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Head and Neck Surgery

(020) Agent Orange and Head and Neck Cancer: a Meta-Analysis

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Neil P. Monaghan, BS

    Clinical Research Fellow
    Medical University of South Carolina
    Charleston, South Carolina, United States

    • Co-Author(s)

  • Kelsey A. Duckett, BS

    Medical student, Clinical Research Fellow
    Medical University of South Carolina
    Charleston, SC, United States

  • SN

    Shaun A. Nguyen, MD, FAPCR

    Professor- Director of Clinical Research
    Medical University of South Carolina
    Charleston, South Carolina, United States

  • Jason G. Newman, MD

    Professor & Director, Division of Head & Neck Oncologic Surgery; Chief, Hollings Cancer Network
    Medical University of South Carolina
    Mount Pleasant, South Carolina, United States

  • AK

    Alexandra E. Kejner, MD

    University of Kentucky
    Lexington, Kentucky, United States

    • Senior Author(s)

  • WA

    William G. Albergotti, MD

    Medical University of South Carolina
    Charleston, SC, USA

Disclosure(s):
Neil P. Monaghan, BS: No relevant relationships to disclose.
Shaun A. Nguyen, MD, FAPCR: No relevant relationships to disclose.
Jason G. Newman, MD: No relevant relationships to disclose.


Introduction: Our objective was to assess the incidence and mortality of head and neck cancer (HNC) in patients exposed to Agent Orange and related dioxins.

Methods: The PubMed, CINAHL, and Scopus, and CINAHL databases were searched from inception to May 05, 2023. A Meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted.

Results: Of 1530 unique abstracts screened, 13 studies were included in the systematic review. Of
8,890,769 patients with reported sex, 92.7% were male. Of 160,449 with reported race, 83%
were white, 9.1% were black. 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 that died. Of those that were not exposed, oropharynx (0.13%) and larynx (0.16%) were the most common sites. On comparison of proportions between groups, HNC incidence of all subsites was significantly more common in those exposed to agent orange than in unexposed controls (Δ 0.06%; 95% CI, 0.04-0.08%, p< 0.0001), however, we do not appreciate a significant increase in frequency of any site-specific cancer among those exposed.

Conclusions: Our findings suggest that HNC overall is more common in those exposed to Agent Orange than those who are not, with most common sites including oral cavity and larynx. Further investigation is warranted to evaluate site-specific outcomes and risk given the limitations of our study design.