Urologic Cancer Risks for Veterans Exposed to Agent Orange
Urologic Cancer Risks for Veterans Exposed to Agent Orange
In 2013, the American Cancer Society (ACS) is estimating that 238,590 new cases of prostate cancer will be diagnosed in the United States (U.S.) and that 29,776 men will die from the disease. Prostate cancer is the second-most common cancer in men, surpassed only by nonmelanoma skin cancers. Prostate cancer occurs more frequently in older men over 65 years of age and is rarely diagnosed before the age of 40. The average age at the time of diagnosis is 67 years. Prostate cancer is the second leading cause of cancer death in American men, and about 2.8% of those diagnosed will die of prostate cancer (ACS, 2013e).
Unfortunately, little is known about the definitive causes of prostate cancer. The research evidence reviewed by the IOM Committee for Veterans and Agent Orange (VAO) took great care to determine whether exposed veterans had increased mortality rates due to limited access to treatment (IOM, 1994).
There are few research studies involving Vietnam veterans and Agent Orange. Many existing studies involve subjects who were involved directly in either the manufacturing of the herbicides or in the application process. Additional information made available to the IOM committee responsible for biennial updates since 1996 has not changed the initial conclusion that there is limited or suggestive evidence of an association between Agent Orange exposure and prostate cancer (IOM, 2011).
For 2013, ACS (2013f) estimates that 7,920 men will be diagnosed with testicular cancer in the U.S. and that 370 men will die from the malignancy. Testicular cancer occurs more often in men under 40 years of age than it does in older men. Caucasian men are at four times greater risk as compared to African-American men. Cryp torch idism (undescended testes) is the leading risk factor. Heredity and environmental risk factors have been inconsistently linked in research studies (ACS, 2013f). Upon review of the evidence, the committee responsible for VAO concluded there is inadequate or insufficient information to make an association between Agent Orange exposure and testicular cancer (IOM, 2011).
Urinary bladder cancer often includes cancer of the urethra, paraurethral glands, and other unspecified cancers of the urinary tract, and is statistically the most common urinary tract cancer. For 2013, ACS (2013a) estimates 54,160 new cases of bladder cancer in men and 17,960 new cases of bladder cancer in women, expecting 15,210 deaths from bladder cancer overall, with about 10,820 male deaths and 4,390 femal deaths. Bladder cancer is the fourth ranked cancer in incidence in men in the U.S. (IOM, 2011).
Bladder cancer risk increases dramatically with age because it occurs mainly in older people. About 90% of individuals diagnosed with bladder cancer are over 55 years of age (ACS, 2013b). This age group coincides with the current age group of the vast majority of Vietnam veterans with Agent Orange exposure.
The most important known risk factor for bladder cancer is tobacco use, explaining approximately half of the bladder cancers in men and a third of the bladder cancers in women. Occupational exposure to aromatic amines and hydrocarbons used in the rubber, leather, textile, paint, and printing industries are also associated with higher bladder cancer incidence. Snails are known to contaminate lakes and ponds with the parasite Schistosoma haematobium in Asia and Africa, which causes the urinary bladder infection referred to as schistosomiasis. Urinary schistosomiasis affects many children and has been linked to bladder cancer in adults. This parasite has rarely been found in the U.S. (ACS, 2013b).
Based on current evidence, the IOM committee was unable to conclude that a link between Agent Orange exposure and bladder cancer exists. There is insufficient evidence to determine such an association (IOM, 2011).
Although the kidney, renal pelvis, and ureter have different characteristics, they are group ed together because they are all exposed to filterable chemicals that appear in urine as they pass through the urinary system (IOM, 1994). For 2013, ACS (2013c) estimates that 40,430 men and 24,720 women will be diagnosed with either renal cell carcinoma or transitional cell carcinoma of the renal pelvis. It is further predicted that about 13,680 people (8,780 men and 4,900 women) will die from this malignancy (ACS, 2013c). Renal cancer is twice as common in men as in women, with African-American men having the highest incidence. It is most commonly seen in individuals over 50 years of age (with the exception of Wilms tumor, which is a childhood carcinoma). Risk factors include tobacco exposure, excessive acetaminophen use, obesity, kidney stones, and occupational exposure to asbestos, cadmium, or organic solvents (ACS, 2013d). Firefighters have been determined to have a high occupational risk for renal cancer (IOM, 2011).
As is the case with bladder cancer, the IOM (2011) reports that the incidence for renal cancer increases with age. The peak age group is 65 to 69, followed by 60 to 64, and then by the 55- to 59-year-old age group. The overall incidence for renal cancer was 2% to 4% of new cancer diagnoses and 4% of annual cancer deaths in 2010 (IOM, 2011).
The IOM committee (2011) again reviewed the scientific evidence and concluded that there is inadequate or insufficient evidence to make an association between Agent Orange exposure and renal cancer.
Urologic Cancers – Veterans and Agent Orange Update 2010
Prostate Cancer
In 2013, the American Cancer Society (ACS) is estimating that 238,590 new cases of prostate cancer will be diagnosed in the United States (U.S.) and that 29,776 men will die from the disease. Prostate cancer is the second-most common cancer in men, surpassed only by nonmelanoma skin cancers. Prostate cancer occurs more frequently in older men over 65 years of age and is rarely diagnosed before the age of 40. The average age at the time of diagnosis is 67 years. Prostate cancer is the second leading cause of cancer death in American men, and about 2.8% of those diagnosed will die of prostate cancer (ACS, 2013e).
Unfortunately, little is known about the definitive causes of prostate cancer. The research evidence reviewed by the IOM Committee for Veterans and Agent Orange (VAO) took great care to determine whether exposed veterans had increased mortality rates due to limited access to treatment (IOM, 1994).
There are few research studies involving Vietnam veterans and Agent Orange. Many existing studies involve subjects who were involved directly in either the manufacturing of the herbicides or in the application process. Additional information made available to the IOM committee responsible for biennial updates since 1996 has not changed the initial conclusion that there is limited or suggestive evidence of an association between Agent Orange exposure and prostate cancer (IOM, 2011).
Testicular Cancer
For 2013, ACS (2013f) estimates that 7,920 men will be diagnosed with testicular cancer in the U.S. and that 370 men will die from the malignancy. Testicular cancer occurs more often in men under 40 years of age than it does in older men. Caucasian men are at four times greater risk as compared to African-American men. Cryp torch idism (undescended testes) is the leading risk factor. Heredity and environmental risk factors have been inconsistently linked in research studies (ACS, 2013f). Upon review of the evidence, the committee responsible for VAO concluded there is inadequate or insufficient information to make an association between Agent Orange exposure and testicular cancer (IOM, 2011).
Bladder Cancer
Urinary bladder cancer often includes cancer of the urethra, paraurethral glands, and other unspecified cancers of the urinary tract, and is statistically the most common urinary tract cancer. For 2013, ACS (2013a) estimates 54,160 new cases of bladder cancer in men and 17,960 new cases of bladder cancer in women, expecting 15,210 deaths from bladder cancer overall, with about 10,820 male deaths and 4,390 femal deaths. Bladder cancer is the fourth ranked cancer in incidence in men in the U.S. (IOM, 2011).
Bladder cancer risk increases dramatically with age because it occurs mainly in older people. About 90% of individuals diagnosed with bladder cancer are over 55 years of age (ACS, 2013b). This age group coincides with the current age group of the vast majority of Vietnam veterans with Agent Orange exposure.
The most important known risk factor for bladder cancer is tobacco use, explaining approximately half of the bladder cancers in men and a third of the bladder cancers in women. Occupational exposure to aromatic amines and hydrocarbons used in the rubber, leather, textile, paint, and printing industries are also associated with higher bladder cancer incidence. Snails are known to contaminate lakes and ponds with the parasite Schistosoma haematobium in Asia and Africa, which causes the urinary bladder infection referred to as schistosomiasis. Urinary schistosomiasis affects many children and has been linked to bladder cancer in adults. This parasite has rarely been found in the U.S. (ACS, 2013b).
Based on current evidence, the IOM committee was unable to conclude that a link between Agent Orange exposure and bladder cancer exists. There is insufficient evidence to determine such an association (IOM, 2011).
Renal Cancer
Although the kidney, renal pelvis, and ureter have different characteristics, they are group ed together because they are all exposed to filterable chemicals that appear in urine as they pass through the urinary system (IOM, 1994). For 2013, ACS (2013c) estimates that 40,430 men and 24,720 women will be diagnosed with either renal cell carcinoma or transitional cell carcinoma of the renal pelvis. It is further predicted that about 13,680 people (8,780 men and 4,900 women) will die from this malignancy (ACS, 2013c). Renal cancer is twice as common in men as in women, with African-American men having the highest incidence. It is most commonly seen in individuals over 50 years of age (with the exception of Wilms tumor, which is a childhood carcinoma). Risk factors include tobacco exposure, excessive acetaminophen use, obesity, kidney stones, and occupational exposure to asbestos, cadmium, or organic solvents (ACS, 2013d). Firefighters have been determined to have a high occupational risk for renal cancer (IOM, 2011).
As is the case with bladder cancer, the IOM (2011) reports that the incidence for renal cancer increases with age. The peak age group is 65 to 69, followed by 60 to 64, and then by the 55- to 59-year-old age group. The overall incidence for renal cancer was 2% to 4% of new cancer diagnoses and 4% of annual cancer deaths in 2010 (IOM, 2011).
The IOM committee (2011) again reviewed the scientific evidence and concluded that there is inadequate or insufficient evidence to make an association between Agent Orange exposure and renal cancer.
