Agent Orange Exposure and Bladder Cancer
Abstract
Scientific Objective and Rationale for the Proposed Project: There is extremely limited research to date that examines whether Agent Orange (AO) exposure and increases risk of bladder cancer (BC). Moreover, the limited data published is based upon very small series. In addition, while one study suggested AO may be linked with death BC, it was not controlled for major confounders such as smoking, which is very common among Vietnam Veterans (i.e., those potentially exposed to AO). As such, the true association between AO exposure and death from BC is unknown. This research proposal addresses BC (Topic Area), AO exposure (Focus Area) and death from BC (Focus Area). AO is a cancer producing agent (i.e., carcinogen) associated with other cancers. Since AO causes cancer and some prior research, while not specific for BC, has found some associations with BC, we believe AO exposure is associated with increased risk of BC and BC death compared to patients without AO exposure. We will use medical data from the largest health system in the country (the Veterans Affairs [VA] Health System) to develop the largest nationwide database to definitively answer the question: Does AO exposure lead to increased risk of BC and death from BC compared to no AO exposure? Principal Investigator’s (PI) Career Goals in Cancer Research: As a urology resident, Dr. Williams (PI) became interested in research centered around the delivery of care for patients with urological cancers. Dr. Williams participated in multiple studies using large patient databases analyzing trends in urological care, as well as evaluations of the quality of care provided to urological populations. Dr. Williams’ next stage in his career development, a Urologic Oncology fellowship, allowed him to apply his prior research experience specifically to the field of BC. Dr. Williams has knowledge in the basics of research including study design, primary data collection and manuscript preparation. Receipt of this award will ensure that he acquires the advanced research skills taking courses to be applied to this project including biostatistics, data management, and research design necessary to develop into an independent investigator and leader in identifying at-risk populations to target novel interventions to improve BC survival. The guidance/mentorship by Dr. Freedland and the entire professional development advisory committee will further reinforce Dr. Williams’ research development and bring his current and future research to the next level. At the conclusion of 3 years, Dr. Williams will have a BC research team with the largest database ever created to study AO and BC (with patient tissues) to successfully apply for further grant funding opportunities. Applicability of the Research: We will determine BC risk according to AO exposure. Using a large, nationwide VA group of patients, these results will be useful to anyone exposed to AO and especially to Vietnam Veterans and their families and have major policy implications regardless of our findings. We will also provide a comprehensive assessment of BC death according to AO exposure. Additional contributions will include insight to the challenges of facilitating BC care through identifying potentially at-risk patients (those exposed to AO) and improving their care. During the 3 years of the award, we expect to publish BC risk results within Years 1 and 2 with BC-specific mortality according to AO exposure results completed in Year 3. Benefit to Active Duty Service Members, Their Families, Veterans, and Other Military Beneficiaries: These results will establish the risk of BC according to AO exposure and help guide interventions (i.e., screening) directed at improving care among Service members, Veterans, and/or family members exposed to AO. The VA has established AO registry health exam clinics aimed at screening for AO-associated diseases of which BC screening could be easily implemented. Furthermore, if
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710576
Entities
People
- Stephen B Williams
Organizations
- United States Army
- University of Texas Medical Branch