Global achievement recorded in Israel - melanoma incidence rates have declined by 30% among Jewish women and stability has been observed among Jewish men. World trends - melanoma incidence rates continue to rise.
Israel Cancer Association information campaigns conducted over the past 20 years have led to decreased morbidity and mortality.
This year marks 20 years since the introduction of Skin Cancer Awareness Week, first initiated by the Israel Cancer Association and conducted in collaboration with all Israeli HMOs, with the approval of the Ministry of Health and the Israel Society of Dermatology and Venereology and Israeli Society of Plastic Surgery:
Upon reviewing trends since 1992, the year when the Israel Cancer Association began this initiative on a national scale, stability in invasive melanoma incidence rates was observed among Jewish men (11.7 per 100,000 in 1992, and 12.3 in 2009), whereas among Jewish women, a 30% decline in the incidence rates of invasive melanoma was observed! (from 13.2 per 100,000 in 1992 to 9.2 to 100,000 in 2009.) In other words, real prevention was accomplished here - resulting in fewer people developing the disease.
Conversely, there has been a significant increase over the years in melanoma in situ morbidity, the initial detection stage enabling very high chances of a cure, both among Jewish men and Jewish women alike. In other words, there has been significant improvement in early melanoma detection.
Among Jewish men, in 2000, the age-standardized mortality rate for melanoma in situ was 5.3 per 100,000 and in 2009, the age-standardized mortality rate increased to 6.4 per 100,000. Among Jewish women in 2000, the age-standardized mortality rate was 3.9 to 100,000 and in 2009, an increase was observed, and the age-standardized mortality rate was 5.3 per 100,000. Dr. Lital Keinan-Boker, Deputy Director of the Center for Disease Control of the Ministry of Health, and a member of the Israel Cancer Association Early Detection Committee, reported that in 2009, 1,293 patients were diagnosed in Israel in 2009 with skin melanoma (invasive and in situ) - 862 patients were diagnosed with invasive melanoma and 431 patients with melanoma in situ. Among the Arab population in Israel, melanoma is a rare disease and the morbidity rates amount to no more than a handful of cases. Miri Ziv, Israel Cancer Association Director General, indicated that "the concerted efforts that have been made upon our initiative - information campaigns and examinations at hundreds of screening stations set up at HMOs throughout Israel have produced these noteworthy results in disease prevention, as well as in early detection which enables a cure. We are especially proud of the exciting report on the decrease in the number of new cancer cases, which has not yet been reported in Australia, the United State, Canada, Scandinavia, and other countries in Europe, where incidence rates are high and still on the rise".
Israeli women, more than Israeli men, have internalized the "sun smart behavior" message, as well as the importance of early detection, and indeed develop the disease at a lower rate; additionally, there has been a tremendous decline in mortality rates. The highest invasive melanoma morbidity rates in 2009 were observed among Israeli natives, both among women (11.9 per 100,000) and men (16.2 per 100,000).
High rates were also observed among those of European and American descent. The lowest rates were observed among women of Oriental/Middle Eastern descent (2.1 per 100,000) and men of North African/African descent (2.7 per 100,000). In the case of melanoma in situ, the highest rates were observed among Israeli natives (8.1 women and 10.3 men per 100,000). The lowest rates were observed among individuals of Oriental/Middle Eastern descent (0.6 women and 2.0 men per 100,000). The risk of developing melanoma (invasive or in situ) during one's lifetime is one in every 36 Jewish men and one in every 45 Jewish women.Among Arab men and women, there is a significantly lower risk of developing the disease (1 per 312 and 1 per 434 respectively). Invasive melanoma survival rates are on an upward trend, from 83% Jewish men diagnosed from 1990-1997 to 86.5% among those diagnosed from 2003-2008. Among women, a similar survival rate was observed (86% and 89% respectively). Age-standardized mortality rates among the Jewish population dropped over the past decade from 2.4 per 100,000 in 2000 to 1.8 per 100,000 in 2009. Mortality rates among men have been stable (2.6 to 2.8 per 100,000 from 1992-2009), and there has been a 56% decrease in mortality rates among Jewish women (from 2.5 per 100,000 in 1992, to 1.1 per 100,000 in 2009).
These trends may also be attributed to Israel Cancer Association's initiatives over the past two decades which have led in an increase in early detection rates:
Prof. Jacob Schachter - Director of the Ella Institute for Treatment and Research of Melanoma, Sheba Medical Center, presented a report "Hot from the Oven" from the ASCO conference held in the United States. Two new biological drugs which have helped make advances in the treatment of advanced melanoma, with less severe side effects, were presented at this conference.
A new information brochure on UV sunscreen products was also presented at the press conference.
This brochure was initiated by the Israel Cancer Association, in collaboration with Rinat Bachar, Cosmetics Licensing Dept. Manager, Pharmacy Division of the Ministry of Health, and Dr. Marina Landau, Dermatologist at the Dermatology Unit, Edith Wolfson Hospital.
The brochure was printed courtesy of the Super-Pharm retail pharmacy chain, and copies shall be distributed at all Super-Pharm drug stores and at the Israel Cancer Association offices.
The brochure explains how to use UV sunscreens, including tips on proper use (not just at the beach), expiration date for sunscreens, provides instructions on how to store sunscreen products, and more.
Interesting findings emerged from a survey conducted by the ICA among adults aged 18 years and older, and among teens aged 15-17.
The survey reviewed awareness, attitudes and behavior in the sun among 621 respondents, 100 of whom were teens and 510 of whom were adults aged 18 years and older. The survey revealed that women are more aware and use more protective measures. An increase in awareness of the additional harmful effects of the sun, aside from skin melanoma, was also noted.
Sunburns was the second most frequently mentioned harmful effect reported by teens (38.6% compared to 6.2% among adults aged 18 years and older), whereas adults indicated skin spots, premature wrinkling and aging of the skin. An increase also emerged in awareness of additional protective measures aside from sunscreen (83%), such as wearing a hat (30%), proper attire (28%), staying in the shade (27%), and going outdoors during sun safe hours (22%). As compared to previous years, there has been increased awareness about the hazardous effects of tanning, both among teens and adults. As compared to a quarter of the respondents in the 2004 survey, over half the teens (55%) and adults (51.6%) indicated that tanning salons are just as dangerous, if not more so, than uncontrolled sun exposure. The increased awareness is a result of the information and education network headed by the Israel Cancer Association in preschools, primary and secondary schools, and in the media: on TV programs for kids and in public service announcements for adults.
Nevertheless, this knowledge is not sufficiently converted into action among teens. A significant percentage of them (66%) still go to the beach at unsafe hours, and a considerable percentage suffer from sunburns (49%).
"Is this your first time at the beach?":
The Israel Cancer Association is launching a new information and education campaign in the written press, under the slogan "Is this your first time at the beach"?, following a survey conducted among teens aged 15 - 17, which showed that young people are aware of the harmful effects of the sun and protective measures against the sun's rays, and yet, their knowledge is not converted into action.
This ad demonstrates the damage that is to be anticipated as a result of uncontrolled sun exposure and behavior that isn't "sunsmart", such as going to the beach at unsafe hours.