Agent Orange as a risk factor for high-grade prostate cancer

Area of Science:

• Environmental Health
• Oncology
• Urology

Background:

• Agent Orange exposure (AOe) is a suspected risk factor for prostate cancer (PCa).
• The specific association between AOe and lethal or high-grade PCa remains unclear.
• This study investigated the link between AOe and high-grade PCa (HGPCa) detection in US veterans.

Purpose of the Study:

• To determine if Agent Orange exposure increases the risk of detecting high-grade prostate cancer (HGPCa) on biopsy.
• To assess the association between AOe and overall PCa, HGPCa, and low-grade PCa (LGPCa) detection.

Main Methods:

• Retrospective analysis of clinicodemographic and laboratory data from 2720 veterans undergoing initial prostate biopsy.
• Multivariate logistic regression was used to estimate risk associated with AOe.
• Separate models assessed the risk of PCa, HGPCa (Gleason score ≥7), and LGPCa (Gleason score ≤6).

Main Results:

• Agent Orange exposure (AOe) was linked to a 52% increased risk of overall PCa detection.
• AOe did not significantly increase the risk of low-grade PCa (LGPCa).
• A 75% increased risk of high-grade PCa (HGPCa) was observed in AOe-exposed veterans, with a 2.1-fold increase for Gleason scores ≥8.

Conclusions:

• The increased risk of prostate cancer associated with Agent Orange exposure is primarily driven by high-grade disease.
• These findings support the need for enhanced prostate cancer screening protocols for Vietnam-era veterans.
• Agent Orange exposure is significantly associated with aggressive prostate cancer detection.