To mark Lung Cancer Awareness Month, the Israel Cancer Association presented updated statistics, courtesy of the Ministry of Health’s National Cancer Registry.
Lung cancer is the third most prevalent cancer disease in the world and the number one death cause in Israel. The main risk factor in lung cancer is in active and passive smoking.
The majority of lung cancer incidence (80-90%) is diagnosed in active or passive smokers. In 2018, 2,693 new cases of lung cancer were diagnosed.
The 5-year relative survival rate was lower in all population and gender groups. However, an imporvement in survival was recorded, most likely due to the newly implemented treatment methods.
Smoking prevention and cessation as a means of preventing the incidence of cancer diseases in general, and lung cancer in particular in a major goal. Nonetheless, according to the National Council for Detection, Prevention and Treatment of Malignant Diseases and the ICA, in January 2021,the Ministry of Health allocated a special budget for a pilot study to test the applicability of a lung cancer early detection program in Israel among smokers with no disease symptoms, using a Low Dose CT. The steering committee is comprised of multi-disciplinary experts, including ICA representatives.
Among the 185 regions reporting to the World Health Organization (WHO), Israel is ranked 42 in lung cancer incidence (the number of new cases diagnosed per year) and 66 in lung cancer mortality. According to the WHO 2020 statistics, lung cancer is the second most prevalent cancer in incidence and the first in mortality worldwide.
According to Israel’s Central Bureau of Statistics’ Leading Causes of Death report published in December 2018, lung cancer accounted for the highest of all types cancer mortality rates among men in Israel (24.1% of total cancer mortality), yet they were significantly lower compared to OECD countries.
According to Miri Ziv, ICA Vice Chairman: “Cigarette smoking is the leading and most critical risk factor for developing lung cancer. The risk for smokers of developing lung cancer is 20 times higher than that of non-smokers, a gap which only increases the more cigarettes are smoked. It’s important to note that a person who stops smoking significantly decreases his chances of developing the disease. There has been a decrease in smoking rates among men, and we are seeing a comparable decrease in lung cancer morbidity rates. I call upon the general public, especially young adults and teenagers, to refrain from this lethal, addictive habit.”
According to Dana Frost, the Israel Cancer Association’s Health Promotion Specialist: “In the last year, we have witnessed an increase in the use of e-cigarettes among teenagers and young adults in Israel and world-wide. Research has shown, that addiction to e-cigarettes is stronger than that of regular cigarettes, and that it can serve as a gateway to using other smoking products. The ICA regards the prevention of smoking product use among teenagers and young adults as a matter of utmost importance for the prevention of future lung cancer incidence and mortality. The measure that has proven to be most effective is raising taxes on smoking products, a key strategy for reducing cancer morbidity and preventing the onset of smoking among young adults and teenagers. To date, tax regulations do not apply to e-cigarettes, which should be taxed just like other smoking products. Public health in the future depends on measures that are taken today.”
Consequently, the absolute number of patients (not the incidence rate necessarily) has increased during the last two decades across all population sectors in Israel. Notably, the rate of female patients has increased, presumably due to their having joined the smoking population.
On Wednesday, November 20, the ICA will hold a free seminar on lung cancer in Tel Aviv, with the generous support of Roche Pharmaceuticals Ltd., at the Council for a Beautiful Israel, Rokach Blvd. 80, Tel Aviv on lung cancer led by senior oncologist Dr. Natalie Maimon-Rabinovich from the Oncology Department at Meir Medical Center with a Q&A panel of top experts in the field. Pre-registration is recommended. Click here or by telephone 03-5721678.
In recent years, a scientific debate is ongoing in the Israeli health system and abroad on the topic of early detection of lung cancer amongst high-risk populations with no disease symptoms.
The debate concerns a screening program by means of CT imaging with low-dose radiation for smokers. The ICA helped professionalize this field in Israel and is in favor of implementing a screening program, provided it is executed in a manner that will bring more benefit than harm to the population screened. The equipment must be inspected for proper functioning and radiation levels, radiologists must be trained to interpret results among smokers, and general physicians must be directed to refer smokers to screening only after presenting its advantages and disadvantages. Studies conducted in the U.S. and Europe have shown that the advantage of the screening is a decrease in mortality, and the disadvantages are a high rate of false positive results, leading to invasive procedures such as biopsy, which pose a serious risk of exposure to infections by smokers whose lungs are highly sensitive. To date, and contrary to statements by various sources, there is no country in the world with public health care that has implemented such a screening program. In the U.S., where the screening is already underway, it is performed under strict guidelines so that only a small percentage gets tested. The ICA is in favor of implementing a quality-controlled pilot program for early detection of lung cancer, so that an informed decision regarding implementing a national program may be reached based on these results.
A cohort study conducted by researchers from Maastricht University, Netherlands, investigated the association between total nut intake as well as the intake of different types of nuts and the risk of developing lung cancer. For the purpose of this study, dietary and lifestyle habits of 120,852 healthy adults, men and women aged 55–69 years, on such topics. After 20 years of follow-up, 2,861 lung cancer cases were identified, most of them non-small cell (SCC, Adenocarcinoma and large cell), and a minority, as known also outside the framework of this research, of small cell subtype – characterized by fast spread and metastasizes at an early stage of the disease, mainly caused by smoking.
According to the research findings, total nut intake was not significantly associated with total lung cancer risk. For small cell carcinoma, high total daily nut intake (more than 10 grams per day, for example 3-4 walnuts, 5 cashew or pecan or 7-9 almonds versus non-consumption was associated with a 38% decrease in the risk for men of developing small cell lung cancer, a less common yet aggressive subtype, which tends to metastasize in early stages of the disease. The decrease in risk was observed more in men have never smoked or had ceased smoking up to one pack of cigarettes a day. Specifically, consumption of tree nuts (such as walnuts, hazelnuts, Brazil nuts, cashew, pecan, pistachios, chestnuts and more) and of groundnuts (peanuts) was associated with a decrease in the of developing small cell lung cancer in men: for each 5 gr per day of tree nuts a 30% decrease and for peanuts a 7% decrease.
For the other lung cancer subtypes, no similar significant associations were seen, and nut intake was not found to be related to the risk of developing lung cancer in women.
High nut intake, primarily tree nuts, was associated with a reduction in the risk of developing small cell lung cancer in men.
Click here for the full research