breast and gynecologic cancer mortality among women veterans in Texas, 1979–2002

Lara Staub Savas, The University of Texas School of Public Health


The purpose of this dissertation was to promote research on women veterans' long-term health risks by providing methodological insights and baseline data to describe breast and gynecologic cancer mortality patterns of women veterans in Texas. Two descriptive mortality studies were conducted (1979-2002). The study aims were to examine Texas women veterans' age- and death-year period-adjusted (and specific) breast and gynecologic cancer mortality patterns for: (1) all female veterans, (2) Vietnam War theater female veterans, and (3) Persian Gulf War (PGW) theater female veterans. The Department of Veterans Affairs' (VA) National Registry of Women Veterans (NRWV) was deterministically linked by Social Security number with computerized Texas death certificates, identifying 20,975 female veteran decedents ages 25 years and over: 5,475 died of malignant cancer (26.1%): 1,019 breast cancers (4.9%), 285 ovarian cancers (1.4%), 103 uterine cancers (0.49%) and 102 cervical cancers (0.49%). Findings indicated significant excess mortality of breast and ovarian cancers, and non-significant measures of effect, close to the null value, for uterine and cervical cancers among all female veterans. For all cancers, the strength of the association depended on the measure of effect used (e.g., standardized mortality ratio, proportional mortality and proportional cancer mortality ratios) and the source of veteran status (e.g., NRWV or Texas death certificates). Vietnam and PGW theater veterans had non-significant increased odds of breast cancer. The second study assessed completeness of four sources of mortality ascertainment for women veterans using the NRWV. The purpose was to guide selection of the most complete source of mortality status data for female veteran studies with death as an endpoint. The aims were to: (1) describe variability of decedents' characteristics, and (2) determine reliability of agreement between all four sources. Deterministic linkage of the NRVW with the Social Security Administration-Death Master File (SSA-DMF), VA and Texas death certificate databases identified 6,889 decedents. Approximately 98% were identified by VA and SSA sources collectively, 94%, of which were identified by the SSA-DMF, and 91% were identified by Texas death certificates. This research provides a framework for conducting occupational and analytic research into women veterans' breast and gynecologic cancer mortality and risk.

Subject Area


Recommended Citation

Savas, Lara Staub, "Breast and gynecologic cancer mortality among women veterans in Texas, 1979–2002" (2006). Texas Medical Center Dissertations (via ProQuest). AAI3259235.