Skip to Main Content
An official website of the United States government
CDAS has a New Look: On December 9th, the CDAS website was updated with a new design! The update incorporates all of the existing CDAS functionality with a more modern and user friendly interface.

Comparative Analysis of Military Veteran Cancer Biomarkers Using the PLCO Dataset as a Civilian Control Cohort

Principal Investigator

Name
Chelsey Simoni

Degrees
D.N.P.-c, M.S.N., M.P.H.

Institution
HunterSeven Foundation

Position Title
Director of Health and Wellness

Email
chelsey@hunterseven.org

About this CDAS Project

Study
PLCO (Learn more about this study)

Project ID
PLCO-1989

Initial CDAS Request Approval
Dec 10, 2025

Title
Comparative Analysis of Military Veteran Cancer Biomarkers Using the PLCO Dataset as a Civilian Control Cohort

Summary
U.S. military veterans represent a unique population with occupational and environmental exposures that may influence cancer risk, presentation, and progression. Veterans who served in Iraq, Afghanistan, and other post-9/11 deployments frequently report symptoms and health concerns that may be linked to carcinogenic exposures, including burn pits, diesel exhaust, and other environmental hazards. Despite increased national attention, there remains a critical lack of large-scale comparative studies evaluating cancer biomarker expression, symptom onset, and risk factors among veterans relative to the general U.S. population.

This project seeks to leverage the NIH Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial dataset as a civilian control cohort to compare against a retrospective dataset of post-9/11 military veterans. The PLCO dataset provides robust demographic, family history, smoking, and cancer biomarker data that are essential for establishing a well-characterized baseline. By integrating these control data with veteran medical records and service-related information, we will examine differences in cancer antigen biomarkers, clinical symptoms, family cancer history, smoking behavior, cancer diagnoses, and time to diagnosis. Additionally, we will assess whether deployment location, military occupational specialty, and duration of service are associated with unique biomarker trends and cancer outcomes.

The proposed analysis aims to clarify whether veterans’ elevated cancer risks can be quantitatively distinguished from non-military populations. Understanding these differences is critical for refining cancer screening, risk stratification, and early detection strategies tailored to military and veteran populations. This study aligns with NIH’s mission to advance public health by identifying high-risk populations, addressing health disparities, and developing evidence-based prevention strategies. Findings will provide actionable insights for clinicians, policymakers, and veteran health programs to improve early detection and outcomes for those who served.

Aims

Aim 1: Establish a civilian control cohort using PLCO data.
We will extract demographic, family cancer history, smoking history, symptomatology, cancer diagnoses, and biomarker data (including PSA, CA-125, CEA, and others available within PLCO). These data will form the baseline for comparison against a retrospective veteran cohort.

Aim 2: Compare symptom presentation, family cancer history, smoking history, and biomarker expression between veterans and civilians.
We will conduct cross-sectional and longitudinal analyses to determine whether veterans demonstrate distinct patterns in cancer antigen biomarkers (e.g., earlier elevation, higher median levels, or distinct clustering by biomarker type). We will also evaluate whether veterans exhibit earlier symptom onset or differential associations with smoking and family history relative to the PLCO cohort.

Aim 3: Assess deployment- and service-related variables as modifiers of cancer risk and biomarker expression.
Within the veteran cohort, we will stratify participants by deployment location, military occupation, and time in service to evaluate whether these exposures are associated with biomarker deviations compared to both veterans without such exposures and PLCO controls.

Aim 4: Develop predictive models for cancer risk stratification in veterans.
By combining PLCO baseline data with veteran-specific exposures, we will generate multivariable models incorporating biomarkers, demographics, service history, and lifestyle factors. These models will identify predictors of elevated cancer risk unique to veterans, supporting the development of tailored screening protocols.

Impact: This study will establish whether military service—specifically deployment exposures and occupational roles—leads to quantifiable differences in cancer biomarkers and disease patterns when compared with a large civilian cohort. Outcomes will directly inform veteran-specific screening guidelines, improve early detection, and provide a foundation for future interventional studies.

Collaborators

Chelsey Simoni HunterSeven Foundation