Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Cancer Incidence in Korean Vietnam Veterans During 1992-2003: The Korean Veterans Health Study

  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Kwandong University College of Medicine)
  • Received : 2013.07.23
  • Accepted : 2013.09.23
  • Published : 2013.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The aim of this study was to investigate the association between Vietnam experience including exposure to military herbicides and cancer incidence in Korean Vietnam War veterans. Methods: The cancer cases of 185 265 Vietnam veterans from January 1, 1992 to December 31, 2003 were confirmed from the Korea National Cancer Incidence Database. The age-adjusted incidence and standardized incidence ratios (SIRs) were calculated using the male population during 1992 to 2003 as a standard population. Results: The age-adjusted overall cancer incidence per 100 000 person-years was 455.3 in Vietnam veterans. The overall cancer incidence was slightly yet significantly lower in veterans (SIR, 0.97; 95% confidence interval, 0.95 to 0.99) than in the general population. The overall cancer incidence in enlisted soldiers was not lower (SIR, 1.00), whereas that in officers was significantly lower (SIR, 0.87) than in the general population. The incidences of prostate cancer and T-cell lymphoma in all veterans, and lung cancer and bladder cancer in enlisted soldiers, and colon cancer and kidney cancer in non-commissioned officers, and colon cancer, kidney cancer, and prostate cancer in officers, were higher than in the general population. The SIR for overall cancer among Vietnam veterans rose from 0.92 for 1992-1997 to 0.99 for 1998-2003. Conclusions: The overall cancer incidence in Vietnam veterans was not higher than in the general male population. Vietnam veterans and military rank subcohorts experienced a higher incidence of several cancers, including prostate cancer, T-cell lymphoma, lung cancer, bladder cancer, kidney cancer, and colon cancer than the general population. The SIR for overall cancer increased over time in Vietnam veterans.

Keywords

References

  1. Institute of Medicine. Veterans and Agent Orange: update 2010. Washington, DC: National Academy Press; 2011, p. 7-10, 54-59.
  2. Stellman JM, Stellman SD, Christian R, Weber T, Tomasallo C. The extent and patterns of usage of Agent Orange and other herbicides in Vietnam. Nature 2003;422(6933):681-687. https://doi.org/10.1038/nature01537
  3. Young AL, Calcagni JA, Thalken CE, Tremblay JW. The toxicology, environmental fate, and human risk of herbicide Orange and Its associated dioxin. Brooks Air Force Base: USAF Occupational and Environmental Health Laboratory; 1978, p. I21-I25.
  4. Institute of Medicine. Veterans and Agent Orange: health effects of herbicides used in Vietnam. Washington, DC: National Academy Press; 1994, p. 84-107.
  5. Yi SW, Ohrr HC. Mortality patterns among Korean Vietnam veterans. Korean J Occup Environ Med 2011;23(3):279-286 (Korean).
  6. International Agency for Research on Cancer. Agents classified by the IARC monographs. Vol. 1-109 [cited 2013 July 20]. Available from: http://monographs.iarc.fr/ENG/Classification.
  7. National Toxicology Program. 2,3,7,8-Tetrachlorodibenzo-p-dioxin. Rep Carcinog 2011;12:396-398.
  8. Akhtar FZ, Garabrant DH, Ketchum NS, Michalek JE. Cancer in US Air Force veterans of the Vietnam War. J Occup Environ Med 2004;46(2):123-136. https://doi.org/10.1097/01.jom.0000111603.84316.0f
  9. Ketchum NS, Michalek JE, Burton JE. Serum dioxin and cancer in veterans of Operation Ranch Hand. Am J Epidemiol 1999; 149(7):630-639. https://doi.org/10.1093/oxfordjournals.aje.a009863
  10. Wilson EJ, Horsley KW, van der Hoek R. Cancer incidence in Australian Vietnam Veterans Study 2005. Canberra: Department of Veterans' Affairs; 2005, p. 79-105.
  11. Ward E, Jemal A, Cokkinides V, Singh GK, Cardinez C, Ghafoor A, et al. Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 2004;54(2):78-93. https://doi.org/10.3322/canjclin.54.2.78
  12. Ohrr H, Yi SW, Hong JS, Yi JJ, Kang HJ, Won JU, et al. An epidemiologic study on the adverse health effects of Agent Orange among Vietnam veterans. Seoul: Yonsei University Health System; 2006, p. 117-118 (Korean).
  13. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer incidence in five continents. Vol. IX. Lyon: International Agency for Research on Cancer; 2008, p. 40-44, 242-243.
  14. Rothman KJ, Greenland S. Modern epidemiology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1998, p. 260-264.
  15. Lynge E. Cancer incidence in Danish phenoxy herbicide workers, 1947-1993. Environ Health Perspect 1998;106 Suppl 2: 683-688. https://doi.org/10.1289/ehp.98106683
  16. Mikoczy Z, Rylander L. Mortality and cancer incidence in cohorts of Swedish fishermen and fishermen's wives: updated findings. Chemosphere 2009;74(7):938-943. https://doi.org/10.1016/j.chemosphere.2008.10.006
  17. Boehmer TK, Flanders WD, McGeehin MA, Boyle C, Barrett DH. Postservice mortality in Vietnam veterans: 30-year follow-up. Arch Intern Med 2004;164(17):1908-1916. https://doi.org/10.1001/archinte.164.17.1908
  18. Wilson EJ, Horsley KW, van der Hoek R. Australian Vietnam Veterans Mortality Study 2005. Canberra: Department of Veterans' Affairs; 2005, p. 69-91.
  19. Cypel Y, Kang H. Mortality patterns among women Vietnam-era veterans: results of a retrospective cohort study. Ann Epidemiol 2008;18(3):244-252. https://doi.org/10.1016/j.annepidem.2007.11.009
  20. Choi YH. Vietnam War. Seoul: Ministry of National Defence, Institute for National Defence and Military History; 2004, p. 168-171 (Korean).
  21. Kogevinas M, Becher H, Benn T, Bertazzi PA, Boffetta P, Bueno-de-Mesquita HB, et al. Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins. An expanded and updated international cohort study. Am J Epidemiol 1997;145(12):1061-1075. https://doi.org/10.1093/oxfordjournals.aje.a009069
  22. Steenland K, Piacitelli L, Deddens J, Fingerhut M, Chang LI. Cancer, heart disease, and diabetes in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. J Natl Cancer Inst 1999; 91(9):779-786. https://doi.org/10.1093/jnci/91.9.779
  23. Boffetta P, Mundt KA, Adami HO, Cole P, Mandel JS. TCDD and cancer: a critical review of epidemiologic studies. Crit Rev Toxicol 2011;41(7):622-636. https://doi.org/10.3109/10408444.2011.560141
  24. Fritz WA, Lin TM, Cardiff RD, Peterson RE. The aryl hydrocarbon receptor inhibits prostate carcinogenesis in TRAMP mice. Carcinogenesis 2007;28(2):497-505.
  25. Gupta A, Ketchum N, Roehrborn CG, Schecter A, Aragaki CC, Michalek JE. Serum dioxin, testosterone, and subsequent risk of benign prostatic hyperplasia: a prospective cohort study of Air Force veterans. Environ Health Perspect 2006;114(11): 1649-1654.
  26. Chamie K, DeVere White RW, Lee D, Ok JH, Ellison LM. Agent Orange exposure, Vietnam War veterans, and the risk of prostate cancer. Cancer 2008;113(9):2464-2470. https://doi.org/10.1002/cncr.23695
  27. Li CY, Sung FC. A review of the healthy worker effect in occupational epidemiology. Occup Med (Lond) 1999;49(4):225-229. https://doi.org/10.1093/occmed/49.4.225
  28. Clegg LX, Reichman ME, Miller BA, Hankey BF, Singh GK, Lin YD, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control 2009;20(4):417-435. https://doi.org/10.1007/s10552-008-9256-0
  29. Wolfe WH, Michalek JE, Miner JC, Rahe A, Silva J, Thomas WF, et al. Health status of Air Force veterans occupationally exposed to herbicides in Vietnam. I. Physical health. JAMA 1990; 264(14):1824-1831. https://doi.org/10.1001/jama.1990.03450140046032
  30. Nagel G, Linseisen J, Boshuizen HC, Pera G, Del Giudice G, Westert GP, et al. Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol 2007;36(1):66-76. https://doi.org/10.1093/ije/dyl275
  31. Gammon MD, Schoenberg JB, Ahsan H, Risch HA, Vaughan TL, Chow WH, et al. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 1997;89(17):1277-1284. https://doi.org/10.1093/jnci/89.17.1277
  32. Islami F, Kamangar F, Nasrollahzadeh D, Aghcheli K, Sotoudeh M, Abedi-Ardekani B, et al. Socio-economic status and oesophageal cancer: results from a population-based case-control study in a high-risk area. Int J Epidemiol 2009;38(4):978-988. https://doi.org/10.1093/ije/dyp195
  33. Mao Y, Hu J, Ugnat AM, Semenciw R, Fincham S; Canadian Cancer Registries Epidemiology Research Group. Socioeconomic status and lung cancer risk in Canada. Int J Epidemiol 2001;30(4):809-817. https://doi.org/10.1093/ije/30.4.809
  34. Joshi S, Song YM, Kim TH, Cho SI. Socio-economic status and the risk of liver cancer mortality: a prospective study in Korean men. Public Health 2008;122(11):1144-1151. https://doi.org/10.1016/j.puhe.2008.04.003
  35. Groome PA, Schulze KM, Keller S, Mackillop WJ, O'Sullivan B, Irish JC, et al. Explaining socioeconomic status effects in laryngeal cancer. Clin Oncol (R Coll Radiol) 2006;18(4):283-292. https://doi.org/10.1016/j.clon.2005.12.010
  36. Aarts MJ, Lemmens VE, Louwman MW, Kunst AE, Coebergh JW. Socioeconomic status and changing inequalities in colorectal cancer? A review of the associations with risk, treatment and outcome. Eur J Cancer 2010;46(15):2681-2695. https://doi.org/10.1016/j.ejca.2010.04.026
  37. Pesatori AC, Consonni D, Rubagotti M, Grillo P, Bertazzi PA. Cancer incidence in the population exposed to dioxin after the "Seveso accident": twenty years of follow-up. Environ Health 2009;8:39. https://doi.org/10.1186/1476-069X-8-39
  38. Jung KW, Won YJ, Park S, Kong HJ, Sung J, Shin HR, et al. Cancer statistics in Korea: incidence, mortality and survival in 2005. J Korean Med Sci 2009;24(6):995-1003. https://doi.org/10.3346/jkms.2009.24.6.995

Cited by

  1. Urinary Bladder Cancer in Dogs, a Naturally Occurring Model for Cancer Biology and Drug Development vol.55, pp.1, 2013, https://doi.org/10.1093/ilar/ilu018
  2. A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer vol.29, pp.10, 2013, https://doi.org/10.1007/s10654-014-9931-2
  3. Agent Orange exposure and cancer incidence in Korean Vietnam veterans: A prospective cohort study vol.120, pp.23, 2013, https://doi.org/10.1002/cncr.28961
  4. Challenges in investigating the association between Agent Orange and cancer: Site‐specific cancer risk and accuracy of exposure assessment vol.120, pp.23, 2014, https://doi.org/10.1002/cncr.28962
  5. Prospective Analysis of Health and Mortality Risk in Veteran and Non-Veteran Participants in the Women's Health Initiative vol.25, pp.6, 2013, https://doi.org/10.1016/j.whi.2015.08.006
  6. A Perspective Discussion on Rising Pesticide Levels and Colon Cancer Burden in Brazil vol.5, pp.None, 2013, https://doi.org/10.3389/fpubh.2017.00273
  7. Inhibitory effect of 2,4‐dichlorophenoxyacetic acid on ROS, autophagy formation, and mRNA replication for influenza virus infection vol.30, pp.8, 2017, https://doi.org/10.1002/jmr.2616
  8. Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies vol.16, pp.None, 2017, https://doi.org/10.1186/s12940-017-0336-z
  9. Cancer Incidence of Korean Veterans vol.43, pp.2, 2013, https://doi.org/10.21032/jhis.2018.43.2.119
  10. A systematic review and meta-analysis of occupational exposures and risk of follicular lymphoma vol.197, pp.None, 2013, https://doi.org/10.1016/j.envres.2021.110887
  11. Association between pesticide exposure and colorectal cancer risk and incidence: A systematic review vol.219, pp.None, 2013, https://doi.org/10.1016/j.ecoenv.2021.112327