Prostate cancer detection in veterans with a history of Agent Orange exposure

Purpose: Agent Orange, a chemical that was widely used in the Vietnam War a s a defoliant, is widely accepted as a health hazard but its potential caus ative role in prostate cancer has been controversial. We evaluated the rate of prostate cancer in veterans referred for prostate biopsy who reported a history of Agent Orange exposure compared to the rate in veterans who deni ed such exposure. Materials and Methods: A total of 400 consecutive veterans referred for pro state needle biopsy in a 30-month period completed a survey regarding Agent Orange exposure. Of these 400 patients 32 (8%) reported previous exposure to Agent Orange. From the remaining 368 patients who denied Agent Orange ex posure 3 consecutive age matched controls were selected per each patient re porting exposure for a total of 96 age matched controls. Prostate specific antigen, prostate cancer, cancer grade and length of cancer in the biopsy c ores were compared in Agent Orange exposed patients and unexposed controls. To determine whether the patient population referred for biopsy was skewed by proportionally more exposed and referred than unexposed patients those referred for biopsy were compared to the overall adult male veteran populat ion followed at the outpatient clinics at our facility. Results: Of the 32 Agent Orange exposed patients 13 (41%) had prostate canc er, while 33 of the 96 controls (34.4%) had cancer. There was no correlatio n of Agent Orange exposure with cancer (r = 0.06). There was also no statis tically significant difference in the 2 groups in regard to PSA (p = 0.90), cancer (p = 0.15), proportion of well differentiated cancers (p = 0.41) or length of cancer in the biopsy cores (p = 0.34). Compared with the total a dult male veteran population followed on an outpatient basis at our facilit y an average of 1.07% of those with a history of Agent Orange exposure were referred for prostate biopsy yearly versus 1.33% of unexposed patients. Conclusions: Agent Orange may have a role in the causation of some types of cancer but we identified no significant relationship of prostate cancer wi th Agent Orange exposure in patients referred for prostate biopsy.