To assess the unique risks of prostate cancer among U.S. veterans, and to advocate for improved care by raising awareness of the gaps in current AUA guidelines that do not address the specific needs of military personnel and veterans.
Ovid interface, Google Scholar, PubMed, and Medline were searched for studies investigating prostate cancer in veterans published between 1975 and 2023. Search terms: "veteran", "military", "molecular markers", "prostate cancer", "prostate cancer risk", and "military exposure" were used. Articles meeting inclusion criteria underwent analysis, data synthesis, and meta-analysis where applicable.
Results from forty-five articles indicate a significant increase in prostate cancer risk associated with exposure to Agent Orange (OR 1.97 [95% CI: 1.64 - 2.37], p < 0.00001), aromatic hydrocarbons (OR 1.14 [95% CI: 1.01 - 1.28], p = 0.03), and a slight increase with cadmium exposure (OR 1.03 [95% CI: 0.96 - 1.09], p = 0.42). While some evidence suggests an association between Camp Lejeune and prostate cancer risk in retrospective cohort studies, logistical regression analysis study did not entirely substantiate this relationship.
This review identifies several exposures that elevate prostate cancer risk. Military veterans should be further questioned about their exposures and potentially treated as a high-risk screening group. Further research is warranted to strengthen these associations, as the current evidence remains limited.
Urology. 2024 Oct 17 [Epub ahead of print]
Shane Kronstedt, Cedrick B Chiu, Eric Wahlstedt, Jackson Cathey, Gal Saffati, Daniela Orozco Rendon, David E Hinojosa-Gonzalez, Aly Alrabaa, Jeffrey A Jones
Scott Department of Urology, Baylor College of Medicine, 7200 Cambridge St., Floor 10, Suite C, Houston, TX 77030, USA. Electronic address: ., UMass Chan Medical School, 364 Plantation St., Worcester, MA 01605, USA., University of Kentucky College of Medicine, 780 Rose St MN 150, Lexington, KY 40506, USA., Duke University, Durham, NC, USA., Scott Department of Urology, Baylor College of Medicine, 7200 Cambridge St., Floor 10, Suite C, Houston, TX 77030, USA., University of Houston, 4302 University Dr, Houston, TX 77004, USA., Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.