Exposures and Bladder Cancer Risk Among Military Veterans: A Systematic Review and Meta-analysis.

To investigate potential carcinogenic exposures in military personnel that are implicated in the development of bladder cancer.

This systematic review aimed to evaluate the association between specific military exposures and bladder cancer risk among veterans.

PubMed, Scopus, and Ovid MEDLINE databases were searched in December 2023 for relevant articles. Inclusion criteria comprised retrospective cohort studies, reviews, and observational studies documenting bladder cancer incidence among military populations exposed to specific agents. A total of 25 studies, involving 4,320,262 patients, met the inclusion criteria. Data extraction followed PRISMA guidelines, and a random-effects model was used for data synthesis.

The meta-analysis revealed significant associations between exposure to Agent Orange (HR 1.17 [95% CI: 1.01-1.36], p < 0.00001) and depleted uranium (HR 2.13 [95% CI: 1.31-3.48], p = 0.002) with increased bladder cancer risk among veterans. Contaminated drinking water showed a trend towards increased risk (HR 1.25 [95% CI: 0.97-1.61], p = 0.08).

The findings suggest a possible association between specific military exposures and heightened bladder cancer risk among veterans, emphasizing the necessity for targeted screening protocols and preventive measures. Further research is essential to identify specific carcinogenic agents and prevalence of exposures among veterans, enabling more effective prevention and management strategies.

Urology. 2024 Aug 15 [Epub ahead of print]

Shane Kronstedt, Jackson Cathey, Cedrick B Chiu, Gal Saffati, David E Hinojosa-Gonzalez, Nikola Rakic, Sagar R Patel, Gabrielle Lyon, Neel Srikishen, Jennifer M Taylor, Jeremy Slawin, Jeffrey A Jones

Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: ., Duke University School of Medicine, Durham, NC 27710. Electronic address: ., UMass Chan Medical School, Worcester, MA, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. Electronic address: ., Young Medical PC. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA. Electronic address: ., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA. Electronic address: .

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