Bladder cancer occurs when some of the cells inside the bladder (often in the inner lining) become cancerous and start growing in an uncontrolled manner. The bladder is a hollow, flexible organ that is part of the body’s natural filtration system, along with the kidneys, urethra, and ureters. This system filters impurities and extra water from the blood to produce urine.1
How common is bladder cancer?
Bladder cancer is more common among men than women, and it affects older people more than younger. The mean age at diagnosis is 73. Bladder cancer represents 4.7% of all new cancer cases in the U.S.2 Overall the chance of developing this kind of cancer is 1 in 27 for men and 1 in 89 for women. However, the chance for any one person’s developing it depends on individual risk factors and exposures.3 The good news is that over the past 10 years, there has been a slight but consistent decline in the number of new bladder cancer cases.2
Agent Orange impact on health
What is Agent Orange?
During the Vietnam War, U.S. forces sprayed millions of gallons of plant-killing chemicals called herbicides to remove forest cover, kill crops, and clear vegetation from areas surrounding military bases. Some of these herbicides were unintentionally contaminated with small amounts of chemicals called dioxins. In 1970, dioxins were shown to cause birth defects in lab animals, and their use in Vietnam was stopped.4
Agent Orange and health problems
During the 1970s, returning veterans from Vietnam began to report problems, including skin rashes, cancers, birth defects in their children, and other health issues. Since then, a number of studies have been conducted to understand if there is a connection between Agent Orange exposure and various health concerns.4
Are there studies that connect Agent Orange and health problems?
To understand more about possible links between Agent Orange and cancer and other health outcomes, the Centers for Disease Control and Prevention (CDC), the US Air Force, and the Department of Veterans Affairs (VA) conducted studies in thousands of Vietnam veterans and other population groups exposed to dioxins. In 1991, Congress enacted the Agent Orange Act, giving the Department of Veterans Affairs the authority to designate certain diseases as caused by Agent Orange exposure. The same law required the National Academy of Sciences (then known as the Institute of Medicine) to review the most recent scientific studies every two years and to advise the Secretary of Veterans Affairs about the strength of the connection between Agent Orange exposure and various types of cancer and other health effects.5
The first study was published in 1994 and was titled “Veterans and Agent Orange.” The report categorized the connection between Agent Orange exposure and health outcomes according to the following framework:
Sufficient evidence of an association
Limited/suggestive evidence of an association
Inadequate/insufficient evidence to determine whether an association exists
Limited/suggestive evidence of no association
What is the connection between Agent Orange and bladder cancer?
Until 2014, the assessment of the medical community was that there was inadequate or insufficient evidence to determine whether an association exists between Agent Orange and bladder cancer. This was based on small studies that showed either no connection or inconclusive evidence connecting Agent Orange and bladder cancer.
However on March 10, 2016, the Institute of Medicine issued its updated report, which strengthened the relationship between Agent Orange and bladder cancer from “inadequate evidence” to “limited/suggestive evidence of an association.”6 The change was based on new evidence from two studies of male Korean War veterans who had served in Vietnam from 1964 until 1973. Results showed that while there was no increase in the rate of bladder cancer diagnosis, there were twice as many deaths attributed to bladder cancer among the high-exposure groups as there were in the low-exposure groups.7
VA policy on Agent Orange and bladder cancer
On November 1, 2017, the Secretary of Veterans Affairs David J. Shulkin announced that he is considering new presumptive conditions (conditions presumed to be related to a person’s service in the military) for qualification of disability compensation. Bladder cancer and other ailments whose connection to Agent Orange had been strengthened according to the most recent scientific report are thought to be under consideration for inclusion. This news came after months of review, and the delay in making a decision frustrated many in the community.7
Two veterans won appeals cases (in 2001 and 2006) claiming their bladder cancer was caused by Agent Orange, so it could be helpful to check with the VA and an experienced attorney if you were exposed to high levels of Agent Orange and have been diagnosed with bladder cancer.8
What is Bladder Cancer? American Cancer Society. Published May 23, 2016. Accessed March 16, 2018.
Key Statistics for Bladder Cancer. American Cancer Society. Published January 4, 2018. Accessed March 16, 2018.
Agent Orange and Cancer. American Cancer Society. Published August 14, 2017. Accessed March 16, 2018.
Agent Orange – Office of Public Health and Environmental Hazards. Department of Veterans Affairs. Published November. Archived from the original on March 7, 2012. Accessed March 16, 2018.
Resources for Veterans. Bladder Cancer Advocacy Network. Published September 20, 2017. Accessed March 16, 2018.
Veterans and Agent Orange: Update 2014. National Academies of Sciences, Engineering, and Medicine. 2016. Washington, DC: The National Academies Press. Accessed March 16, 2018.
Tom Philpott. After 18 months of study, VA delays adding new Agent Orange illnesses. Stars and Stripes. Published November 2, 2017. Accessed March 16, 2018.
Jennifer M. Taylor. Veterans & Bladder Cancer - Part I: Medical Breakdown of Veterans with Bladder Cancer. Patient Insight Webinars in the Veterans & Bladder Cancer Series. Bladder Cancer Advocacy Network. Published March 22, 2016. Accessed March 16, 2018.