Agent Orange and head and neck cancer: A systematic review and meta‐analysis

Abstract Objective To assess the incidence of head and neck cancer in patients exposed to Agent Orange and related dioxins. Methods Studies were identified through CINAHL, PubMed, and Scopus. Primary studies were identified through April 2023. Articles were included reporting incidence of head and n...

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Main Authors: Neil P. Monaghan, Kelsey A. Duckett, Shaun A. Nguyen, Jason G. Newman, Alexandra E. Kejner, W. Greer Albergotti
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:World Journal of Otorhinolaryngology-Head and Neck Surgery
Subjects:
Online Access:https://doi.org/10.1002/wjo2.198
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author Neil P. Monaghan
Kelsey A. Duckett
Shaun A. Nguyen
Jason G. Newman
Alexandra E. Kejner
W. Greer Albergotti
author_facet Neil P. Monaghan
Kelsey A. Duckett
Shaun A. Nguyen
Jason G. Newman
Alexandra E. Kejner
W. Greer Albergotti
author_sort Neil P. Monaghan
collection DOAJ
description Abstract Objective To assess the incidence of head and neck cancer in patients exposed to Agent Orange and related dioxins. Methods Studies were identified through CINAHL, PubMed, and Scopus. Primary studies were identified through April 2023. Articles were included reporting incidence of head and neck cancer and/or deaths due to head and neck cancer in participants exposed to Agent Orange. Meta‐analysis of proportions was conducted to calculate incidence and mortality by primary site in those who were exposed to Agent Orange and for control groups. A comparison of proportions was used to compare rates in exposed and control groups. Results Of 1530 unique abstracts screened, 13 studies were included in the systematic review. Of the exposed patients with reported subsites, oral cavity (31.2%), and larynx (14%) were the most common. Of the exposed patients with reported deaths and subsites, oropharynx (0.25%) was the most common primary site in patients who died. The most common subsites of those who were not exposed, oropharynx (0.13%), and larynx (0.16%). Head and neck cancer of all subsites was more common in those exposed to Agent Orange than in unexposed controls (difference 0.061%; 95% confidence interval: 0.04%–0.08%, p < 0.0001). Conclusions Our findings suggest that head and neck cancer is more common in those who were exposed to Agent Orange than those who were not. Additionally, individuals exposed to Agent Orange were more likely to die from head and neck cancer. Further investigation is warranted to evaluate subsite‐specific outcomes given the limitations of our study design.
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spelling doaj-art-441e7ea6d5ca4e1e8cc9428cf824ddc02025-08-20T02:58:38ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812025-03-0111113814610.1002/wjo2.198Agent Orange and head and neck cancer: A systematic review and meta‐analysisNeil P. Monaghan0Kelsey A. Duckett1Shaun A. Nguyen2Jason G. Newman3Alexandra E. Kejner4W. Greer Albergotti5Department of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USADepartment of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USADepartment of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USADepartment of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USADepartment of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USADepartment of Otolaryngology—Head and Neck Surgery Medical University of South Carolina Charleston South Carolina USAAbstract Objective To assess the incidence of head and neck cancer in patients exposed to Agent Orange and related dioxins. Methods Studies were identified through CINAHL, PubMed, and Scopus. Primary studies were identified through April 2023. Articles were included reporting incidence of head and neck cancer and/or deaths due to head and neck cancer in participants exposed to Agent Orange. Meta‐analysis of proportions was conducted to calculate incidence and mortality by primary site in those who were exposed to Agent Orange and for control groups. A comparison of proportions was used to compare rates in exposed and control groups. Results Of 1530 unique abstracts screened, 13 studies were included in the systematic review. Of the exposed patients with reported subsites, oral cavity (31.2%), and larynx (14%) were the most common. Of the exposed patients with reported deaths and subsites, oropharynx (0.25%) was the most common primary site in patients who died. The most common subsites of those who were not exposed, oropharynx (0.13%), and larynx (0.16%). Head and neck cancer of all subsites was more common in those exposed to Agent Orange than in unexposed controls (difference 0.061%; 95% confidence interval: 0.04%–0.08%, p < 0.0001). Conclusions Our findings suggest that head and neck cancer is more common in those who were exposed to Agent Orange than those who were not. Additionally, individuals exposed to Agent Orange were more likely to die from head and neck cancer. Further investigation is warranted to evaluate subsite‐specific outcomes given the limitations of our study design.https://doi.org/10.1002/wjo2.198Agent Orangehead and neck cancerVietnam ConflictVietnam War
spellingShingle Neil P. Monaghan
Kelsey A. Duckett
Shaun A. Nguyen
Jason G. Newman
Alexandra E. Kejner
W. Greer Albergotti
Agent Orange and head and neck cancer: A systematic review and meta‐analysis
World Journal of Otorhinolaryngology-Head and Neck Surgery
Agent Orange
head and neck cancer
Vietnam Conflict
Vietnam War
title Agent Orange and head and neck cancer: A systematic review and meta‐analysis
title_full Agent Orange and head and neck cancer: A systematic review and meta‐analysis
title_fullStr Agent Orange and head and neck cancer: A systematic review and meta‐analysis
title_full_unstemmed Agent Orange and head and neck cancer: A systematic review and meta‐analysis
title_short Agent Orange and head and neck cancer: A systematic review and meta‐analysis
title_sort agent orange and head and neck cancer a systematic review and meta analysis
topic Agent Orange
head and neck cancer
Vietnam Conflict
Vietnam War
url https://doi.org/10.1002/wjo2.198
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