Findings of New Research Study on Genetic Carriership in Israel
Prof. Efrat Levi-Lahad, Director of the Medical Genetics Institute at Shaarei Tzedek Hospital, in conjunction with physicians from the oncology network at the medical center, the Medical Survey Institute, and Prof. Eitan Friedman of the Oncogenetic Unit at Sheba Medical Center, conducted a study under the auspices of the ICA, which investigated the risk of carriership identified randomly, with no personal or family history.
8,000 healthy men of Ashkenazi origin were randomly examined in this study. 175 of the men were identified as BRCA1 or BRCA2 mutation carriers. Female relatives of these carriers were examined, and it emerged that the carriers who were randomly identified (via healthy men) had a 75-80% chance of developing breast or ovarian cancer.
The research study indicates that conducting a general screening for inherited breast and ovarian cancer susceptibility in the Ashkenazi population in Israel should be considered. Conducting such a screening requires an analysis of implementation possibilities, including psychosocial and economic ramifications.
Today only about 30% of women are entitled to genetic screening actually undergo the test.
Therefore, the unequivocal recommendation is to immediately increase this low percentage.
Are breast cancer patients at a higher risk of other types of cancer?
The Israel Cancer Registry of the Health Ministry's Center for Disease Control, researched this matter and presents new facts for the first time:
Upon overviewing the Center's database, women who were diagnosed with breast cancer were identified, and the statistics were compared with the Israel Cancer Registry's database, in order to identify cases of additional primary cancer that is not breast cancer, at least half a year after the basic diagnosis.
The research population consisted of 44,773 women who were diagnosed with breast cancer in 1991-2005, of whom 3,707 (8%) were diagnosed later on with an additional malignant tumor that is not breast cancer, 82% of whom were 50 years of age and older.
In 11% of (401) of the cases, the additional tumor was diagnosed within a year of the initial breast cancer diagnosis, a third (1,236) cases were diagnosed within a year to 5 years following the initial diagnosis, whereas the majority, (56% of the cases, 2070) were diagnosed from 5 to 10 years or more after initial diagnosis.
The cumulative risk of developing an additional malignant tumor among breast cancer patients (among survivors) increased as age at diagnosis for cancer of the breast increased. Most of the patients who developed an additional malignant tumor were 60 years of age and older when they were diagnosed with breast cancer.
The cumulative risk of developing an additional malignant tumor was directly connected to the stage of the breast cancer at diagnosis. For example: the risk of developing the disease ten years after initial diagnosis ranges from 9% in those who have been diagnosed with the disease at an early stage, to 36% in those who have been diagnosed with metastatic breast cancer.
The most common additional malignant tumor among breast cancer patients is colorectal cancer (18%). This is followed by uterine cancer, lung cancer, melanoma and ovarian cancer, similar to the distribution in the female population of Israel.
In comparison to same-age peers in the general population, breast cancer patients have a 24% higher risk of developing an additional malignant tumor of any kind, with the exception of breast cancer.
Mammography Screening Test: is this a potentially life-saving test, or a test which leads to over-diagnosis?
The evaluation of the efficacy of the mammography screening program is measured by the screening test's capacity to lower breast cancer mortality in a given population.
European researchers, experts in screening programs, have recently published (September 2012, Journal of Medical Screening) a series of articles which give an overview of this subject with the aim of obtaining a clearer picture of the efficacy of mammography screening, particularly in view of the arguments concerning over-diagnosis.
Researchers indicate the fact that many studies published in various European countries use disparate methodologies, which makes it difficult to compare them. The investigators opine that some of the arguments regarding the efficacy of the mammography screening program derive from the inappropriate use of research methods which sometimes make it difficult to establish the true efficacy of the program.
For example, in observational research studies, a decrease in mortality was observed, ranging from 25%-31% among women who were summoned to undergo a mammography screening and 38%-48% for women who underwent a screening in practice. Research studies of this kind are valid only when there is long-term information about women who are screened in the program, information which facilitates connecting the woman's screening history with her cause of death.
An additional research study surveyed the data of the research studies which examined the benefits of mammography as opposed to the disadvantages inherent in this screening test, which derive from over-diagnosis.
In order to demonstrate these data, the research investigators gave a sample of a tangible population consisting of 1000 women of the age of 50.
According to this example, in a small city which does not participate in the screening program, with a population of 1000 women between the ages of 50-51, it is anticipated that during a 30-year follow up period, 67 women will be diagnosed with breast cancer and about 30 of them will succumb to the disease.
In a different city, with a population of the same size, which participates in a controlled screening program that summons women to undergo a screening test once every two years, starting from the age of 50, for a period of 20 years, it is anticipated that 21-23 women will succumb to breast cancer over a 30-year period, and 4 women will be diagnosed due to false-positive results.
According to the calculations of scientists, for every 1000 women screened once every two years, starting from the age of 50, 7-9 cancer-related deaths shall be prevented, on the other hand, there will be 4 cases of over-diagnosis during the follow-up period.
Night Work and the Risk of Cancer among Men
Several research studies have discussed the link between night shifts and a higher risk of developing breast cancer among women. In a new research study recently published in the American Journal of Epidemiology, research scientists conclude that night work among men increases their risk of developing a number of cancers.
The research study conducted in Montreal, Canada involved men aged 35 to 70 years, residing in the Montreal metropolitan area, who have been diagnosed with a cancer.
In interviews conducted between 1970 and 1985, among 3,137 male cancer patients diagnosed with 11 of the most prevalent cancers, data was collected on their demographic and lifestyle characteristics, as well as their occupational history. These data were compared to a control group with background characteristics, such as age and place of residence, similar to those of the patient group.
The research study found evidence among men of a possible association between night work and a higher risk of lung, colorectal, pancreatic, bladder, and prostate cancer and non-Hodgkin's lymphoma. Among these men there was no evidence of a higher risk of developing melanoma, renal or esophageal cancer.
The research scientists indicate that among men who worked the night shift for more than 10 years, an increased risk for prostate, intestinal and bladder cancer, as well as non-Hodgkin's lymphoma, was observed.
The main reasons for the increased risk of developing cancer were related to exposure to light at night, sleep disturbances, shift work, as well as a lifestyle associated with an imbalanced diet, lack of physical exercise, a high BMI and Vitamin D deficiency. Scientists believe that reduced production of the sleep hormone melatonin is the main reason for the increased risk, due to this particular lifestyle.
In view of the fact that the frequency of night work is on the rise, investigators emphasize that further epidemiological studies are required to verify the research data. These studies should methodologically and accurately investigate the data relating to exposure to night jobs, exposure to artificial light at night and melatonin levels among this male population segment.
Ref: Night Work and Risk of Cancer among Men; American Journal of Epidemiology, October 3, 2012
ICA shows global cancer organizations how World Cancer Declaration targets are implemented using a cancer advocacy "Toolkit"
In 2011, the Union for International Cancer Control (UICC) represented by the ICA in Israel, initiated an international treaty, the "World Cancer Declaration" signed by millions of people across the globe and in Israel. This document contains 11 targets that are addressed to the decision makers in various countries, as a tool to help bring the growing cancer crisis to the attention of governments and health policymakers in order to significantly reduce the global cancer burden which takes an enormous human toll and incurs tremendous financial costs.
The UICC has published a detailed manual for the implementation of the Declaration targets in collaboration with the Association of European Cancer Leagues (ECL). In this manual the ICA was given the privilege of demonstrating how it has taken steps in implementing these guidelines.
Global cancer organizations may use the declaration as a gauge for their activity in the fight against cancer and may utilize the manual as a "toolkit" for implementing the declaration targets.
New! In view of the increase in breast cancer survival rates, ICA is now opening a unique breast cancer survivor workshop, aiming to enhance quality of life for survivors and their families, provide them with guidance for a healthy life, and encourage them to return to a full and active life. The workshop consists of several sessions relating to various topics, such as: nutrition for breast cancer survivors, the impact of treatments on sexual health, breast cancer treatment side-effects, "Conquering the Past, Connecting to the Present, and Creating the Future", "How to Continue?" and more.
Participation is free of charge, andf the sessions will be held at the "Together we are Strong" Support Center in Givatayim, as of 12 November.
Additional workshops will be held for other breast cancer survivors throughout the year.
A unique ICA project in collaboration with the women's website "Onlife" features leading female personalities from different areas of activity photographed holding a sign of their choice related to breast cancer. Immediately upon the distribution of the photos across the web, women will be called upon to upload their photos with signs relating to breast cancer. The collection of photos will be published on the ICA Facebook page, on "Onlife" and on all "Ha'aretz Group" websites, and will be accompanied by articles, research studies and articles relating to this subject.
"Celebrating Life" Seminar for Women Coping with Breast Cancer will be held 30 October 2012 at Kfar Hamaccabiya.
In keeping with annual tradition, the Estée Lauder Companies in Israel, in collaboration with the ICA, will illuminate well-known Israeli landmarks in pink lights in order to increase breast cancer awareness.
Annual ICA "Doorknock" Fundraising Campaign is held 22 October 2012.
Public donations enable the ICA to finance dozens of studies conducted by physicians and research scientists seeking a cure for cancer, as well as to fund informational activities aimed at increasing public awareness and prevention, financially support the initiation and construction of national early detection programs leading to higher cure rates, economically support cancer patients in need, lend a hand to child cancer patients in keeping up with their studies, run summer camps for cancer patients and their families, assist in the set-up of oncology departments at hospitals throughout Israel, finance posts for nurses, psychologists, dieticians and social workers who assist cancer patients at hospitals and in community clinics, and to endeavor on behalf of cancer patients in Israel and promote their rights. The ICA calls upon the general population to open their doors and hearts and to contribute for patients and against the disease.
The ICA's annual fundraising campaign is an important source of funds for the ICA, as its activity receives no government funding whatsoever.
We frequent households in Israel from north to south in this campaign, including Israeli embassies across the globe. Thousands of school-age children and members of youth movements, take part in the "Door Knock" campaign, in close collaboration with the education system and ICA volunteers who are active in over 70 branches throughout the country.
The ICA requests that the public verify that an official ICA receipt has been provided.