Israel Cancer Association announces 2016 Skin Cancer Prevention and Detection Awareness Week Kick-off scheduled to take place from May 23-29, 2016.
During the week from 23-29 May (inclusive), hundreds of skin check-up clinics will open in health care funds across Israel, providing skin check-ups free of charge as part of Skin Cancer Awareness Week initiated by the ICA.
About a third of melanoma patients are currently diagnosed at a very early stage, thus enabling high chances of a cure.
The percentage of those diagnosed at the in-situ-early stage has risen 7-fold in women and 4-fold in men since the 80s.
The survival rates have increased significantly.
In mortality rates there has been a trend towards stabilization.
Prof. Lital Keinan-Boker, Deputy Director of the Israel Center for Disease Control (ICDC) of the Ministry of Health and Advisor to the ICA, presented up-to-date National Cancer Registry statistics for 2013:
Morbidity Rates (Incidence).
This year, 1,634 new patients were diagnosed in Israel with malignant melanoma (1,115 with an invasive tumor and 519 with an in-situ tumor), meaning 30% of patients are diagnosed at a very early stage of the disease, which enables high chances of a cure.
Of the 1,115 patients diagnosed with invasive melanoma, 94% were Jewish, 1% Arabs, and 5% were "others" (non-Arab Christians and those unaffiliated with any particular religion).
In Arab society in Israel, malignant melanoma is a rare disease.
The trends in invasive melanoma incidence indicate stability in morbidity rates in the middle of the last decade, with slight fluctuations in morbidity among men (12.4 in 2012, as opposed to 15.1 in 2013) and women (9.6 in 2012, as opposed to 10.7 in 2013).
Since the 90s' the morbidity rates in men are higher than those in women.
In-situ Melanoma - Very Early Stage of the Disease:
The morbidity rate of in-situ melanoma has been on a very significant upward trend since the early 90s, when the ICA commenced its activity promoting early detection, both among men (an increase from 0.3 in 1980 to 7.0 in 2013) and among women (an increase from 0.4 in 1980 to 5.5 in 2013).
Since the end of the 90s, men have been diagnosed at a higher rate than women.
Most of the patients (over 70%) with invasive melanoma, or in-situ melanoma, were 55 years old or older at diagnosis.
The 5-year survival rates for melanoma are high and on an upward trend. The percentage among men increased to 88.3% and in women to 92.5%.
As per 2013, 4,136 invasive melanoma survivors, and 2,134 in-situ melanoma survivors were living in Israel.
In 2013, 214 melanoma patients succumbed to the disease in Israel; 127 men and 87 women.
The mortality rates were on a downward trend and there has been stability since the early 2000s, with the average age being 73 among men and 74 among women.
Among Arab society in Israel, mortality rates for melanoma are very low.
Graph: Trends in Invasive Melanoma Mortality in Israel, 1980-2013, Jewish population, by sex
Additional details regarding melanoma by place of birth, age and international comparisons may be found in the enclosed report. Please click here to read the complete report.
A New ICA Telephone Survey
600 Interviewees: 400 adults aged 18 and over.
200 teens aged 15-17.
The survey was conducted by TACK Growth Strategies Ltd.
What emerged from this new survey?
Most of the interviewees (about 90%) did not think that they were at risk of developing skin cancer.
The adult interviewees who thought that they were at risk were mainly: those who are currently patients, or who contracted skin cancer in the past, removed a mole diagnosed as cancerous, people with skin lesions, or those under the supervision of a dermatologist.
Two thirds of the teens thought that they were at risk and a third of the adults attributed this to risk factors for the disease such as light coloured skin, freckles, red hair, or Ashkenazi ethnic background.
Individuals who removed a suspicious mole, but who do not necessarily take precautions when going out into the sun.
16% of the adults removed a suspicious mole and 5% found out that it was a cancerous growth. Teens also reported having removed a suspicious mole (10%), and 1% found out that it was a cancer growth.
70% of the individuals who had a mole removed are now more careful when going out into the sun; however, about 20% did not change their behavior.
High awareness of the dangers of unprotected sun exposure
Nearly everyone (about 80%) knows that unprotected sun exposure may cause skin cancer!
Teens are concerned mainly about burns (the most significant risk factor), while adults are concerned about skin damage such as: spots, wrinkles, aging and drying up of the skin.
There has been a significant increase in recognizing sun exposure as a key risk for skin cancer, mainly among teens, [the percentage has risen] from 58% in 2014 to 79% in 2016.
Everyone is aware of the ICA 'Sun Smart' Rules of Safety
Sunscreen lotion is still perceived as the most important safety measure, although, compared to previous surveys, the importance of additional protective measures has also risen - such as wearing a hat, sun exposure at safe hours, staying in the shade, or wearing long-sleeves and pants.
75% of the adults protect themselves from the sun by using sunscreen lotion, women (81%) more than men (68%), and adults aged 18-34 more than adults aged 55+ (88% as opposed to 59% respectively).
The young people in the survey protect themselves against the sun's harmful rays by using sunscreen lotions, while older adults prefer the shade and protective clothing.
"It won't happen to me", or belittlement and negligence are the significant reasons why people don't protect themselves from the sun.
"A tan is beautiful" or "sexy", are sayings that are OUT!
In comparison to previous surveys, there has been a decrease [in the percentage of those] referring to a tan as something beautiful, or something to which people aspire, and as a result of which, they fail to take precaution while in the sun.
In the survey conducted in 2004, more than half the interviewees aged 18 and over thought that a "tanned" look was "sexy", and only a third of the interviewees thought that a tanned look "isn't sexy".
Compared to a survey in 2014, in which 27% of the interviewees thought that a tan is beautiful, in the 2016 survey, 15% thought so. Meaning, there has been a genuine decrease.
People choose staying in the shade as the main protective measure against the sun and make sure to go outdoors at safe hours.
Over 80% of the interviewees, adults (18+) and teens indicated that they make an effort to stay in the shade. There are increased reports of going outdoors at safe hours, mainly after 4pm; the number of those who did so increased from 46% in 2012 to 61% in 2016 among teens.
Adults use a hat as a protective measure more often, compared to teens (60% compared to 39% respectively).
An over 50% increase in those who prefer to go to the beach after 4pm.
Compared to previous surveys, there has been a significant decrease in the number of beach goers who go to the beach at unsafe hours (according to a 2012 survey, about 2/3 (66%) of teens went to the beach at unsafe hours, as opposed to 30% in 2016, and according to a 2004 survey, 46% of adults went to the beach at unsafe hours, as opposed to 19% in 2016). Meaning, there has been an increase in the number of individuals who go to the beach at safe hours, respectively.
Adopt sun-smart behavior and prevent your skin from burning!
There has been a significant decrease in the number of those reporting sunburn as a significant risk factor for developing melanoma.
In a 2012 survey 49% of teens reported that they got sunburnt while in 2016, 17% reported getting sunburnt. Among the adults, in 2012, 19% reported getting sunburnt, and 9% reported so in 2016.
The vast majority does not use tanning beds, but among those who do use them, male teens stood out in particular!
5% of the teens reported that they had used tanning beds: 8% of the males and only 1% of the females.
Adults reported less use of tanning beds (3%), and random use: when there are spots on the body, 'once', etc.
New ICA Initiatives and Activities to Increase Awareness of the Risks of Sun Exposure
New! Cosmeticians will be trained to detect suspicious skin lesions and refer customers to dermatologists.
New initiative of the ICA in collaboration with the Israel Cosmeticians Association: Cosmeticians are uniquely positioned to closely examine the skin of their customers, and inspect areas of the skin that are not exposed to the eye. This training is designed to equip them with the tools to detect suspicious lesions on facial skin, neck, the nape of the neck, and the hands, and refer customers to a dermatologist for a skin screening, as required.
The training will be held during Skin Cancer Awareness Week on 23 May, and will be delivered by Prof. Shalom Avshalom, Advisor to the ICA and Director of the Plastic Surgery Unit at Meir Medical Center in Kfar Saba, who will train the cosmeticians on a volunteer basis.
In 2014, a similar training session was held for hairstylists, upon the initiative of the ICA, in collaboration with the Hairdressers' Association of Israel.
ICA Skin Cancer Awareness Week in collaboration with the healthcare funds
Upon the initiative of the ICA, and in collaboration with the healthcare funds, over 300 skin lesion examination booths will open across Israel during the week of May 23-29 (inclusive), providing screenings free of charge.
To schedule an appointment, insureds are asked to contact the healthcare fund to which they belong.
A list of stations will also appear in the local newspapers and more information may be obtained by contacting the ICA Telemeida teleinformation service at 1-800-599-995.
A melanoma and BCC - basal cell carcinoma - seminar is scheduled to take place on Wednesday, June 29, at the ICA Headquarters in Givatayim. The seminar is geared towards patients, survivors and their families; admission is free.
The seminar is being held courtesy of Roche Pharmaceuticals Israel Ltd., which leads the 'Roche Lends a Hand' project.
Super Pharm, and its private-label brand Life, have continued to assist the ICA in promoting the fight against skin cancer this year as well: Super Pharm will donate one shekel from the sales of all LIFE sun screen products. The funds that Super Pharm will raise will be dedicated to ICA's extensive skin cancer public education activities and promotion of prevention and early detection.
Public information pamphlets produced courtesy of Super Pharm will also be distributed at Super Pharm outlets; these pamphlets were prepared by the ICA in collaboration with the Pharmacy Division at the Ministry of Health and experts in the field, and aim to provide guidance to the public for the proper use of sun protection products.
During the summer months, starting from May, the ICA will reinforce the public information network on sun-safe behavior subjects and early detection of skin cancer, by advertising through the various media channels, delivering lectures at educational institutions, summer camps, and workplaces, and by distributing various informational materials free of charge.
The ICA Information Center Presents New Research Studies
Do environmental factors have an impact on vacationers' sun safety behaviors?
Researchers of San Diego State University sought to examine the link between sun protection behaviors of vacationers at various resorts across the United States and Canada, on the one hand and environmental variables on the other.
The researchers conducted interviews and observations among 7,878 subjects - vacationers aged 18 and over, at 41 different vacation resorts across the United States and Canada from 2012-2013. The interviews and observations were held in different areas of the vacation resorts, such as: swimming pools, beaches, golf courses, outdoor dining areas, etc.
A brief interview was conducted among 3,531 vacationers, regarding the use of sunscreen lotions, sunburns during the current vacation and last year's vacation, and reports on the time spent outdoors that day. Immediately, upon the conclusion of the interview, the vacationers were observed to see if hats were used, if there was clothing coverage, etc. The interviews and observations were conducted from 12-2pm.
Among the remaining 4,347 vacationers, only observations were conducted, during the daytime, from 10am to 4pm, and the manner in which people protected themselves from the sun's harmful rays - by wearing a hat, sunglasses, long-sleeved clothing and pants, and spending time in the shade - was documented.
Similarly, the researchers documented environmental data regarding UV rays, temperature and cloud cover from the weather channels, and the meteorological services, on the days and in the places where observations and interviews were conducted.
The various data were weighted using statistical models, and based on these data, it emerged that in most cases, vacationers made sure to protect themselves from the sun, the higher the temperatures were. Conversely, in cases where the weather was cloudy, and in colder resorts, which were high above sea level, most of the vacationers were less careful when it came to protecting themselves against the sun's harmful rays.
The researchers explain that in most cases, the vacationers' behavior was influenced by the level of cloud cover, and the temperatures, which were not in any way related to the UV radiation levels: cloud cover does not block UV rays and in elevated areas high above sea level, the temperatures are indeed lower, however the UV radiation is higher, and therefore sun exposure is dangerous in these areas as well, necessitating the proper protection.
In short, the researchers indicate that this research study indicates the need to increase public awareness of the environmental variables that are unrelated to UV radiation levels, so that they will be able to make wiser decision as to how to be "sun smart".
This study was published in the April 2016 issue of the Environmental Research Journal
Do people who work outdoors adopt the proper sun protection behaviors?
Researchers from various European countries and from South America sought to examine outdoor workers' risk for developing different types of skin cancer, as opposed to that of individuals working indoors. The researchers conducted their study on the basis of data from 1,728 people who developed skin cancer of different types; Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and melanoma in various European countries, and the control group encompassed 1,550 healthy people with similar demographic data.
The subjects answered questions regarding their work such as: outdoor work or indoor work, type of work, duration of work, etc. Out of all the respondents, men and women, 1416 people indicated that their employment included outdoor work, such as agriculture, construction, seamanship, etc., and 1861 people indicated that their work was performed in an indoor environment. The average age of the participants was 68 years. The researchers even examined additional characteristics among the research participants such as: type of skin, smoking habits, use of sunscreen products, engaging in outdoor hobbies, and damage caused to the skin as a result of sun exposure, educational levels, and health literacy.
Upon the analysis of the questionnaires, it emerged that 66% of the outdoor workers engaged more frequently in outdoor hobbies, as opposed to 58% of the indoor workers. However, only 44% of them used sun screen lotion upon sun exposure, as opposed to 60% of the indoor workers, in both occupational exposure, and during leisure time. Moreover, the outdoor workers on average had lower educational levels than the indoor workers, and felt less confident in understanding medical information as opposed to the indoor workers.
And indeed, when the researchers compared the participants' behavior to their health status, it emerged that:
The outdoor workers were at a greater risk than the indoor workers of developing skin cancer of different types as well as actinic keratosis (AK), which are scaly lesions of the skin, caused by exposure to UV rays, and which may develop into skin cancer:
78% of the outdoor workers suffered from some kind of cutaneous damage as a result of sun exposure, as opposed to 66% among the indoor workers.
38% of the outdoor workers, as opposed to 29% of the indoor workers, were diagnosed with several types of skin cancer during their lifetime.
Additional findings showed the accumulated risk of sun exposure time among outdoor workers: for the agricultural and construction workers there was a 2.5-fold higher risk of developing AK and squamous cell carcinoma (SCC) and a 1.8-fold higher risk of developing basal cell carcinoma (BCC), as opposed to other outdoor workers.
The risk of other outdoor workers of developing AK or Basal Cell Carcinoma was 1.5-fold higher than the general population.
The risk of developing all types of skin cancer (mainly the types that are not melanoma) and AK was significantly great among workers who worked outdoors for many hours for 5 years or more.
In short, the researchers indicate that outdoor workers are at a high risk of developing different types of skin cancer that are not melanoma, particularly if they work outdoors for many hours during the day for many years, as opposed to people who work indoors. The researchers emphasize that they must be provided with the appropriate information on how to protect themselves against the sun's harmful rays and that public awareness of the possibilities of early detection must be heightened.
The research study was published in the April 2016 issue of the Journal of the European Academy of Dermatology and Venereology
Alcohol Consumption Increases Risk of Basal Cell Carcinoma (BCC) in Women and Men
Past studies have shown that among populations that consume a large amount of alcohol, there is an increased prevalence of sunburn, which is an established skin cancer risk factor. Researchers of various universities in the United States sought to examine whether there is a link between alcohol consumption and the risk of developing Basal Cell Carcinoma (BCC) - the most prevalent skin cancer which usually develops after prolonged exposure to the sun's rays over the years.
The researchers conducted a study on the basis of data from 167,765 American women and 43,697 American men between the ages of 36-54. The data was collected every 2-4 years over a follow-up period of over 20 years.
The participants were asked to fill out questionnaires about their daily alcohol consumption habits and BCC morbidity, as well as weight and height data, smoking habits, physical activity, ethnic origin, family history of melanoma among first-degree relatives, natural hair color, number of moles on their arms or on their legs, the skin's response to sun exposure after two hours and up, during childhood or during adolescence, the number of serious sunburns, and the time spent in direct sunlight during the week in the middle of the day, under occupational circumstances and during leisure.
According to the research findings, and upon weighting the sun exposure data and other data of the subjects, it emerged that high alcohol consumption - an amount exceeding 30 gm per day (more than 2 cans of beer), increased the risk of developing Basal Cell Carcinoma (BCC) by 27% among women and by 18% among men, as opposed to men and women who did not consume alcohol at all. In addition, the researchers discovered that while wine and liquor increased the risk of developing Basal Cell Carcinoma (BCC) more than other alcoholic beverages, such as beer and red wine, and indicated that the risk of morbidity remains the same during all years of follow-up.
The researchers explain that the carcinogenic impact of alcohol increases the risk of BCC, and it is also a factor that weakens the immune system, thereby triggering the development of defective cells that have undergone mutation, and increasing the risk of developing cancer. The researchers indicate that the combination of alcohol and UV radiation can explain the biological mechanism behind the research findings, and recommend conducting additional studies on this subject.
The article was published in the November 2015 issue of The American Journal of Clinical Nutrition