To mark Lung Cancer Awareness Month, the Israel Cancer Association presented the latest lung cancer statistics, courtesy of the Ministry of Health’s National Cancer Registry.
Lung cancer is the third most prevalent cancer worldwide, and the number one death cause in Israeli population. The main risk factor for lung cancer is active and passive smoking.
The absolute majority of lung cancer incidences (80-90%) are diagnosed in smokers or ex-smokers. In 2018, 2,693 new lung cancer patients were diagnosed in Israel.
The relative 5-year survival rate is low among all population sectors and genders. But an improvement in survival rate was shown, apparently due to the new treatments methods implemented. Moreover, it is known that smoking cessation following lung cancer diagnosis improves effectiveness of treatment and survival rate, and more patients are probably following their physician's advice.
Prevention of smoking uptake as well as smoking cessation as a means of preventing cancer diseases in general and lung cancer in particular – is a key objective. Nonetheless, according to the National Council for Detection, Prevention and Treatment of Malignant Diseases and the Israel Cancer Association, in January 2021, the Ministry of Health allocated a special budget for a pilot study to examine the implementation of a lung cancer early detection program amongst symptom-free smokers in Israel, using LDCT. The steering committee was comprised of multidisciplinary experts on the topic, including Israel Cancer Association representatives.
Amongst the 185 regions reporting to the WHO, Israel is ranked 42 in incidence (number of new cases diagnosed per year), and 66 in lung cancer mortality. According to the 2020 WHO statistics, lung cancer is the second most prevalent cancer in terms of incidence, and the first in terms of mortality.
According to the Ministry of Health Cancer Registry, there are 5,637 lung cancer survivors and patients still coping with the disease live in Israel today.
Prof. Lital Keinan-Boker, Director of the Israel Center for Disease Control (ICDC) at the Ministry of Health explains: "Lung cancer is the third most prevalent cancer in the world. The main risk factor for lung cancer is active and passive smoking. The absolute majority of lung cancer cases, about 80%-90% are diagnosed in smokers or ex-smokers. Other risk factors include age, occupational exposure, low socio-economic level, exposure to Radon and air pollution. The relative five-year survival rate from lung cancer is low in all gender and population groups, yet it is shown that in Jewish men and women, as well as Arab women, the relative survival rates of patients diagnosed between 2008-2013 was typically higher than the rates among patients diagnosed between 1996-2001.
According to Moshe Bar-Haim, ICA Director General: "smoking is the most significant, critical risk factor in lung cancer. Active or passive smoking is the cause for the absolute majority of lung cancer morbidity. In recent years, we see a steady rise in the use of e-cigarettes among youth and teenagers. These products are harmful and highly addictive. Addiction to e-cigarettes is stronger than addiction to regular cigarettes, and either way, are a health hazard! It is important to know that a person who stops smoking significantly reduces their risk of lung cancer. As of today, the most effective measure found against the smoking phenomenon is raising the taxes on smoking products, and it is the main strategy in reducing cancer mortality and preventing youth and teenagers from taking up smoking."
In recent months, we have witnessed the aggressive advertising and marketing of the tobacco industry, which runs a billion dollar business, in the various media outlets, targeting various population groups (youth, Orthodox society, Arab society). According to WHO, 8 million people worldwide die of smoking each year. Throughout the years, each time more evidence was obtained about the severe harmful effects of smoking cigarettes, the tobacco companies developed a new product and marketed it as "less harmful", such as cigarettes with filters (the filter will sift the toxins, an unfounded claim). In recent years, new smoking products are being marketed aggressively and manipulatively under the guise of being "less harmful."
It should be clearly stated – There is no healthy smoking! Neither by heating nor by vaping! Don't let them sell you their stories. Smoking kills. There is no partial cancer.
They leave the nicotine inside. They want to retain the smokers and attract new customers to become addicted.
Due to the complexity of data collection, the most updated statistics of the National Cancer Registry at the Ministry of Health refers to 2018, and is the most updated as of today. This registry includes the patient population and not a survey from which estimations are calculated, as some countries do.
The data given by the National Cancer Registry at the Ministry of Health shows that in 2018, 2,693 new patients were diagnosed with lung cancer in Israel, 61.6% of which are men and 38.4% of which are women. 1,908 patients died of the disease.
Lung cancer is responsible for 9.5% of new cancer incidence in Israel, and 16.6% of cancer morbidity. The main risk of lung cancer was seen amongst patients 55+ in all population and gender groups and the incidence rates were higher in men compared to women and higher in Arab men. Similarly, most mortality was seen in men compared to women and highest in Arab men.
Lung cancer is the number one cancer death cause in Israeli population.
It is responsible for 21.1% of all cancer mortality amongst Israeli men, and 11.8% of all cancer mortality amongst Israeli women.
The relative five-year survival rate from lung cancer is low in all gender and population groups, yet it is shown that in Jewish men and women, as well as Arab women, the relative survival rates of patients diagnosed between 2008-2013 was typically higher than the rates among patients diagnosed between 1996-2001.
The temporal trends in cancer incidence during the 23 years between 1996-2018 were examined according to population and gender. In Jews and others, a clear moderate decrease in lung cancer was seen in Jewish men, whereas amongst women, a clear increase was seen until 2014, and stable from 2014 and on. In Arab men and women, incidence rates were stable throughout the period with no clear change seen.
The temporal trends in cancer incidence during the 23 years between 1996-2018 were examined according to population and gender. In Jews and others, a clear statistical moderate decrease was seen in Jewish and other men throughout the period of 1996-2018, whereas amongst Jewish and other women, a clear statistical moderate decrease was seen only from 2011, while prior to that, in 1996-2011, a clear statistical increase was seen. In comparison, amongst Arab men and women, mortality rates were stable throughout the period. The highest mortality rates as well as incidence rates were seen in Arab men.
Like tobacco cigarette (TCIG) smoking, long-term electronic cigarette (ECIG) vaping in young people is associated with elevated cellular oxidative stress (COS), which is important in the pathogenesis of many diseases, including atherosclerosis. As with TCIG smoking, even infrequent ECIG use may be associated with adverse biological effects with implications for future health risks. Importantly, the proportion of high school students who have used ECIGs within 1month of the time of study has skyrocketed, approaching30% in theUS.3,4 The purpose of this study was to evaluate the association of a single session of ECIG vaping on COS in immune cells in young people who do not smoke or vape compared with young people with long-term TCIG or ECIG use.
Among 32 healthy participants in this randomized clinical crossover trial, the mean (range) age was 24 (21-33) years, and 19 individuals were male. Nine individuals had long-term (more than 1 year) TCIG use, 12 had long-term ECIG use, and 11 did not have any history of TCIG or ECIG use. Baseline characteristics did not differ between the 3 groups, and tobacco-use burden at baseline did not differ between the ECIG and TCIG groups (eMethods in Supplement 2) Immune cells were collected before and 4 hours following supervised sessions of either vaping, using an ECIG with 5% nicotine, or sham vaping (puffing on a straw) in random sequence as previously described. We used established flow cytometry methods to determine COS in immune cells by investigators blinded to the study groups.
The Kruskal-Wallis test was used to compare the 3 tobacco use groups and the Mann-Whitney Utest was used to compare the vaping vs sham groups. Tests were 2-tailed, and the level of significance was set at P < .05. As this was a small, exploratory study, we did not adjust for multiple comparisons.
Representative data of measures of COS have been published. Consistent with our prior findings, all baseline measures of COS were lowest in individuals who never smoked, intermediate in individuals who currently used ECIGs, and highest in individuals who currently smoked TCIGs (data not shown).
Exposure to a single vaping session, but not the sham-control session, increased the percentage of CD45+ immune cells that were positive for CellROX Green 1.3-fold compared with the history of smoking or vaping or individuals who currently used ECIGs or TCIGs.
Compared with sham control, a single vaping session did not affect other measures of COS in cell subtypes of individuals with no history of smoking or vaping or individuals who currently used ECIGs and individuals who currently smoked TCIGs.Link to the full article
Obesity is known as a risk factor for the development of certain types of cancer such as breast, esophageal and colorectal cancer. However, the link between obesity and lung cancer is more complex, and clinical researches conducted showed that unlike other types of cancer, obesity is suggested to have a beneficial in NSCLC.
Hypothesizing that this “obesity paradox” arises partly from the limitations of using body mass index (BMI) to measure obesity, we quantified adiposity using preoperative computed tomography images. This allowed the specific determination of central obesity as abdominal visceral fat area normalized to total fat area (visceral fat index [VFI]). In addition, owing to the previously reported salutary effect of metformin on high-BMI patients with lung cancer, metformin users were excluded. We then explored associations between visceral obesity and outcomes after surgical resection of stage I and II NSCLC. We also explored potential immunologic underpinnings of such association using complimentary analyses of tumor gene expression data from NSCLC tumors and the tumor transcriptome and immune microenvironment in an immunocompetent model of lung cancer with diet-induced obesity.
We found that in 513 patients with stage I and II NSCLC undergoing lobectomy, a high VFI is associated with decreased recurrence-free and overall survival. VFI was also inversely related to an inflammatory transcriptomic signature in NSCLC tumors, consistent with observations made in immunocompetent murine models wherein diet-induced obesity promoted cancer progression while exacerbating elements of immune suppression in the tumor niche.
In all, this study uses multiple lines of evidence to reveal the adverse effects of visceral obesity in patients with NSCLC, which align with those found in animal models. Thus, the obesity paradox may, at least in part, be secondary to the use of BMI as a measure of obesity and the confounding effects of metformin use.
Link to the full article