This story, part of a series of investigative reporting projects by Military.com on service member and veteran health, was supported by the Pulitzer Center. You can read our first story on missileer cancer worries here.
The Air Force has found some elevated rates of cancer among missileers, maintainers and other job positions responsible for handling U.S. intercontinental ballistic missiles, according to early and inconclusive results from a wide-ranging health study.
The early results, shared by the service and reported for the first time here, indicate elevated rates of breast and prostate cancers, but Air Force officials said more data and information is still needed before drawing conclusions. The service offered a glimpse into the initial findings of the ongoing study -- triggered by reports of high cancer rates among missileers -- when Air Force Global Strike Command briefed airmen on Feb. 23.
Missileers have suspected for years that work in ICBM facilities was causing cancer among airmen, and a grassroots effort recently began tracking and reporting the cases. The Air Force largely ignored the issue for the past two decades following assessments that downplayed any risk at the facilities, but it reversed course last year as cancer cases were made public by ordering the study and cleanup efforts at missile bases.
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"We are seeing in the data that breast and prostate cancers may be trending toward an increased incidence in the missile community, which mirrors some other nationally published data reviewing cancer incidents in the U.S. military more broadly," Charles Hoffman, an Air Force Global Strike Command spokesman, said in a statement.
The study is examining cancer rates among missileers, security forces, maintainers, facility managers and other career fields that may be at risk from exposure to carcinogens and toxins.
So far, the research has only looked at Defense Department records. The current phase of the study did not include data from Department of Veterans Affairs medical records, the DoD cancer registry or the VA cancer registry, according to an Air Force Global Strike Command memo.
It "captures fewer than 25% of total cancer cases" that will likely be found by the study, the memo said.
The initial data includes Department of Defense medical records from 2001 to the present, accounting for more than 2 million individuals. Of that number, officials found data covering roughly 84,000 missile community members, including 8,000 missileers.
It "is a limited slice of our population of interest," Air Force officials said, adding "notably, it does not capture cases seen outside the military system."
The data set used for the initial findings found 198 cancer cases in the missile community, including 13 cases of female breast cancer, 24 cases of prostate cancer and 23 cases of non-Hodgkin lymphoma in that cohort.
Military.com conducted a monthslong investigation into cancer among missileers that included government record requests, a two-day site visit to one of the nation's nuclear missile bases, and dozens of interviews with current and former Air Force missileers, as well as the relatives of some who have passed away.
That investigation found the U.S. government has overlooked evidence of cancer clusters for years. Two separate small studies of missileer cancer clusters in the early 2000s failed to recognize the growing problem in the community, with that lack of recognition making it difficult for some missileers to prove to the Department of Veterans Affairs that their illnesses were related to military service, a precursor to securing some benefits.
The military branches also appear to have failed to account properly for contaminants that have been linked to cancer for decades, particularly PCBs, which were detected last year at unsafe levels in some missile facilities during an initial round of environmental sampling.
Anecdotally, former missileers have been vocal about seemingly elevated rates of a variety of cancers, but particularly blood cancers such as non-Hodgkin lymphoma.
As of February, the nonprofit Torchlight Initiative, a grassroots organization of former missile community members, found that 87 -- or about 25% -- of the 347 registered cancer cases in their registry were blood cancers such as lymphoma, leukemia and myeloma. By comparison, 10% of cancer diagnoses in the U.S. are blood cancers, according to a fact sheet from Yale Medicine, the Ivy League university's medical school.
However, Air Force officials said that based on the limited findings, "we are not observing any increased rates of [non-Hodgkin lymphoma]" but added that more data is needed.
Many missileers who have been diagnosed with cancer have had difficulties applying for and receiving VA benefits. That is due, in part, to a large number of them not believing they were eligible. Some have been told their illness or injury was not connected to service or that their diagnosis occurred outside the military system with a private practice doctor long after separation.
"What is important to understand is that the epidemiology study is still nascent but progressing to eventually deliver responsible data to draw conclusions from at the end of the study," Hoffman said in an emailed statement. "We are not making assumptions based on these first results to keep integrity with the full epidemiology study."
Meanwhile, airmen were also told about a variety of policy changes during the Air Force Global Strike Command briefing last month. Service officials also shared findings from an additional round of environmental health studies examining exposure of a wide range of contaminants, such as asbestos, radon and polychlorinated biphenyls, or PCBs, at the nation's nuclear missile bases.
One of those changes will be to the maintainers and missileers manuals and technical orders, updating and explaining how to deal with toxins as well as how bases clean for carcinogens.
Air Force Global Strike Command Surgeon General Col. Gregory Coleman said "the next steps include creating standard PCB response procedures for any areas of concerns that may be identified in the future, establishing or updating Maintenance Technical Orders (TOs), establishing or updating bioenvironmental response checklists, establishing or updating Civil Engineering (CE) manuals, and refining Launch Facility (LF) sampling plans," according to a statement.
Last month's town hall also revealed the findings from a second round of environmental testing, comprising 2,400 additional samples at F.E. Warren Air Force Base in Wyoming, Malmstrom Air Force Base in Montana and Minot Air Force Base in North Dakota.
"All air, water and soil samples were below laboratory limits of detection or were within acceptable regulatory levels for any chemicals or hazards," Coleman said in a prepared statement to Military.com.
Missile Procedures Trainers, the devices that missileers use to learn and practice their mission, were also sampled at each base during the newest round of testing, and PCBs were not detected.
Notably, the Missile Alert Facilities where many PCBs were detected during last year's initial sampling were "not re-sampled as the persistent nature of PCBs does not change seasonally and cleaning efforts are still underway," Air Force Global Strike Command officials said in their presentation.
Air Force officials said Vandenberg Space Force Base in California, which does rocket launches and missile tests, is also being reexamined. In mid-February, air, water, radon and PCB sampling was done, and those results are currently being analyzed.
Launch facilities, called LFs, the underground areas where the ICBMs are held, are also being sampled at Vandenberg, which could "help inform further LF testing" at the missile wings, officials said in the presentation.
Related: They Stood Sentry over America's Nuclear Missile Arsenal. Many Worry It Gave Them Cancer.
