In this 2010 photo taken in Camp Taji, Iraq, bird flock around a tractor moving trash into a burn pit.

In this 2010 photo taken in Camp Taji, Iraq, bird flock around a tractor moving trash into a burn pit. Mayra Beltran / Houston Chronicle via Getty Images

A silent killer is stalking veterans of Iraq and Afghanistan

Cancer strikes GWOT vets at rates that recall Agent Orange. We’re not doing enough to support them.

On Dec. 9, the Air Force special operations community mourned Alan Yoshida, a combat controller who deployed with an Army Special Forces team into Afghanistan in the first days of the Global War on Terror in 2001. Yoshida, who spent years recovering from wounds sustained in an errant bomb strike, is remembered for developing safety technologies to protect his close air support colleagues. But he could not escape the silent killer that stalks so many GWOT veterans: cancer.

Yoshida’s story is far too common. While I was recently interviewing combat veterans for a forthcoming history on the War on Terror, two other service members from a small sample of sources notified me that they too were battling cancer: a British soldier who served in Iraq and Afghanistan spent this year undergoing treatment for lymphoma, and a German Army air controller with multiple Afghanistan rotations had just been diagnosed with prostate cancer. 

In fact, combat veterans of the post-9/11 wars are disproportionately affected by cancer. When the War on Terror officially ended on December 31, 2022, the Pentagon’s official count noted 3,965 U.S. service members had been killed in direct combat, while a further 1,180 died in incidents not directly related to combat (accidents, suicides, illnesses, and injuries). In total, our nation’s longest war claimed 5,145 service members, an average of 257 per year.

Yet between January and May of last year, 108 GWOT combat veterans are known to have died of cancer, according to researchers at the Hunter Seven Foundation. That’s nearly equivalent to the pace at which servicemembers died in combat during the war. And those 108 cases represent only the ones reported to the Foundation. An estimated two to three million U.S. service members were deployed in America’s post-9/11 wars, according to statistics collated by the National Library of Medicine. More than  500,000 have been diagnosed with some form of cancer since 2001

That is an inordinately high rate of cancer in an otherwise healthy cohort of individuals under 40 years old, according to a 2020 study in the Journal of Military Medicine, that suggested combat and other service-specific factors as possible causes.

And yet this quiet epidemic has gone largely unreported, sparking little action. The current silence is hauntingly similar to the indifference Vietnam veterans experienced following their service in Southeast Asia, which left more than 650,000 of them suffering from Agent Orange exposure and subsequent cancers and other exposure morbidities.

In the long fight to pass the 2022 PACT (Promise to Address Comprehensive Toxics) Act in Congress—which mandates health coverage for broad toxic exposures for GWOT and Gulf War veterans—it came to light that as recently as 2021 the Veterans Administration (VA) was denying 80 percent of Gulf War sickness claims. Until 2020, the VA was also denying nearly 80 percent of GWOT veterans’ claims of burn pit injuries.  After the passage of the PACT Act last year, the VA has processed some 843,500 claims related to burn pit and other toxic exposures, roughly an 80 percent acceptance rate for claims. 

Yet the passage of the PACT act is only an important first step. Congress and the federal government must be less reactive, and more preventive, in understanding and dealing with the causes of this insidious threat that is stalking our service members. In the long decades after 9/11, America’s combat veterans had our back. It’s past time that we had theirs.  

Ethan Brown is a Senior Fellow at the Center for the Study of the Presidency & Congress, and a former Air Force Joint Terminal Attack Controller (JTAC).