{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:13:50Z","timestamp":1785338030396,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"US Department of Veterans Affairs","doi-asserted-by":"publisher","award":["CSR&D W1810"],"award-info":[{"award-number":["CSR&D W1810"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000892","name":"Prostate Cancer Foundation","doi-asserted-by":"publisher","award":["PCFCHAL02"],"award-info":[{"award-number":["PCFCHAL02"]}],"id":[{"id":"10.13039\/100000892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Agent Orange exposure (AOE) is considered a presumptive cause of prostate cancer (PCa) in the Veterans Affairs (VA) population; however, cohort studies reported inconsistent associations of AOE and PCa incidence and outcomes. In this nationwide cohort study, Vietnam veterans who received VA care were evaluated for associations of AOE and PCa incidence and adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Vietnam veterans 17\u201325 years old during military service (1962\u20131971) who received VA health care between 2005 and 2020 were stratified by presumptive AOE assigned by the VA and followed until death from any cause or censoring on September 31, 2023. Multivariable Cox models permitted estimation of adjusted hazard ratios (aHRs) of AOE with PCa incidence, de novo metastasis (DNM), any metastasis, metastatic castration\u2010resistant PCa (mCRPC), all\u2010cause mortality (ACM), or PCa\u2010specific mortality (PCSM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2.6 million Vietnam veterans at risk for PCa, 779,472 (30%) had AOE. Compared to unexposed veterans, AOE veterans had higher PCa risk (aHR, 1.15; 95% confidence interval [CI], 1.15\u20131.16), higher DNM (aHR, 1.17; 95% CI, 1.16\u20131.17), any metastasis (aHR, 1.17; 95% CI, 1.16\u20131.17), mCRPC (aHR, 1.17; 95% CI, 1.16\u20131.17), ACM (aHR, 1.41; 95% CI, 1.41\u20131.42), and PCSM (aHR, 1.17; 95% CI, 1.16\u20131.17) in adjusted models. Sensitivity analyses suggested robustness of association between AOE and all\u2010cause mortality, but selection bias could explain associations with PCa outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Presumptive AOE was associated with higher PCa incidence, mortality, and adverse outcomes. Although associations may not be causal, AOE may predict worse PCa outcomes in the Veterans Affairs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70007","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T05:38:55Z","timestamp":1752903535000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prostate cancer incidence and outcomes among Vietnam veterans receiving care in the Veterans Health Administration"],"prefix":"10.1002","volume":"131","author":[{"given":"Ashley\u2010Marie Y.","family":"Green\u2010Lott","sequence":"first","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"},{"name":"Department of Urology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananta","family":"Wadhwa","sequence":"additional","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa V.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Urology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Urology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace L.","family":"Haroldsen","sequence":"additional","affiliation":[{"name":"University of Utah  Salt Lake City Utah USA"},{"name":"Veterans Affairs Salt Lake City Healthcare System  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy B.","family":"Shelton","sequence":"additional","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1892-4127","authenticated-orcid":false,"given":"Michael S.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Beenhouwer","sequence":"additional","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"},{"name":"Department of Medicine David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Chamie","sequence":"additional","affiliation":[{"name":"Department of Urology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"},{"name":"UCLA Jonsson Comprehensive Cancer Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-9552","authenticated-orcid":false,"given":"Brent S.","family":"Rose","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System  San Diego California USA"},{"name":"Department of Radiation Oncology University of California, San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara N.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Department of Medicine Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Corporal Michael J. Crescenz Veterans Affairs Medical Center  Philadelphia Pennsylvania USA"},{"name":"Department of Genetics Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G.","family":"Nickols","sequence":"additional","affiliation":[{"name":"Veterans Affairs Greater Los Angeles Healthcare System  Los Angeles California USA"},{"name":"Department of Urology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"},{"name":"UCLA Jonsson Comprehensive Cancer Center  Los Angeles California USA"},{"name":"Department of Radiation Oncology David Geffen School of Medicine at the University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9055-3538","authenticated-orcid":false,"given":"Kosj","family":"Yamoah","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology H. 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