A small initial study highlighted a “significant link” between the disease and “exposure to certain explosives”.
The research was sparked by the experience of Gareth Collett, a retired British Army brigadier and former head of UK bomb disposal, who was diagnosed with bladder cancer in November 2023 at the age of 56.
Dr Collett, who is now an academic at the University of Wales Trinity Saint David, shared his story in a private group on social media for retired and serving ammunition technicians, and within days other members reported similar diagnoses.
Colleagues from Dr Collett’s university, along with teams at the University of Birmingham, King’s College London, University of Glasgow and South Wales NHS Trust surveyed veterans who had served within one particular explosive ordnance disposal squadron since 1970.
Of the 203 responses, bladder cancer accounted for 27% of all cancers diagnosed.
This is a “considerable excess compared to the UK general population”, according to researchers.
When analysing the types of explosives veterans encountered, the study found weekly exposure to nitro-explosives during disposal was 2.8 times more frequent for those diagnosed with bladder cancer compared with those diagnosed with other cancers.
Dr Collett, an executive director at UWTSD’s Wales Institute for Science and Art (Wisa), said: “This research isn’t about blame; it’s about raising awareness amongst veterans and general practitioners, protecting those still serving, and ensuring that lessons are learned.
“Our findings suggest that there is a significant link between exposure to certain explosives encountered by ammunition technicians during their careers and bladder cancer, and a definitive study based on these findings could lead to real change that saves lives.”
Since the research began, two more veterans have been diagnosed with bladder cancer, taking the total to 14.
Dr Collett was an ammunition technical officer for more than three decades, serving in Northern Ireland, the Balkans, Iraq and Afghanistan.
“I was fortunate to survive when many of my friends and colleagues did not,” he added.
“However, I carry psychological scars and wasn’t expecting to deal with another unwanted consequence of military service.
“The diagnosis was somewhat of a shock and the treatment quite invasive. It affects your life and those around you.”
Professor Rik Bryan, director of the Bladder Cancer Research Centre at the University of Birmingham and a co-author of the study, said: “Despite the relatively small size of this initial study, the findings provide a strong signal that there is a considerably increased risk of bladder cancer amongst members of the ammunition technician profession who are exposed to certain explosives on a regular basis.
“This risk is significant enough to warrant urgent further investigation and a definitive study working with as many veterans as possible.”
About 10,500 people are diagnosed with bladder cancer in the UK each year.
Blood in the urine is the most common symptom, but other symptoms can include a burning sensation or a sudden or more urgent need to urinate.
Prof Bryan also called for clinicians to “have greater awareness” of potential risks among veterans.
“Bladder cancer is a common cancer, but many people may not be aware that, beyond blood in the urine, there are other signs of the disease such as changes in urination and bladder irritation that mimic the symptoms of a urine infection or cystitis,” he said.
“The majority of patients with these symptoms do not have bladder cancer, but further investigation should be initiated, particularly in at-risk populations.
“With this study the signs point to a group of heroic individuals who have served our country being at a greater risk of developing bladder cancer, and we would recommend that healthcare professionals have a greater awareness of a potential risk amongst veterans.”
The findings have been published in the medical journal BJU International and presented at the European Association of Urology Annual Congress in Madrid.
A spokesperson for the Ministry of Defence said: “We are committed to ensuring the safety of our people, whose health is a top priority, and will carefully review this new research.”
