Service members tacitly understand the physical dangers they signed up for upon joining the military.

However, what others did not anticipate was that their greatest threat would not be the combat itself but rather the toxic materials found in barracks and the equipment they once used: asbestos.

Unfortunately, decades of exposure to this natural mineral have left a lasting imprint on veterans in the City and County of Honolulu, as they have become vulnerable to developing mesothelioma, a rare malignant tumor.

Early detection is essential for effectively treating this disease. Yet one of the greatest challenges is that mesothelioma is often misdiagnosed, which delays treatments and makes outcomes poorer.

The federal government must establish a national mesothelioma registry to ensure earlier intervention.

This systemic database would identify at-risk veterans and proactively invite them for check-ups, giving them accurate diagnoses and timely therapies and ultimately saving their lives.

The Toll On Hawaiʻi Vets

Mesothelioma is an unusual type of cancer that mainly starts in the mesothelium, the protective tissue lining the body’s cavities and internal organs. This disease is commonly associated with exposure to asbestos, a natural mineral comprising tiny fibers that can be lodged in the body and remain dormant for many years before triggering serious health issues.

But since the symptoms of mesothelioma — such as chest pain, shortness of breath, and consistent coughing — are often similar to those of more common illnesses, it is frequently misdiagnosed. It goes undetected until it reaches a more advanced and less treatable stage.

Tragically, the crisis has already taken a devastating toll in Hawaiʻi. An interactive map revealed that between 1999 and 2017, there were 747 asbestos-related deaths statewide, including 139 attributed to mesothelioma and 54 to asbestosis. A significant number of these cases were concentrated in Honolulu, which accounted for approximately 532 asbestos-related fatalities.

Many of the individuals affected were veterans who served at locations known for extensive asbestos contamination, such as Joint Base Pearl Harbor-Hickam, Schofield Barracks, and the former Barbers Point Naval Air Station. This incidental environmental concern calls for a systemic approach to monitor and provide tailored care to susceptible veterans.

The Misdiagnosis Crisis

Misdiagnosis is one of the greatest threats to mesothelioma patients today. Recent statistics indicate that 80.8% of stage 1 cases were erroneous as they were “upstaged” to later stages.

Similarly, nearly 70% of stage 2 findings were incorrect, while 35.4% of stage 3 diagnoses were inaccurate. Alarmingly, even 12.8% of patients who were thought to be terminally ill, being at stage 4, were later down-staged after reevaluation.

For veterans in Honolulu, geographic isolation and limited access to specialized care worsen this problem. Without proactive surveillance, veterans will not be evaluated earlier and may only discover mesothelioma when it is already too late for any meaningful intervention.

Why Veterans Need This

Establishing a national mesothelioma registry would be a transformative step in addressing the diagnostic delays and systemic gaps that continue to affect veterans in Hawaii and nationwide.

By consolidating data from the Department of Veterans Affairs, Department of Defense, and affiliated healthcare systems, such a registry could systematically identify personnel likely exposed to asbestos during their service and encourage them to undergo screenings to know about their current health condition.

This approach would help healthcare providers and authorities immediately refer affected individuals to specialists and ensure they receive timely and stage-appropriate treatments.

In addition, this shift from reactive to preventive care could tackle diagnostic delays and improve the health outcomes of patients effectively. It is because a registry would streamline how mesothelioma cases are tracked, diagnosed, and treated, which promotes consistency in clinical practices and enables more efficient allocation of medical resources.

Equally important, the national mesothelioma registry would be a critical tool for researchers, providing them with comprehensive epidemiological data to better understand exposure patterns, regional trends, and disease progression. The findings of these crucial studies could set a precedent for what health strategies should be implemented and drive the development of innovative and targeted therapies.

Given these benefits, it is only fitting that the federal government and the partner stakeholders push for creating a national mesothelioma registry. These entities should realize that this systemic database would strengthen veterans’ support and catalyze broader mesothelioma care and research advancements.