Cirrhosis of the Liver A Presumptive Medical Condition in Former Prisoners of War

Secretary of Veterans Affairs Anthony J. Principi has determined that it is appropriate to add cirrhosis of the liver to the list of diseases for which VA presumes service connection in all former POWs interned or detained for at least 30 days. The determination was made after review of a study by the Institute of Medicine (IOM).

Cirrhosis is a degenerative liver disease, commonly caused by chronic alcohol consumption. Alcohol consumption, however, was not determined to be a contributing factor to the incidence of cirrhosis among former POWs.

In October 2000, IOM published results of a study that found a significantly higher risk of cirrhosis among former World War II POWs compared with control groups. Cirrhosis mortality was not found to be associated with any differences in levels of alcohol consumption among World War II and Korean POWs and Korean controls, which were similar to those among U.S. males. Therefore, it appears that alcohol consumption does not provide an explanation for the higher mortality rates identified in POWs.

IOM initially conducted a 30-year follow-up of American POWs of World War II and the Korean Conflict and found evidence of increased mortality from cirrhosis in American former POWs compared to the U.S. general population. Furthermore, the results of the October 2000 IOM study are consistent with other studies, including a 1999 mortality follow-up of British POWs and a 1968 mortality study of Australian World War II POWs.

A final regulatory amendment to 38 CFR 3.309(c) was published in the Federal Register, pages 42602-42603, on July 18, 2003. This final amendment adds cirrhosis of the liver to the list of conditions for which entitlement to service connection is presumed for former prisoners of war (POWs) under 3.309 (c). This regulatory change is based on scientific and medical research findings.