The John P. Murtha Cancer Center (MCC) at Walter Reed National Military Medical Center, the Department of War’s only Center of Excellence for cancer care, recently hosted its 2025 Cancer Prevention Summit at the medical center.

Physicians and subject matter experts in cancer prevention, care and research discussed a range of topics during the summit, including cancer survival in the Military Health System (MHS), cancer incidence and survival by military occupation, cancer risk mitigation, the future of cancer care (early detection and interception), and next-generation cancer screening, among other issues.

“Cancer is a readiness issue,” said Dr. Craig D. Shriver, director of the MCC and MCC Research Programs (MCCRP).  A retired colonel in the U.S. Army, Shriver added that more than 1,500 active-duty service members are diagnosed with cancer annually among “the healthiest, generally young, and most active of the nation’s population. “Every one of them is important to the military and warfighter readiness. When we lose one to treatment for a while, or [the service member] has to be transitioned out of the military, it impacts readiness,” said Shriver.

Dr. Kimberly Robins, of the MCCRP, explained that factors impacting cancer incidence include exposures such as occupational hazards, demographics (age, sex, race/ethnicity), lifestyle factors (tobacco use, diet, physical activity, obesity) and genetic predispositions. She added that factors that affect cancer detection, diagnosis and treatment include access to care, screening practices, medical surveillance and reporting completeness.

“The MHS provides universal access to care,” Robins stated. She added that cancers among MHS beneficiaries are more likely detected and earlier detected because of the military’s requirement for regular health exams. However, some military occupations may increase the risk of certain cancers, studies have shown.

Better detection in military medicine

For most cancer sites, the incidence was lower in the military than the general population, particular among younger individuals, Robins stated. She added there’s a higher incidence in the military for prostate, thyroid and breast cancers, especially among older individuals, and higher incidence rates in the military were observed for localized breast, prostate, thyroid, soft tissue sarcoma, and Hodgkin lymphoma. Again, this may be because of the military emphasis on regular health exams and its universal access to care for its beneficiaries, which also may contribute to earlier detection.

Dr. Jie Lin, also of the MCCRP, agreed that the overall cancer mortality rate has been declining steadily since the early 1990s, mostly in the most common cancers such as lung, colorectal, breast and prostate cancers. “The decline results from early detection of some cancers, smoking reduction and treatment,” she added. “With the universal access to health care, MHS beneficiaries with cancer have improved survival outcome compared to the patients in the U.S. general population,” Lin said.

U.S. Air Force Col. (Dr.) Ian Stewart, vice chair for clinical research at the Uniformed Services University (USU), discussed traumatic brain injury [TBI] and the subsequent risk of brain cancer. “We found that moderate/severe TBI and penetrating TBI, but not mild TBI, were associated with the subsequent development of brain cancer. Given that TBI is a common injury incurred in the course of military service, further research is needed,” he added.

Lifestyle modifications: diet, exercise, regular exams

U.S. Air Force Maj. (Dr.) Zachary Rupert, a preventive medicine physician at USU and Walter Reed, said lifestyle modifications can reduce cancer risk. He explained that this includes reducing the consumption of ultra-processed foods and eating more fruits and vegetables while decreasing red meats and sugar-sweetened beverages. In addition, he encouraged people to be physically active to help avoid excess body weight, which can increase the risk of some cancers. He also encourages people to avoid use of tobacco and limit alcohol intake. He also urged people to protect themselves from the sun’s dangerous UV rays.

Rupert added that studies have estimated that about roughly 40 percent of cancer cases in the United States in 2019 were attributable to modifiable risk factors including smoking, secondhand smoke exposure, nutrition, lack of exercise, ultraviolet radiation exposure, and several carcinogenic infections.

Dr. Juvianee Estrada-Veras, head of genetics in the MCCRP, said, “Advancements in genetic testing, risk assessment, and understanding of the natural history of these syndromes may lead to more personalized monitoring strategies [for cancer risk mitigation]. Tumor surveillance is a critical component of managing hereditary cancer predisposition syndromes. Early detection through tailored strategies for children and adults saves lives, improves outcomes,” he added.

“We can change the cancer experience through early detection and intervention,” said Dr. Betsy O’Donnell, director of the Multi-Center Early Detection Clinic at the Dana Farber Cancer Institute. She said clinical pathways for accurate diagnostic evaluations are evolving providing a tremendous opportunity for research – clinical, translational and basic – for early cancer detection.

Multi-cancer detection (MCD) tests aim to close the gap between traditional [and targeted] screening for cancers, explained MCCRP pathologist Kristen Natale. “Traditional screening saves lives, but it leaves many cancers undetected,” she added. MCD assays include cancer-related biomarkers, which circulate in blood; and next-generation sequencing, used to detect a wide range of genetic mutations, she explained. In addition, multi-omics combines genomic data with other biological information, and proprietary artificial intelligence algorithms “analyze complex data and identify patterns that may indicate cancer,” she stated.

The Murtha Cancer Center at Walter Reed Bethesda (MCC) is a tri-service center where military beneficiaries can receive exceptional care in all disciplines of cancer treatment. For more information, visit https://walterreed.tricare.mil/Health-Services/Specialty-Care/Murtha-Cancer-Center/About-Murtha-Cancer-Center.