Sunday, April 22, 2012

Higher Rates of Lung Cancer Among Gulf War, Other Veterans; Immediate Medical Research Funding Availability through CDMRP


Written by Anthony Hardie, 91outcomes.com

(91outcomes.com) - The Congressionally Directed Medical Research Program (http://CDMRP.army.mil) has announced research grant opportunities for the Lung Cancer Research Program.

The Fiscal Year 2012 (FY12) Defense Appropriations Act provided $10.2 million in research funding for the peer reviewed programs managed by the U.S. Department of Defense (DOD) office of Congressionally Directed Medical Research Programs (CDMRP). 

Funding is now for medical researchers interested in cutting edge research on lung cancer.  Studies have found that Lung Cancer affects Gulf War and other veterans at rates higher than their non-deployed and non-military service counterparts.  


Elevated Lung Cancer Among Gulf War, Other Veterans

A study of state cancer registry data published in April 2010 (Dr. Heather Young et al, Annals of Epidemiology) found the incidence of lung cancer to be substantially higher among Gulf War veterans than their non-deployed counterparts (adjusted proportional incidence ratios, 1.15; 95% confidence interval, 1.03−1.29).  

A closer look at this study's data (Figure 1) shows very large spikes of cancer diagnosis in 1993 and 1995-96, smaller spikes in 1999 and 2001, followed by a slow but steady increase from 2003-06 (the last year of study data) despite a correspondingly steady decrease in lung cancer rates among non-deployed Gulf War era veterans.  

Other studies have found higher rates of lung cancer associated with other military service.   According to the Lung Cancer Alliance, "One of the first studies to document disparity in lung cancer incidence and mortality was carried out by the VA in 1987 and indicated that former Marine ground troops in Vietnam died of lung cancer at a 58% higher rate than marines who did not serve in the war."


Early CT Lung Cancer Screening Saves Lives and Money - But VA is Far Behind in Implementing It

“We’ve known for years that our veterans are being diagnosed and dying of lung cancer at higher rates than civilians,” said Lung Cancer Alliance Board Chairman Admiral T. Joseph Lopez USN (Ret).

According to the Lung Cancer Alliance, lung cancer is the "leading cancer killer," and "accounts for 30% of all cancer deaths, and takes more lives each year than the next four biggest cancers - breast, prostate, colon and pancreatic cancers - combined."

However, there's not just doom and gloom.  Major national research efforts, including by the by the International Early Lung Cancer Action Program (I-ELCAP), have found that early CT ("CAT") scan screening for lung cancer can reduce mortality by more than 60 percent.  

In keeping with these powerful research recommendations and the recognition that veterans are at substantially higher risk than their non-military service counterparts, the nations largest veterans service organization continue to urge VA to implement CT lung cancer screening for veterans.  

The Independent Budget for Fiscal Years 2012 and 2013, authored by AMVETS, Disabled American Veterans (DAV), Paralyzed Veterans of America (PVA) and Veterans of Foreign Wars (VFW), include a section on the impact of lung cancer and urged that the VA set up pilot programs that would offer CT screening to veterans at high risk for lung cancer.  

In addition to substantially improving survival rates, detecting and treating lung cancer at early stage is far less expensive than late stage, says Lopez:  "Screening not only saves lives and money but enables those treated and cured to continue to lead productive lives."

To date, VA has not implemented these recommendations, continuing to rely solely on highly inefficient X-Rays even for veteran populations at very high risk for lung cancer like the Qarmat Ali cohort.  

Indeed, it is only through active Congressional intervention and direction that there is specific funding for Lung Cancer research at DoD.  

Meanwhile, the VA's FY13 budget recommendation has funding for general cancer research, and for "lung disorders" -- presumably respiratory disorders -- but there's no specific funding allocation for lung cancer and disappointingly not any specific mention of implementation of the early CT lung cancer screening recommended by the national VSO's.  


Lung Cancer Among 1991 Gulf War Veterans - Does Mustard Gas Play a Role in Increase Gulf War Lung Cancer Rates?

In January 2010, a study of Iranian veterans exposed to mustard gas during the 1981-88 Iran-Iraq Gulf War found that a single exposure to mustard was linked to resultant lung cancer.  Its authors concluded, "it is well documented that SM [sulfur mustard, mustard gas] can cause human lung cancer after long-term exposure, but there has not been strong and definitive evidence for only short-term and acute, single, high-dose exposure until now."

U.S and some Coalition troops were exposed to mustard gas during the 1991 Gulf War, including after U.S. troops detonated Iraqi munitions containing sarin, cyclosarin, and mustard at Khamisiyah, Iraq in the days following the end of fighting during the 1991 Gulf War. Prior to conclusive documentary evidence demonstrating the U.S. Central Intelligence Agency had advance knowledge of chemical munitions at this site, Pentagon officials denied any deployment of Iraqi chemical munitions into the theater of combat operations.  To date, the Pentagon has never admitted the presence of Iraqi chemical munitions at other alleged sites within the 1991 Gulf War combat theater.

Thousands of U.S. and coalition troops were also likely exposed to low levels of mustard and other chemical warfare agents during the 1991 Gulf War air bombing campaign that targeted Iraqi chemical warfare munitions production and storage facilities.  Investigations by the U.S. Senate Banking Committee, chaired by then-Senator Don Riegle (D-Mich.) found strong evidence of downwind dispersal of the chemical agents and subsequent fallout and troop exposure following coalition bombings.  Czech and other Coalition chemical warfare specialized troops' detection of chemicals during the 1991 Gulf War air bombing campaign added further evidence to these findings.  

Ground troops' reported detection of mustard and other chemical warfare agents during breach operations in southern Kuwait and other occasions during the 1991 Gulf War were repeatedly denied as accurate by Pentagon officials.  However, with little or no evidence to back up their claims and repeated occasions of conclusive evidence disproving Pentagon officials' claims, many Gulf War troops and Congressional officials never believed these denials.

Some U.S. troops have specifically claimed mustard gas detection and exposure, including in Congressional hearings -- and including this author.  One U.S. soldier, PFC Fisher, developed a confirmed mustard agent burn to his skin near the northwestern Kuwait-Iraq border.  Pentagon officials predictably downplayed this additional evidence that Iraqi forces did indeed deploy chemical munitions onto the battlefield.  

In April 2010, an Institute of Medicine committee concluded in its report that 250,000 of the approximately 697,000 U.S. veterans of the 1991 Gulf War suffer from chronic multisymptom illness, popularly known as Gulf War Illness.  They further concluded that the illness is a unique diagnostic entity, that it "cannot be reliably ascribed to any psychiatric condition," and that it also affects other U.S. forces.  

It remains unclear whether mustard gas may play a role in the demonstrated increased rates of lung cancer among U.S. veterans of the 1991 Gulf War, who were also exposed to a veritable toxic soup of environmental toxins and hazards.  However, it is clear that mustard and its resultant carcinogenity cannot be ruled out as an exposure and risk for thousands of potentially exposed Gulf War veterans.


Immediate Opportunity for Medical Research Funding

An announcement from the Congressionally Directed Medical Research Program last week provided the following information on lung cancer medical research funding opportunities:


---------- message ----------
From: communications@cdmrp.org <communications@cdmrp.org>Date: Wed, Apr 18, 2012 at 9:36 AM
Subject: JUST RELEASED! FY 2012 DOD LCRP Program Announcements
The Fiscal Year 2012 (FY12) Defense Appropriations Act provides research funding for the peer reviewed programs managed by the Department of Defense (DOD) office of Congressionally Directed Medical Research Programs (CDMRP).  
This e-mail is to notify the research community of the recently released funding opportunities from the Lung Cancer Research Program. Detailed descriptions of each of the funding opportunities, evaluation criteria, and submission requirements can be found in the respective Program Announcements. 
Each Program Announcement is available electronically for downloading from the Grants.gov website (http://www.grants.gov), and will be  available within 48 hours on the CDMRP website (http://cdmrp.army.mil/funding/prgdefault.shtml) and the CDMRP eReceipt System (https://cdmrp.org). 
 -----------------------------------------------------------------
Lung Cancer Research Program newly released Program Announcements: -          
  • Idea Development Award     
  • Translational Research Partnership Award       
  • Concept Award (Will be released at a later date around the beginning of June 2012)   
All current and previous funding opportunities are available on the CDMRP website (http://cdmrp.army.mil).

Subsequent notifications will be sent when additional funding opportunities are released. A listing of all CDMRP funding opportunities can be obtained on the Grants.gov website by performing a basic search using CFDA Number 12.420.
Please do not respond directly to this message.  To be added or removed from this email list please send an email to help@cdmrp.org.
  
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Additional information on Lung Cancer and Gulf War and other veterans:





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