Prostate Cancer Control and Survival in Vietnam Veterans Exposed to Agent Orange

Everly, Lydia; Merrick, G.S.; Allen, Zachariah A.; Butler, W.M.; Wallne, K.E.; Leif, J.H.; Galbreath, Robert W.; Adamovich, Edward

doi:10.1016/j.ijrobp.2008.06.1145

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Previous studies in cohorts of patients treated in the Veterans Affairs (VA) system, have found a slight decrease in age at diagnosis, higher incidence of stage IV disease and lower rates of biochemical control, but no differences in overall survival or other clinical outcomes. 17,30,31 We report here for the first time a clear association between Agent Orange exposure and prostate cancer diagnosis, metastasis and specific mortality among MVP participants. Additionally, it was not previously known how prostate cancer risks associated with Agent Orange exposure might interact with inherited risk.…”

Section: Discussionmentioning

confidence: 63%

Healthy lifestyle and prostate cancer risk in the Million Veteran Program

Pagadala

Lui

Lynch³

et al. 2022

Preprint

View full text Add to dashboard Cite

Prostate cancer risk is understood to be mostly unchangeable and inherited. Currently, the strongest known risk factors for developing prostate cancer are age, race/ethnicity, family history and some specific genetic elements. The impact of healthy lifestyle on prostate cancer survivorship is a research priority because of potential impact on quality of life, progression of disease, and tolerance to treatment. Several studies have identified an association between tobacco use, low physical activity, and obesity with increased risk of prostate cancer progression and prostate cancer-related death. Additionally, environmental exposure to carcinogens is known to increase cancer risk including Agent Orange, a chemical agent used in the Vietnam War (1955-1975). Recent studies suggest a healthy lifestyle can mitigate a high inherited prostate cancer risk and risk of lethal prostate cancer, as shown in a combined analysis of two cohorts of health professionals. In this study, we utilize data from over 870,000 participants in the Million Veteran Program (MVP) to investigate the association of modifiable, environmental, and other factors on prostate cancer risk in a diverse population when accounting for the common major inherited risk factors: race/ethnicity, family history, and polygenic risk. The healthy lifestyle score (Range 0-4) is tabulated using answers to 60 questions in the MVP database for each participant, with a point assigned for each of the following: not a current smoker, healthy weight (body mass index [BMI] ≥ 30), strenuous activity >4 days per week, and a healthier than average diet. In this cohort, race/ethnicity, family history were associated with higher prostate cancer risks. When accounting for race/ethnicity and family history of prostate cancer, Agent Orange exposure was an independent factor for prostate cancer diagnosis (HR 1.06, 95% CI 1.04-1.09). Healthy lifestyle score was associated with a lower risk of metastatic prostate cancer (HR 0.80, 95% CI 0.77-0.82) and of fatal prostate cancer (HR 0.81, 95% CI 0.76-0.85) in the MVP cohort. Importantly, healthy lifestyle score was independently associated with reduced metastatic (HR 0.90, 95% CI 0.87-0.93) and fatal prostate cancer (HR 0.89, 95% CI 0.83-0.96) when accounting for race/ethnicity, family history, and genetic risk (PHS290). We report that environmental exposures are independently associated with prostate cancer risk when accounting for major inherited risk factors (family history, ancestry, and polygenic risk). Adherence to a healthy lifestyle is associated with lower risk of prostate cancer and with lower risk of dying from prostate cancer, which offsets high inherited risk.

show abstract