SCS AUA 2024: Should Veterans be Classified as High Risk for Prostate Cancer Screening: A Review of the Current Literature

(UroToday.com) The 2024 South Central AUA annual meeting included a session on prostate cancer, featuring a presentation by Dr. Gal Saffati discussing a systematic review regarding whether veterans should be classified as high risk for prostate cancer screening. Prostate cancer is a major concern as the most common non-skin cancer among U.S. males.


Veterans have a significantly higher prostate cancer incidence, affecting 1 in 5, compared to 1 in 8 in the general population. The AUA developed guidelines for prostate cancer, but they do not account for military personnel and veterans with unique risks due to their service. As such, the aim of this study presented at the 2024 South Central AUA annual meeting was to assess these risks, create awareness, and advocate for increased screening for veterans.

Google Scholar, PubMed, and Medline using the Ovid interface were searched for studies published between 1990 and 2023 investigating prostate cancer in veterans. Search terms included: “veteran”, “military”, “molecular markers”, “prostate cancer”, “prostate cancer risk”, and “military exposure” were used. Additional studies were identified from reference lists of included articles, were analyzed, and the data summarized. For studies that reported odds ratios or standardized incidence ratios of prostate cancer risk for a given exposure, a meta-analysis was conducted.

A total of 45 articles were included in the review:Google Scholar, PubMed, and Medline using the Ovid interface were searched for studies published between 1990 and 2023 investigating prostate cancer in veterans. Search terms included: “veteran”, “military”, “molecular markers”, “prostate cancer”, “prostate cancer risk”, and “military exposure” were used
Among 4 studies, Agent Orange was associated with increased odds of developing prostate cancer (OR 1.97, 95% CI 1.64, 2.37):Among 4 studies, Agent Orange was associated with increased odds of developing prostate cancer (OR 1.97, 95% CI 1.64, 2.37)
Cadmium is found in aircraft components, munitions, electrical equipment, paints, and welding materials. However, among 2 studies, cadmium was not associated with an increased incidence of developing prostate cancer (OR 1.03, 95% CI 0.96, 1.09):
Cadmium is found in aircraft components, munitions, electrical equipment, paints, and welding materials. However, among 2 studies, cadmium was not associated with increased incidence of developing prostate cancer (OR 1.03, 95% CI 0.96, 1.09):
Finally, among 6 studies, aromatic hydrocarbons (ie. benzene, styrene, toluene, xylene) were associated with increased odds of developing prostate cancer (OR 1.14, 95% CI 1.01, 1.28):
Finally, among 6 studies, aromatic hydrocarbons (ie. benzene, styrene, toluene, xylene) were associated with increased odds of developing prostate cancer (OR 1.14, 95% CI 1.01, 1.28):
Dr. Saffati concluded his presentation discussing a systematic review regarding whether veterans should be classified as high risk for prostate cancer screening with the following take-home points:

  • This review identified several exposures that significantly elevate prostate cancer risk
  • Military veterans should be further questioned about their exposures and potentially treated as a high risk screening group.
  • Further research is warranted to strengthen these associations, as the current evidence remains limited.

Presented by: Gal Saffati, Research Fellow, Baylor College of Medicine, Houston, TX

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2024 South Central American Urological Association (AUA) Annual Meeting, Colorado Springs, CO, Wed, Oct 30 – Sat, Nov 2, 2024.