By Special Operations Association of America.
Results from a study commissioned by the U.S. Special Operations Command (SOCOM) found that members of the special operations forces (SOF) community are facing cancer at a rate 18 percent higher than their conventional forces counterparts.
The Special Operations Association of America (SOAA) has long highlighted the health effects that SOF personnel experience due to exposures during intensive training and deployment cycles. These include exposures from suppressors that blow toxic particulates into operators’ faces, lead on weapons ranges and in Military Operations in Urban Terrain (MOUT) facilities, chemicals and pesticides in military foods, and weapons and explosives overpressure that can lead to traumatic brain injury, which has a range of second- and third-order health effects across body systems.
SOAA applauds SOCOM’s study, which demonstrates how cancers are impacting the SOF community. Like SOCOM, SOAA would like to see additional studies completed in the future to understand what drives these cancers, and how to treat them.
SOCOM’s Study
In September 2023, SOCOM requested that the Assistant Secretary of Defense for Health Affairs carry out an assessment of cancers affecting the SOF population, noting that the “unique” exposures they face in complex environments may subject them to “different risks of cancer than the general military population.”
The resulting study was carried out by the Armed Forces Health Surveillance Division (AFHSD) and the Department of Veterans Affairs (VA). Utilizing information from the Defense Medical Surveillance System, Department of Defense Cancer Registry, VA Corporate Data Warehouse, and VA Central Cancer Registry, the study outlined two study cohorts consisting of personnel who joined the service between 2001 and 2023
One cohort consisted of 231,733 SOF personnel. The second cohort consisted of 5,154,301 non-SOF personnel, including one specially delineated subset: the 1,613,934 non-SOF personnel who had deployed at least once for more than 30 days.
Across the cohorts, researchers investigated the incidents of all malignant cancers, as well as incidents of 14 specific cancers which were selected for particular study because of their commonality, “concern from advocacy groups, and prior case studies that demonstrated increased incidence in military populations.”
Results Show Increased SOF Cancer Risk
Researchers found that the SOF cohort experienced 2,105 cases of cancer, or 76.51 cases per 100,000. The cases included 49 distinct cancer types.
The non-SOF cohort experienced 30,191 cases of cancer, or 65.31 cases per 100,000.
For most cancers, the median and mean age at diagnosis were similar, or older, for the SOF cohort than the non-SOF cohort. This was not the case with prostate cancer diagnoses, for which the mean age at diagnosis was six years younger for SOF personnel, and with lung and bronchus cancer diagnoses, where the mean age was 3.6 years younger for SOF personnel.
In addition to the overall 18 percent increased risk of all cancers in the SOF cohort, the study found a 33 percent increased risk in melanoma of the skin and a 21 percent increased risk of testicular cancer in the SOF cohort compared with the non-SOF cohort.
The largest numbers of incident cases for SOF personnel were of testicular cancer (345 cases), melanoma of the skin (210 cases), and thyroid cancer (154 cases). For non-SOF personnel, testicular cancer (3,975), thyroid cancer (2,913), and melanoma of the skin (2,385) were the most prevalent cancers.
AFHSD surmised that “occupational exposure” to ultraviolet light through “frequent deployments, and the likelihood of being deployed to austere environments where access to appropriate sun protection may be limited” could explain the higher risk of melanoma found in the SOF cohort.
Because testicular cancer is “most common in males in their late 20s to early 30s,” AFHSD noted it was “not surprising that testicular cancer was the most frequent cancer diagnosis.” However, AFHSD also expressed that there is a need to explore the SOF cohort’s increased testicular cancer risk in future studies. They noted that most “known risk factors” are “not solely associated with serving in the Special Forces,” but could “include exposure to endocrine disrupting factors that are seen in firefighting and military occupations, and exposure to pesticides.”
Mortality Findings
Despite having a greater risk of cancer than their non-SOF peers, the AFHSD study found that SOF personnel had a 40 percent lower cancer mortality rate than non-SOF personnel.
Of the 2,173 deaths from any cause that the SOF personnel experienced, 103 occurred because of cancer, resulting in a cancer mortality rate of 3.96 deaths per 100,000. Brain and nervous system cancers, colon and rectum cancers, and leukemia accounted for the highest numbers of deaths due to cancers in the SOF cohort.
The cancer mortality rate for non-SOF personnel was determined to be 6.6 deaths per 100,000, or 5.86 deaths for 100,000 for the non-SOF deployed cohort.
Operators Vs. Enablers
To fulfill SOCOM’s request that they determine whether “assessed and selected SOF personnel” faced “distinct differences” compared with SOF support personnel, AFHSD compared cancer rates among SOF operator and enabler personnel. For the purposes of the study, AFHSD considered SOF personnel who had held an operator MOS for any length of time as an operator.
AFHSD found there were “no statistically significant differences by cancer type” between the SOF operator and enabler communities.
Sensitivity Studies
The study included several sensitivity analyses, one of which involved removing the restriction date on joining the military. This increased the number of individuals, and the ages of individuals, in each cohort. As a result, the cancer incidence rate “more than doubled” for SOF personnel and “more than tripled” for non-SOF personnel.
With the new parameters, researchers still found a 9 percent higher incidence rate of all cancers for SOF personnel compared to non-SOF personnel, a 22 percent increased risk of melanoma for SOF personnel, and a 13 percent increased risk of testicular cancer for SOF personnel.
The mortality rate for SOF personnel remained lower than both non-SOF cohorts with the increased service date parameters. The mean and median ages at diagnosis also remained lower for the SOF cohort for “all cancer types, except bone and joints and testicular cancer.”
Further Studies Needed
SOCOM’s latest study was a vast improvement over a prior 2016 study which used a problematic algorithm to assess the members of the SOF population and only examined service members’ cancer diagnoses during their time on active duty. As a result, the 2016 study only found SOF personnel to be at increased risk of bladder cancer.
Though vastly superior to the 2016 study, the current study did not answer all of the questions that SOCOM posed about cancer incidence in the SOF population. Because AFHSD could not “capture cancer encounters/diagnoses that occurred outside of the DOD and VA medical care that were not billed through TRICARE or the VA,” the study likely undercounted the total incidents of cancer in the populations they studied.
Additionally, AFHSD could not compare SOF and non-SOF personnel cancer rates with those of the civilian population because it would have “added up to 2 additional years” to the study completion timeline.
SOCOM also asked AFHSD to look for “identifiable trends, characteristics, exposures, or other factors” that could elevate SOF personnel’s cancer risks, and asked whether military health systems were equipped to “detect early cancer and provide holistic, integrated cancer care commensurate with national averages and treatment outcomes.” Neither of these questions was answered in the study.
Future Research
SOCOM and AFHSD’s work is an important first step in understanding that SOF personnel are facing increased cancers compared with their non-SOF cohorts. In the future, it is vital to continue conducting the research that SOCOM has suggested to understand what aspects of SOF service increase personnel’s risk of cancer, and how cancers can be detected and treated early. Continuing evaluations of cancer rates in the SOF, non-SOF, and civilian population are vital to track changes in populations over time.
Understanding which unnecessary exposures can keep SOF personnel in peak physical condition as they operate worldwide is vital. Equally important is gaining information about which exposures can help them maintain physical health after they leave the service.
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This article was provided by the Special Operations Association of America (SOAA). A non-profit organization, SOAA avocates for the special operations community, from the front lines to the halls of Congress. https://soaa.org/
USSOCOM Report: Study on the Incidence and Prevalence of Malignant Cancers Among U.S. Special Operations Forces, produced by the Armed Force Health Surveillance Division, Defense Health Agency, November 2025, PDF, 41 pages.
The report can be read online or downloaded at this link.