Agent orange (AO) was a defoliate used extensively in the Vietnam War. It contained a possible carcinogen called TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin). AO exposure (AOe)has been linked to sarcoma, Hodgkin’s disease and non-Hodgkin’s lymphoma, with some evidence for respiratory cancers, prostate cancer (PCa) and multiple myeloma.
Early detection of PCa has not been especially successful using the prostate-specific antigen (PSA) test. Better tests are needed for screening of patients at high risk of cancer after exposure in Vietnam to AO contaminated with possibly carcinogenic dioxin.
This study consisted of an analysis of 2,270 Vietnam veterans with an initial prostate biopsy. Information was collected regarding risk factors for PCa and AOe. Government files were accessed regarding the AOe of each subject. The study results showed there was no difference in the BMIs of veterans with PCa and those without PCa. PCa was found in 32.9% of veterans referred for biopsy. Of the veterans, 7.5% were AOe. AOe was significantly associated with increased risk of PCa on biopsy compared to those without AOe. AOe veterans had a 74% increased risk of high grade PCa and were diagnosed at a younger age. AOe is predominantly associated with high-grade PCa. AOe could serve as a marker for those in whom biopsy would be more likely to diagnose PCa.
Of all the branches of the military the Marine Corps had the highest rate of AOe at 14.3%. By comparison, no correlation was seen in the frequency of PCa and any specific branch of the military.
CONCLUSION: People with a history of AOe have a 75% increased risk of having PCa on an initial biopsy. It may be useful to include AOe in the decision making-process of whether to do a prostate biopsy.