Gulf War Veterans

Members of Congress have raised concerns about whether Gulf War veterans have a higher risk of developing certain cancers because of their exposure to hazards in the Persian Gulf. GAO found that none of the data sources that provide information on the health characteristics of Gulf War veterans can be used to reliably estimate the incidence of tumors. Existing federal and state data systems are generally limited by poor coverage of the Gulf War veteran population and problems of reporting accuracy and completeness. The Defense Department (DOD) and the Department of Veterans Affairs (VA) have tried to improve the usefulness of these data systems but have not developed the capability to specifically address questions about tumors or other illnesses among Gulf War veterans. As a result, it is not known how many Gulf War veterans have tumors or whether they have a higher incidence of them than do other veterans. DOD and VA have recently funded research studies that should provide additional information on tumor cases. However, these studies are not the product of a systematic effort to study the incidence of tumors, and limitations will prevent the studies from providing reliable and valid estimates of tumors among Gulf War veterans.

GAO noted that: (1) none of the data sources that provide information on the health characteristics of Gulf War veterans can be used to reliably estimate the incidence of tumors; (2) VA's benefits information system can track the vital status and causes of deaths among Gulf War veterans; (3) however, not all cancers result in death and those that do may take several years to show up; (4) as a result, the system will underreport overall incidence; (5) DOD and VA maintain large hospitalization reporting systems; (6) however, a large majority of Gulf War veterans do not use DOD and VA hospitals and there has been little effort to determine whether this hidden population has health conditions similar to those of the population captured by the reporting systems; (7) DOD's reporting system also does not account for outpatient medical care; (8) VA has recently begun to fill this gap for its outpatient facilities, but it may take several years before consistent and reliable reporting is available; (9) a national cancer registry reports aggregate population rates and trends but cannot be used to track the Gulf War population; (10) DOD and VA health registries report information on the type of health problems Gulf War veterans have experienced at the time of their examination; (11) however, because not all veterans are examined, the information collected cannot be used to estimate the frequency of illnesses among all Gulf War veterans; (12) VA is conducting a national survey to study the general health status of Gulf War veterans; (13) the study uses representative samples of deployed and nondeployed veterans; (14) however, the response rate to the survey has been low and the study's sample size may be too small to assess any elevated incidence of most cancers; (15) DOD and VA have initiated efforts to improve the utility of these data systems but have not developed the capability to specifically address questions about tumors or other illnesses among Gulf War veterans; (16) as a result, it is not known how many Gulf War veterans have tumors or whether they have a higher incidence of them than other veterans; and (17) according to agency officials, no other plans aside from periodic assessments of mortality have been made to monitor tumor cases within this population.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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