There is a “significant” link between toxic exposures during military service and the prevalence of lung cancer among veterans, according to a study presented at the International Association for the Study of Lung Cancer (IASLC)’s 2024 World Conference on Lung Cancer, held recently in San Diego.
The study, led by researchers from Vanderbilt University and presented at the meeting highlights the need for veteran-specific screening guidelines that go beyond traditional factors like tobacco use and age.
Researchers used electronic health records from the Veterans Affairs (VINCI) and the Department of Defense (DaVINCI) to gather data on tobacco use and military exposures. The study included veterans who received care between January 1, 2022, and December 31, 2023 and included toxic exposures involving Agent Orange, Airborne Hazard/Burn Pit, Camp Lejeune, Radiation, Gulf War, and other unspecified exposures.
Veterans were categorized based on their tobacco use as having ever, never, or unknown, and then self-reported toxic exposures. Those who declined toxic exposure screening were excluded from the study. The researchers then stratified patients by toxic exposure status, tobacco use status, and age, and investigated the association between service branch and exposure. Logistic regression modeling was used to adjust for age, tobacco use status, and exposure status.
Key FindingsOut of 7,031,577 veterans who completed the toxic exposure screening, 2,132,015 (29.8%) tested positive for toxic exposure. The unadjusted prevalence of lung cancer was 1.6% in the overall cohort, with a slightly higher rate of 1.7% among veterans with any toxic exposure compared to 1.5% among those with no exposure.
The study revealed significant variations in lung cancer prevalence based on the type of toxic exposure. For instance, veterans exposed to Agent Orange had a lung cancer prevalence of 3.6%, while those exposed to Gulf War toxins had a prevalence of 0.9%. The median age also varied markedly across different exposure types. Marine veterans exposed to Agent Orange had the highest lung cancer prevalence at 3.8%, while Coast Guard veterans with Gulf War exposures had the lowest at 0.3%.
ImplicationsThe findings underscore the critical role of considering toxic exposure in lung cancer risk assessments for veterans. The study suggests that many veterans’ lung cancer risks exceed the PLCO (Prostate, Lung, Colorectal, and Ovarian) Cancer Screening Trial’s 1.6% cutoff, indicating a need for more comprehensive screening guidelines tailored to veterans’ unique risk profiles.
The researchers concluded that their findings not only shed light on the heightened cancer risks faced by veterans but also calls for immediate action to update screening protocols to better serve those who have served their country.
ReferenceMeyers P, Perkins A, Patel B, et al. Evaluating the Relationship Between Veteran Toxic Exposure Status and Lung Cancer Prevalence. Presented at the 2024 World Conference on Lung Cancer; September 7-10, 2024; San Diego, CA. Abstract P3.01.F.01. https://cattendee.abstractsonline.com/meeting/20598/Session/225
