Veterans Sought For Million Veterans Program

By Nancy K. Crevier

Dr Daniel Federman of Newtown, professor at Yale University School of Medicine and primary care provider with the Department of Veterans Affairs (VA) Connecticut Healthcare System in West Haven, along with VA Connecticut site coordinator Karen Anderson, spoke Monday, July 16, with The Bee concerning the national Million Veteran Program. Dr Federman leads the program in Connecticut.

The initiative was launched in January 2011 in Boston and New Haven, and is now underway in 40 sites across the nation, said Ms Anderson. According to information provided by VA public affairs spokesperson Pamela Redmond, the Million Veteran Program is an “unprecedented research program to advance disease screening, diagnosis, and prognosis, pointing the way toward more effective, personalized therapies. With 40,000 genes packed into a single cell, changes to genes are like spelling mistakes in an instruction manual: some mistakes can be more harmful than others and some cause more serious health problems than others. Yet if scientists compare any two individuals’ genes, they’ll see that those genes are 99 percent identical.” It is small changes in genes that affect individuals.

“We’ve known the importance of genes for a long time,” said Dr Federman, “beginning in 1990 with the Human Genome Project that tried to describe all of the genes. That took ten years. Since then, it has become much less expensive to sequence a patient’s genes. This project is ambitious in trying to obtain blood from a million vets in the country,” he said.

Smaller studies have been undertaken in Great Britain and the United States, said Dr Federman, but the Million Veteran Program is of much broader scope. It is hoped that by studying the genes of one million veterans, researchers can better understand how tiny genetic changes impact health, and ultimately provide more highly personalized health care.

It is estimated that it will take up to seven years to collect the blood samples required from one million veterans and consolidate genetic, military exposures, health, and lifestyle information into one database. Authorized researchers in the future would then have access to the genetic information.

There are multiple reasons that veterans are the ideal population for this program. “The VA is a large organization and shares an advanced, common electronic medical records system already,” Dr Federman said, and veterans are people who have already displayed a willingness to help the country and to help other people.

“Veterans also provide a broad spectrum of ages and sexes now,” said Ms Anderson. “Pretty much, we are looking at veterans of the Vietnam era, a few World War II veterans, and we would expect to see some younger veterans from Iraq and Afghanistan,” she said.

“Future researchers will have access to these patients’ medical records from this research,” said Dr Federman. “They could see what genetic abnormalities the patient had and what happened to that person over his or her lifetime, linking certain genetic abnormalities to the outcome. If we have a million patients,” he said, “in the not too distant future, we may be able to check a person’s blood and run a genomic, which determines the genes you have and disease susceptibility.”

For example, said Dr Federman, the only way now to test for penicillin allergy is to administer penicillin and see if a person has a bad reaction. In the future, drawing blood could predict if penicillin was something to avoid.

The program is currently seeking volunteers to take part in the blood sample collection, said Dr Federman.

“It is really a very simple process,” Ms Anderson said, “consisting of two surveys, a face-to-face 20-minute induction into the study, and the blood draw of a small sample of blood.” Blood samples containing genetic material and health information are labeled with barcodes, and do not include names. They are stored in a secure manner. During the face-to-face meeting, any questions are answered, as well, said Ms Anderson.

Walk-ins are welcome. “We are located outside Firm A, Building 2, of the VA in West Haven. You must be a veteran to take part,” she said, “and you must be a veteran who is receiving health care at the VA. More information, or if someone wants to make an appointment, can be done by calling 866-441-6075,” she said.

Genetics And Disease

The Million Veteran Program is simply creating the database at this particular point, Ms Anderson emphasized. All information gathered is anonymous and confidential. “We will send out random newsletters to let them know what is going on with research as it happens, but this is not an individual assessment of genes or to provide specific patient care.”

“We are trying to find out what genetic differences lead to illness,” Dr Federman said. “We know now that at age 50, the risk of colon cancer goes up. But, there are people who may be prone to not getting colon cancer. Maybe they should have screening for pancreatic or kidney cancers instead. We would be able to individualize better in the future, we hope. This research may not be able to help our generation, but it may help our children, or our grandchildren,” he said. The ability to personalize care may mean lower medical costs, if unnecessary screenings are not done, or if disease is caught at an earlier stage.

With genetic information available, patients would know what to look for, said Ms Anderson, “Kind of a heads up.”

“I think that with diseases that are treatable or curable, patients would want to know,” said Dr Federman. “There are many contributors to health and disease. There is a complex interplay between genetic makeup and environmental exposures. [What we learn from this program] could help tease that out,” he said.

With the ability to compare DNA and genetic material of a million veterans, genetic research and better health care for veterans and others could be greatly advanced.

“We hope that veterans will hear about the Million Veteran Program and want to take part,” said Dr Federman. “We are seeking now to reach out and spread the word in Newtown and other area towns.”

More information about the Million Veteran Program is available at www.research.va.gov/mvp.