Executive summary
Background
Perceived ill-health of Vietnam veterans and their families has been a public issue since 1978. Initially, the major concern was possible effects of exposure of Vietnam veterans to some herbicides (notably Agent Orange) used during the Vietnam conflict.
Two studies, of mortality among Vietnam veterans and of birth defects in their children, were commissioned by the Commonwealth Government in the early 1980s but did not find any effects attributable to the use of chemicals in Vietnam. The Royal Commission into the Use and Effects of Chemical Agents on Australian Personnel in Vietnam was established in 1983.
Dapsone was one of the chemicals reviewed by the Royal Commission. During the Vietnam conflict Australian forces had used this drug, initially for the treatment of falciparum malaria and later also for its prevention. The Royal Commission recommended studies into the carcinogenicity of dapsone. The recommendation was supported by the Hogg report, which was commissioned by the Commonwealth to coordinate its response to the findings of the Royal Commission.
The Department of Veterans' Affairs asked the Australian Institute of Health and Welfare (AIHW-then called the Australian Institute of Health) to conduct a study of cancer incidence in relation to dapsone use. A protocol, completed in November 1990, defined the study aims and design, dealing with data collection and analysis, limitations of the study, reporting, and privacy. This protocol was accepted by the Scientific Advisory Committee formed to advise the Minister for Veterans' Affairs on the study, the State and Territory cancer registries, and the AIHW Ethics Committee.