World Cancer Day

 Increasing the discourse about cancer through the media has raised awareness as to the options for prevention and a cure and has "shattered" certain myths.

 A new ICA survey has revealed that teens believe more than adults that cancer is a preventable disease and not necessarily "predestined" disease and that in some cases it may be cured.

 The survey further indicates that there has been significantly increased awareness that smoking is a leading cause of cancer, as well as heightened cognizance of the fact that a lack of physical exercise and obesity cause cancer.

 Most of the respondents expressed acceptance of complete conventional treatment provided by physicians, and singled out their attending physician as the preferred source of medical information.

 The National Cancer Registry and the Ministry of Health Israel Center for Disease Control (ICDC),  gave an overview of trends over the past two decades (1990-2010):

 Overall cancer incidence among Jewish women is stable, and a slight increase has been observed among Jewish men, while the mortality rates have dropped among both sexes.

 Cancer mortality rates are very low in Israel, compared to most OECD countries.

 Among the Arab population, an increase in cancer incidence rates has been observed, as well as a slight increase in mortality rates among men and a downward trend among women. The main increase in incidence rates began over the initial decade. This trend has been moderated over the second decade (1990-2000).

 Trends over the past two decades:

 Breast Cancer (the most common cancer): There has been a decline in incidence and a significant downward trend in mortality among Jewish females. Among Arab females, an increase in incidence has emerged alongside a decline in mortality.

 Prostate Cancer: There has been an increased incidence among Jewish and Arab males and an increased mortality among both populations.

 
 Israel ranks 13th highest in overall cancer incidence, as compared to OECD countries (as per 2008), and 33rd in overall mortality rates (as per 2009).
  

 The downward trends in mortality attest to improvement in patient survival, as a result of the Israel Cancer Association's extensive information and education activity which encourages prevention, early detection and enhancement of treatment modalities and patient rehabilitation.
  

 An epidemiological research study that compiled data on over 2 million teens in Israel indicates a link between overweight and obesity during adolescence on the one hand, and different types of cancer (renal, bladder, pancreatic and colorectal cancers). The research study also shows a growing trend of excess weight gain and obesity among teens in Israel.
  

 As part of the NCD (Non-Communicable Diseases) Alliance activity, a plan of action for the prevention and control of non-communicable diseases was put forward at the historical UN high-level meeting held in September 2011.  In order to ascertain its implementation, the WHO established global targets and measures for the prevention and control of NCDs.
  

 Among the targets: a 25% reduction in mortality rates from cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, as well as a decrease in health risk factors, such as tobacco use, obesity, high blood pressure, and excessive salt intake and alcohol consumption, as well as fat and cholesterol consumption.
  

 With the approach of World Cancer Day, the ICA ran a campaign to increase prevention and healthy lifestyle awareness among teens, in collaboration with "Rosh 1", a leading teen magazine. The magazine featured articles, tips, personal stories, photos and more.
  

 The ICA in collaboration with Gitam BBDO advertising agency, launched a new ad marking World Cancer Day, called the "The Scene of the Crime".  The ad will be launched through the media, with the aim of raising healthy lifestyle awareness.

 An additional ad addressing women who smoke while they are pregnant cautions against the implications of smoking during pregnancy, and the hazards for the smoker, the fetus and the newborn. The ad was produced upon the initiative of the ICA and in collaboration with Gitam BBDO, and was presented at the 2012 Golden Fish Print Awards.

 The ICA is a partner in the "A Healthy Life" Project initiated by Dr. Rachel and Udi Miron, who own "Ananei Tikshoret", a campaign aimed at increasing healthy lifestyle awareness and creating a behavioral change vis-à-vis obesity and physical activity.

Incidence and Mortality Patterns - Specific Types of Cancer

 Breast Cancer

 3,810 women developed breast cancer in Israel in 2010.

 The statistics indicate a stable trend of age-standardized incidence among Jewish women (a 2% drop), and an upward trend among Arab women (a 26% increase); this upward trend in incidence may be attributed to the fact that Arab women have adopted a more Westernized lifestyle.  In 2010, incidence rates among Arab women were still lower than those among Jewish women.

 930 women succumbed to breast cancer in Israel in 2010. The statistics indicate a significant downward trend in mortality among Jewish and Arab women alike.
 
 Prostate Cancer

 2,390 men succumbed to prostate cancer in Israel in 2010. The statistics indicate an upward trend among Jewish and Arab men alike (perhaps as a result of over-diagnosis).

 370 men succumbed to the disease in 2010, while statistics indicate a downward trend in mortality rates among Jewish men (72%) and Arab men (37%) alike.
   

Key statistical highlights of the recent  ICA telephone survey with the approach of World Cancer Day, conducted among 500 adults (ages 18 and over) and 200 teens (ages 15-17), with the assistance of Mutagim Research Institute:
 
 Lifestyle:

 Smoking: 11% of adults and 3% of teens indicated that they smoke over 10 cigarettes a day.

 Weight: there has been an increase in the percentage of those reporting that their body weight is the desired weight (56% in 2012 compared to 49% in 2008), and a decrease in the percentage of those reporting body weight exceeding the desired weight, or obesity (35% in 2012, 37% in 2008).

 Prevention:

 The majority of teens (86%), vs. adults (69%), believe that cancer diseases are not "predestined" and may be prevented.

 There has been a significant increase in awareness that smoking is the leading cause of cancer. 58% of adults indicated smoking as the main cause of cancer compared to 37% in 2005. Teens are also more aware of the danger inherent in smoking with regard to cancer risk (69%).

 Additionally, there has been a significant increase in awareness of the relation between lack of physical exercise and the risk of cancer (in 2005 1%, in 2008 4.9%, and in 2012 19%), as well as heightened awareness of the link between obesity and cancer (2005 1%, 2008 26%, 2012 30%).

 In other words, there has been intensified awareness of lifestyle risk factors for cancer and this awareness is approaching the actual impact of these risk factors in percentages, as established in the HARVARD report ratified by the WHO in 2007.

 Cures:

 Today there are more people who believe that something can be done about cancer/to prevent cancer, and that it may be cured (76% of those ages 18 and older, and 82% among teens), compared to 2008 (70%) and 2005 (66%).

 Most of the respondents expressed favorable views on conventional treatment provided by physicians (83% ages 18 and older, 94% ages 15-17). A minority expressed favorable views on alternative treatment only (1%).

 The respondents singled out their attending physician as the preferred source of medical information (65% ages 18 and older, 45% ages 15-17).  This was followed by internet/google searches (29% ages 18 and older, 25% ages 15-17).

 Prof. Arnon Afek, Head of the Health Ministry's Medical Administration, presented a joint epidemiological study of IDF researchers, Tel Aviv University and Hebrew University of Jerusalem, as well as the Hadassah, Sheba and Beilinson Medical Centers on "Obesity among Teens in Israel as a Strong Predictor of Cancer Risk":

 
 Upon analysis of the epidemiological data, including statistics on obesity and overweight among over 2 million Israeli teens born between 1950 and 1993, researchers showed that the percentage of those who are overweight has increased 1.4 fold among male teens, and 1.8 fold among female teens, reaching a level of 17.4% among male teens and 14.6% among female teens.

 The obesity rate has increased 4.6 fold and 6 fold respectively, reaching a level of 6.33% among male teens and 52% among female teens.

The research also examined morbidity contributed by different types of cancer and the correlation to adolescent obesity. (Statistical processing has not yet been completed vis-à-vis female teens).

 In an epidemiological study during 20 million years of followup, Dr. Leibe and his research staff showed that overweight and European descent are linked to a higher prevalence of renal cancer.

 In an additional research study, the above scientists showed higher prevalence of urinary tract cancer among those who are overweight.

 Dr. Levi and other research scientists indicated a twofold risk for pancreatic cancer among overweight teens and/or adolescents who have a low level of education. Colorectal cancer was also found to be prevalent among those suffering from overweight. Testicular cancer was not found to be epidemiologically related to overweight, but was found to be related to country of origin.

 A clear picture emerged from these research studies regarding the relationship between overweight and obesity during adolescence and different types of cancer.

 The research scientists' conclusion was that "health promotion intervention at a young age and healthy lifestyle awareness programs can have a significant impact on future public health and may help reduce cancer and cardiovascular morbidity". 
 
 As part of the NCD (Non-Communicable Diseases) Alliance activity, a plan of action for the prevention and control of non-communicable diseases was put forward at the historical UN high-level meeting held in September 2011.  In order to ascertain its implementation, the WHO established global targets and measures for the prevention and control of NCDs:

 Among the targets: a 25% reduction in cardiovascular, cancer, diabetes, and chronic respiratory diseases mortality rates, as well reductions in health risk factors, such as tobacco use, obesity, high blood pressure, excessive salt intake and alcohol consumption, as well as fat and cholesterol consumption. 
 

New Research Studies

 "Physical fitness and  cardiovascular and pulmonary function under stress among children who have survived cancer"

 400 children are diagnosed with cancer annually, and about 80% recover thanks to enhanced quality of cancer care.  However, research studies indicate that children who had cancer and survived the disease face increased risk of recurrence, or risk of morbidity attributed to other chronic diseases.  Additionally, they are at a higher risk of premature death during their lifetime.  Regular physical activity may reduce these risk factors.

 An ICA-financed research study conducted by Dr. Gal Dubnov-Raz and a team of scientists, evaluated the physical fitness of children who contracted cancer and completed their treatments, compared to children with no history of disease.  A total of 22 children participated in the study.

 The study indicates that children who recover from cancer have a work capacity that is lower than anticipated, as opposed to children of the same age, and their aerobic capacity is lower, as compared to healthy children.   No significant decrease was noted in cardiovascular and pulmonary capacity of cancer survivors.

 A positive correlation emerged between the extent of improvement in physical fitness and improvement in the indicator of quality of life in societies*, increase in body mass of thin people, bone density and more.

 The researchers conclude that the low physical fitness of cancer survivors derives from lack of physical activity, and not from significantly damaged cardiovascular, pulmonary or muscular function. 

 In view of the importance of engaging in regular physical activity, researchers recommend that child cancer survivors engage in physical activity, even during treatments, and suggest that they be active like other children their age.

 
 Indicator of quality of life in societies is based on the quality of life questionnaire and refers to several sub-indicators: emotions, health, scholastic achievement and social functioning.*

The article was published in "Berefuah" Volume 151, Issue 2, February 2012.

 The relationship between deep fried fast food consumption and prostate cancer

 Researchers from the Fred Hutchinson Cancer Research Center in Seattle, U.S. explored the link between the consumption of deep fried foods and the risk of prostate cancer. The scientists emphasize that there is evidence attesting to the fact that cooking at high temperatures can increase the risk of contracting prostate cancer. Adding oil or fat to deep fried cooking has raised additional concern, and has not been sufficiently reviewed in the context of this type of cancer.  Carcinogens such as aldehyde, acroline acrylamide and others may form in this cooking process.

 This study reviewed 2 groups of men: 1,549 men diagnosed with prostate cancer, of whom 534 were diagnosed with more aggressive prostate cancer, and 1,015 men diagnosed with less aggressive prostate cancer.  With the help of a questionnaire, the male subjects responded to questions regarding the frequency and content of their meals.  They were asked about weekly consumption of French fries, fried chicken, fried fish, and doughnuts.

 In the patient group, the aggressive characteristics of the prostate cancer from which they suffered were also examined.  These indicators included stage of the disease, Gleason score, and PSA level. 

 The research results attested to a positive correlation between the consumption levels of French fries, fried chicken, fried fish and doughnuts, on the one hand, and the increased risk of prostate cancer.   Additionally, most of the findings cited a slightly stronger link between the consumption of these foods and aggressive prostate cancer.

 Nevertheless, the scientists emphasize that at this point, it is still unclear as to whether this increased risk may be attributed to the specific method of food preparation (deep frying), or whether it derives from the food's actual exposure to high temperatures and/or other aspects related to a Westernized lifestyle.

Please click here to read this article which was published in the Prostate Journal on 17 January 2013. 
     
 The relationship between consumption of isoflavones and endometrial  cancer

 Researchers at the University of Hawaii examined the relationship between consumption of legumes, soy, tofu and additional isoflavones and the risk of developing endometrial cancer.  Isoflavones are Phytoestrogens, estrogen-like chemicals found in nuts, soy beans, legumes and other plant foods.

 The research scientists examined 46,027 post-menopause women who have not undergone a hysterectomy.  These women participated in a large-scale study conducted from 1993-1996, and with the help of questionnaires, provided detailed information regarding their food consumption and additional personal variables.  489 women were diagnosed with endometrial cancer during the follow-up period which lasted for some 13 years.

 After taking additional variables into consideration, such as cancer risk factors, the researchers established that there is a reduced risk of endometrial cancer among women who indicated generally increased isoflavone consumption. This reduced risk is not observed among those who consumed only soy or legumes or tofu in increased amounts.   Meaning the total consumption of isoflavones of different kinds was the important component that reduced risk.

Click here to read the study which was published in the Journal of the National Cancer Institute in January 2012.

   
 Even moderate alcohol consumption increases the risk of developing several types of cancer
 
 In a multi-center research, researchers from universities in Italy, Canada, the U.S., Iran and Sweden, examined the relationship between alcohol consumption and the risk of developing different types of cancer.

 The relationship between moderate or heavy alcohol consumption and the risk of developing colorectal, breast, throat, liver, oral cavity and laryngeal cancer is known and backed by many scientists, however little is known about the relationship between cancer and moderate alcohol consumption.

 As part of a meta-analysis, the research scientists surveyed 222 studies which reviewed about 92,000 people who moderately consume alcohol.  There were 60,000 people who do not drink at all, who were included in the control group.

 Upon  reviewing the research studies it emerges that those who moderately consume alcohol, are at a 17% higher risk of developing mouth and laryngeal cancer, at a 30% higher risk of developing esophageal cancer and at a 5% higher risk of developing breast cancer.

 The scientists estimate that during 2004, some 5,000 deaths as a result of laryngeal cancer, 2,400 deaths as a result of esophageal cancer and 5000 deaths as a result of breast cancer were related to moderate alcohol consumption throughout the globe. The study found no relationship between moderate alcohol consumption and the risk of developing colorectal, liver or throat cancer. 

Please click here to read the article which was published in the Annals of Oncology Journal, in an August 2012 issue.