Cancer in Vietnam veterans

The use of Agent Orange and other herbicides in Vietnam by the U.S. military has garnered much controversy over the past 40 years, despite the existence of many epidemiologic studies about the health effects of serving in Vietnam. Unfortunately, many of these studies have limitations such as no detailed exposure information, selection bias, or information bias. This study sought to improve upon other studies\u27 limitations by probabilistically linking a comprehensive list of male Vietnam veterans to population-based mortality (1979-2003) and cancer incidence (1995-2003) registries of Texas male residents born between 1912 and 1958. This study examined the association of military service in the Vietnam theater and cancer in Texas male residents in two nested case-control studies (mortality and incidence), comparing specific cancer sites to colorectal cancer controls. Mortality and morbidity odds ratios (MOR) and 95% confidence intervals (CI) were calculated using logistic regression, adjusting for age, race and Hispanic ethnicity. No information was available for other potential confounders, such as smoking and alcohol consumption. In 2003, Vietnam veterans showed increased incident nasal and nasopharyngeal cancer (MOR: 3.56, CI: 1.75-7.23), Hodgkin\u27s disease (MOR: 2.11, CI: 1.13-3.94), bone and joint cancer (MOR: 1.72, CI: 0.60-4.90), oral cancer (MOR: 1.34, CI: 1.02-1.75), prostate cancer (MOR: 1.39, CI: 1.17-1.64), liver cancer (MOR: 1.53, CI: 1.12-2.09), pancreatic cancer (MOR: 1.43, CI: 1.04-1.98), testicular cancer (MOR: 1.37, CI: 0.53-3.52) and chronic lymphocytic leukemia (CLL) (MOR: 1.25, CI: 0.76-2.05) compared to non-Vietnam veteran Texas residents after adjustment for confounders. Smaller increased effects of service in the Vietnam theater on respiratory system cancers, bladder cancer, renal cancer, esophageal cancer, and stomach cancer would likely be severely reduced or eliminated if it had been possible to control for smoking. Protective effects of service in Vietnam were seen for multiple myeloma, male breast cancer, male genital system cancer other than prostate, and all leukemias combined, excluding CLL. Similar results were seen in analyses of 1995-2003 incidence and mortality data. There were no obvious patterns of increased cancer mortality by branch of service or pay grade.