Pd29-04 Association of Agent Orange Exposure and Prostate Cancer Incidence and Metastasis Among Vietnam Veterans Diagnosed and Treated in the Veterans Health Administration

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD29)1 May 2024PD29-04 ASSOCIATION OF AGENT ORANGE EXPOSURE AND PROSTATE CANCER INCIDENCE AND METASTASIS AMONG VIETNAM VETERANS DIAGNOSED AND TREATED IN THE VETERANS HEALTH ADMINISTRATION Ashley-Marie Green-Lott, Ananta Wadhwa, Anissa V. Nguyen, Lorna Kwan, Candace L. Haroldsen, Jeremy B. Shelton, Karim Chamie, Martin Schoen, Matthew Rettig, Kara N. Maxwell, and Isla P. Garraway Ashley-Marie Green-LottAshley-Marie Green-Lott , Ananta WadhwaAnanta Wadhwa , Anissa V. NguyenAnissa V. Nguyen , Lorna KwanLorna Kwan , Candace L. HaroldsenCandace L. Haroldsen , Jeremy B. SheltonJeremy B. Shelton , Karim ChamieKarim Chamie , Martin SchoenMartin Schoen , Matthew RettigMatthew Rettig , Kara N. MaxwellKara N. Maxwell , and Isla P. GarrawayIsla P. Garraway View All Author Informationhttps://doi.org/10.1097/01.JU.0001008736.23117.7f.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Agent Orange, a dioxin-containing herbicide used during the Vietnam War from 1962–1971, is a known carcinogen and presumptive causative agent of prostate cancer (PCa). Previous studies evaluating risk of PCa incidence and aggressiveness in veterans with self-reported Agent Orange exposure (AOE) have reported conflicting results. Here, we assembled a retrospective cohort of U.S. Vietnam veterans reporting exposure status during the military service period when Agent Orange was deployed to determine associations of AOE with PCa incidence and/or metastasis (synchronous and/or metachronous), when accounting for patient clinical characteristics in the diverse Veterans Affairs (VA) population. METHODS: In this population-based retrospective cohort study, male U.S. veterans receiving regular care in the VA healthcare system between 2005–2020, who were aged 17–25 when serving in Vietnam at the time Agent Orange was deployed (1962–1971), were identified in accordance with a VA central institutional review board approved protocol. Patient and clinical characteristics such as race/ethnicity, BMI, Charlson comorbidity index, tobacco use, first PSA age and value, and total PSA value prior to PCa diagnosis were compared between veterans with and without AOE. A Cox proportional hazards model permitted calculation of adjusted hazard rate (aHR) associated with AOE and PCa diagnosis, de novo metastatic disease, and metastatic progression. RESULTS: Of the 2.5 million veterans included in the analytic cohort, 759,779 (29%) reported AOE. After adjusting for race/ethnicity, tobacco use, and clinical covariates, veterans with AOE displayed a greater PCa incidence rate than those without exposure (aHR=1.17; 95% CI 1.14, 1.21). De novo metastatic PCa and metastatic progression rates were also higher in veterans reporting AOE (aHR=1.32; 95% CI 1.31, 1.34; aHR=1.30; 95% CI 1.29-1.31, respectively). CONCLUSIONS: This large, VA-wide retrospective cohort of Vietnam veterans at risk of PCa who served during the time Agent Orange was deployed validates previous studies demonstrating significant associations between AOE and PCa incidence/aggressiveness. Future studies evaluating the molecular, immunologic, and other biological mechanisms associated with AOE could yield insights related to PCa screening, diagnosis, and treatment. Source of Funding: National Institutes of Health K08CA215312, KNM; 5P50CA092131, R01 PAR-20-077, IPG); US Department of Defense (W81XWH211075, IPG; W81XWH-19-1-0435, KY); Prostate Cancer Foundation (PCF17CHAL04, PCF22CHAL02 IPG; 20YOUNG02, KNM; PCF19YOUN20, JS), Burroughs Wellcome Foundation (1017184, KNM); Basser Center for BRCA at the University of Pennsylvania (KNM); Jean Perkins Foundation (IPG), STOP Cancer Foundation (IPG), VA CSRD Merit Award POP-001 (IPG); Association of VA Surgeons Resident Research Award (85479, AYG) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e619 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ashley-Marie Green-Lott More articles by this author Ananta Wadhwa More articles by this author Anissa V. Nguyen More articles by this author Lorna Kwan More articles by this author Candace L. Haroldsen More articles by this author Jeremy B. Shelton More articles by this author Karim Chamie More articles by this author Martin Schoen More articles by this author Matthew Rettig More articles by this author Kara N. Maxwell More articles by this author Isla P. Garraway More articles by this author Expand All Advertisement PDF downloadLoading ...