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8 Jul 2014

VA rejects link between Gulf War service and cancers

US Army Soldiers with Mask
Soldiers with the U.S. Army's 7th Corps huddle in a bunker in eastern Saudi Arabia with gas masks and chemical suits just after U.S. planes started bombing Iraq on Jan. 18, 1991, during the Persian Gulf War.
WASHINGTON — The Department of Veterans Affairs has rejected a request from members of Congress and veterans advocates to make brain cancer, lung cancer and migraines presumptive conditions for Gulf War veterans. Officials said they cannot prove the high rate of these illnesses among Gulf War vets are related to military service.

#VA officials said the number of brain cancer deaths for troops exposed to sarin gas was too low to be conclusive, though it was double the rate of troops not exposed.

And the rate of lung cancer deaths, though 15% higher than those who did not serve in the 1991 Gulf War, is "inconclusive" because researchers did not know how many of the servicemembers smoke.

"I'm disappointed with their decision, but hold out hope that further studies will convince the VA," Rep. Timothy Walz, D-Minn., told USA TODAY. "We must ensure our brave veterans get the care they need, and this is part of that effort."

If a veteran is diagnosed with a presumptive condition, Veterans Affairs is required to assume that it is military-connected, and that the veteran is then entitled to medical or disability benefits associated with the diagnosis.
Those exposed to smoke after oil wells were set on fire in Iraq, as well as to sarin gas after the U.S. bombed a munitions plant in Khamisayah, Iraq, saw an increased risk of brain cancer, according to a study Rep. Mike Coffman, R-Colo., and Walz cited in letters to former VA secretary Eric Shinseki in March.

As many as 100,000 troops may have been exposed to sarin, a nerve agent, according to the Defense Department, but a recent study shows more may have been affected.

Gulf War vets also saw a "significant relative excess" of lung cancer, according to a second study. And a third study showed that veterans with chronic fatigue syndrome or Gulf War Illness were likely to also suffer migraines, the lawmakers wrote.

"I am very interested in your opinion of whether the studies enclosed are sufficient to add these three health problems to the list of presumptives related to Gulf War Illness," Coffman wrote in March. "If you believe they are not, please detail the VA's current and planned efforts related to these three problems."

Robert Jesse, VA's acting undersecretary for health, turned down the request, saying that the Institute of Medicine found "inadequate and insufficient evidence" for an association between Gulf War service and the diseases.

"IOM stated that there 'is no consistent evidence of a higher overall incidence of cancer in veterans who were deployed to the Gulf War than in non-deployed veterans,'" Jesse wrote in a letter to Walz.

Ron Brown, president of the National Gulf War Resource Center, said the official response flies in the face of VA's own research.

"What they've done is used the overall population of deployed veterans during Desert Storm," he said. "If you use the whole population, it does not show an increase of cancers, but if you look at Khamisiyah, there are significant increases of cancers."

A 2007 Institute of Medicine study found that, though the number of cases was small, the brain cancer death rate for servicemembers in the sarin-gas exposure zone was twice as high as for servicemembers outside it, according to the American Journal of Public Health. For unexposed soldiers, the brain cancer death rate from 1991 to 2000 was 12 per 100,000. For those near Khamisiyah, the rate was 25 per 100,000.

Jesse said, in his letter, that there had been "little previous evidence" of a connection between sarin and brain cancer.

According to a VA website about the study, "Controlling for oil well fire smoke exposure, Army Gulf War veterans who were potentially exposed to nerve agents at Khamisiyah had a higher mortality rate from brain cancer compared to Army veterans who were not considered exposed."

Victoria Davey, VA's chief officer of public health, wrote in a letter to Brown that there was a 15% "excess risk of lung cancer" associated with Gulf War deployment, but said that study was inconclusive because the researchers didn't know whether the servicemembers were smokers. She wrote that there was a concern because about 5% more Gulf War veterans smoked than did veterans who did not deploy.

According to the American Cancer Society, the average age of someone who smokes who is diagnosed with lung cancer is 70. Fewer than 2% of all cases are found in people younger than 45. According to VA, the average age of a Gulf War veteran is 44.

Gulf War veterans already have presumptive status for chronic fatigue syndrome, fibromyalgia, gastrointestinal disorders, and undiagnosed illnesses that include weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders and sleep disturbances, according to VA.

Data recently released by the VA show that 80% of disability claims filed by Gulf War veterans for conditions related to the war were denied.

"This is nothing new," Brown said. "Our veterans have been fighting for 23 years to get the benefits they've earned." USA Today

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