Female veteran cancer survivors had significantly higher prevalence of poor physical and mental health compared to civilian women, while male veterans showed no significant HRQoL differences compared to civilian men.
Key Findings
Results
Female veteran cancer survivors had higher prevalence of poor physical health compared to female civilian cancer survivors.
Adjusted prevalence ratio (aPR) for poor physical health among female veterans vs. female civilians: 1.35 (95% CI 1.02–1.77)
Analysis used sex-stratified, survey-weighted Poisson regression with robust variance
Sample included 753 female veterans (2.3% of total female survivors) and 32,150 female civilian survivors
Results were adjusted for sociodemographic and clinical covariates
Results
Female veteran cancer survivors had higher prevalence of poor mental health compared to female civilian cancer survivors.
Adjusted prevalence ratio (aPR) for poor mental health among female veterans vs. female civilians: 1.45 (95% CI 1.06–1.98)
Outcome was defined as poor mental health days as a binary outcome
Female veterans and civilians did not differ significantly in education, employment status, or history of chronic conditions (all p > 0.05)
The disparity in mental health occurred despite no measurable sociodemographic or comorbidity differences between female veteran and civilian groups
Results
Male veteran cancer survivors did not differ significantly from male civilian cancer survivors on any HRQoL outcome.
Veteran status among males was not associated with poor physical or mental health (all p > 0.05)
HRQoL outcomes examined included fair/poor general health, poor physical health, poor mental health, and activity-limiting poor health
This null finding occurred despite male veterans having substantially greater comorbidity burden than civilian men
Results
Male veteran cancer survivors had a substantially higher comorbidity burden and older age distribution compared to male civilian cancer survivors.
Male veterans aged ≥75 years: 54.4% vs. 25.9% for civilian men (p < 0.001)
History of cerebrovascular accident: 9.8% in male veterans vs. 5.7% in civilian men (p < 0.001)
History of coronary artery disease: 25.4% in male veterans vs. 15.9% in civilian men (p < 0.001)
Male veterans were less likely to be employed (20.1% vs. 39.6%) or be college graduates (41.9% vs. 47.5%) compared to civilian men (all p < 0.001)
Total sample included 11,213 male veterans (34.3% of male survivors) out of 32,710 male cancer survivors
Results
Female veteran and civilian cancer survivors did not differ significantly in sociodemographic characteristics or chronic condition history.
No significant differences were observed between female veterans and civilians in education, employment status, or history of chronic conditions (all p > 0.05)
This contrasts sharply with male veterans, who differed from civilian men on all measured sociodemographic and clinical covariates
Female veterans represented only 2.3% (n = 753) of the total female survivor sample (n = 32,903)
Methods
The study analyzed cancer survivors from the 2017–2022 Behavioral Risk Factor Surveillance System (BRFSS) with a total sample of 65,613 survivors.
Sample comprised 32,710 men and 32,903 women
11,213 men (34.3%) and 753 women (2.3%) were identified as veterans
Outcomes included fair/poor general health, poor physical health days, poor mental health days, and activity-limiting poor health
Sex-stratified, survey-weighted Poisson regression with robust variance was used to estimate incidence rate ratios (IRRs) for day-count outcomes and prevalence ratios (PRs) for binary outcomes
What This Means
This research suggests that female veterans who have survived cancer face notably worse physical and mental health outcomes compared to female civilians with cancer, while male veterans do not show the same disparities relative to civilian men. The study drew on data from over 65,000 cancer survivors surveyed between 2017 and 2022, and found that female veteran survivors were about 35% more likely to report poor physical health and 45% more likely to report poor mental health than their civilian counterparts. Interestingly, these differences emerged even though female veterans and female civilians had similar levels of education, employment, and chronic disease history — suggesting that factors specific to military service or the intersection of gender and veteran identity may contribute to these health gaps.
For male veterans, the picture was different. Although male veterans were considerably older, had higher rates of heart disease and stroke, and were less likely to be employed or college-educated than civilian men, their reported physical and mental health outcomes were statistically similar to those of male civilians. This may reflect the protective role of healthcare access through the Veterans Health Administration (VHA), which could be helping to offset the higher disease burden seen in male veterans.
This research suggests that survivorship care programs — both within the VHA and in civilian healthcare settings — may need to be tailored differently for men and women. Female veterans in particular may benefit from integrated care that addresses mental health support, chronic disease management, and social risk screening. The findings point to a potential gap in how cancer survivorship care is currently delivered to women who have served in the military.
Alizai Q, Chatzipanagiotou O, Mevawalla A, Sarfraz A, Angez M, Ejaz R, et al.. (2026). Service and Suffering: Comparative Analyses of Health-Related Quality of Life Among Veteran and Civilian Cancer Survivors.. Psycho-oncology. https://doi.org/10.1002/pon.70596