Breast cancer incidence in Israel is high (5th highest), however breast cancer mortality rates are low (9th highest) and show a downward trend, compared with countries with the highest rates of breast cancer in the world.
For the first time ever, there fhas been a decline in breast cancer mortality among Arab women as well.
Breast cancer patients have a 24% higher risk of developing an additional malignant tumor of any kind, apart from breast cancer, as compared to their same-age peers in the general population.
Gaps in compliance rates to undergo mammography screening that once existed between sub-populations in Israel have been narrowed, and the gap between Jewish and Arab women has virtually dissipated. The current compliance rates among new immigrants and ultra-Orthodox women are about 5%-10% lower than compliance rates among the general population.
A recent research study has indicated that genetic testing for hereditary mutations should be included in the screening tests among the general population.
A mere 30% of women who are entitled to get a genetic test actually undergo one.
The number of cancer deaths prevented by the mammography screening program significantly outweighs the number of women who have had false-positives, based on a series of recently published articles in Europe which review the efficacy of screening tests.
With the means currently available, over 5,000 cancer deaths a year may be prevented in Israel by maintaining a healthy lifestyle, and through early detection of common cancers.
Mr. Dudi Weissman, President of Alon Group, and 2012-2013 "Door Knock" Fundraising Campaign Chairman, announced the kick-off of the ICA's 52nd annual fundraising campaign at the press conference marking the campaign. The organization's activity is made possible solely through public donations, and receives no government subsidies whatsoever.
Mr. Dudi Weissman will serve as Chairman of this year's fundraising campaign, which constitutes a significant source of funding for the ICA. Thousands of school-age children and members of youth movements participate in this campaign, in close collaboration with the education system and ICA volunteers.
Mr. Dudi Weissman, President of Alon Group: "I responded willingly to Mr. Leon Recanati's request to lead this year's "Door Knock" campaign, out of the recognition of the need for resources to find new ways of overcoming the manifestations of the disease. We at Alon Group, along with the general population, will do our utmost to make sure that the campaign yields results to further its intended goals".
The campaign will focus on family-related projects such as "Family for Survivors" and "Family Empowerment Project" aimed at providing support to the cancer patient's family. These activities are financed through donations made to the ICA.
These projects are part of the group's activities under the corporate responsibility of Alon Group, Holdings Blue Square, focusing on family as a value.
Donations raised through the "Door Knock" campaign will allow the ICA to purchase modern state-of-the-art medical equipment for medical centers treating cancer patients, to fund dozens of research studies conducted by physicians and research scientists in Israel and throughout the globe in the fight against cancer, in the hopes of finding a cure for the disease, to initiate and establish national early detection programs to diagnose various cancers and boost cure rates, to support cancer patients who need financial assistance, to establish oncology departments in hospitals across Israel and to finance nursing and social work jobs for professionals who assist cancer patients in hospitals and community clinics.
There are currently over 200,000 cancer patients undergoing treatment or being monitored in Israel. Statistics show that each year, there are 28,000 new cancer patients, 400 of whom are children.
Thanks to the promotion of research and the emphasis on enhancing diagnostic methods, early detection and treatment modalities, there has been a significant increase in the number of children cured of the disease, who currently number about 75%, and there has also been considerable improvement in the quality of life of patients. ICA's activity is made possible through public donations, and receives no government subsidies whatsoever, hence the crucial importance of the "Door Knock" fundraising campaign which facilitates potentially life-saving activity.
This year's "Door Knock" Fundraising Campaign is held on Monday, 22 October 2012.
New Breast Cancer Statistics and Seasonal Trends marking Breast Cancer Awareness Month
Dr. Lital Boker-Keinan, Head of the Israel Cancer Registry and Deputy Director of the Health Ministry's Center for Disease Control (ICDC):
Breast cancer is the most prevalent type of cancer in women in Israel and throughout the globe.
One in every 7.5 Jewish women and one in every 14 Arab women will develop invasive breast cancer over the course of their lifetime (from age 0 to 90).
After an increase in age-standardized invasive breast cancer incidence rates in the 90s, there has been a steady decline since the early 2000s as well as stability among Jewish women.
Over the years, an increase in invasive breast cancer has been observed among Arab women.
Additionally, the incidence rates for in situ breast cancer have increased over the years among both Jewish women and Arab women; the most prominent increase was observed in the 90s at the launch of the National Joint ICA-Healthy Ministry Initiative on Breast Cancer Early Detection.
A downward trend in mortality rates has been observed among both Jewish and Arab women.
The increase in the incidence of in situ breast cancer rates and the decline in mortality rates indicate the detection of the disease at its early stages, enhanced treatment and higher chances of a cure.
19,010 Israeli women diagnosed with breast cancer from 2005-2009 survived or are still coping with the disease, of whom 16,851 were diagnosed with invasive breast cancer and 2,159 were diagnosed with in-situ breast cancer.
In 2009, 4,005 patients were diagnosed with the invasive breast cancer and 492 patients were diagnosed with in situ breast cancer.
Stage of Disease at Diagnosis:
In the 90s the ICA initiated the National Breast Cancer Early Detection Program in association with the Health Ministry, geared toward women between the ages of 50-74, recommending one mammography screening every two years. One of the efficacy indicators of the program is the percentage of women diagnosed at an early stage.
The percentage of women diagnosed with early-stage cancer (in situ breast cancer, and early stage invasive cancer) has increased from 57% of patients diagnosed in 2007 to 62% in 2009.
Birthplace and Age-specific Invasive Breast Cancer Incidence Rates:
Most invasive breast cancer morbidity is observed in women over the age of 50, among both Jewish and Arab women (80% and 54% respectively).
The highest rate is observed among native Israeli women (101 per 100,000) and the lowest rate was observed among native African women (68 per 100,000).
Breast Cancer Survival Rates:
There has been an upward trend in relative breast cancer survival rates, and the current survival rate exceeds 85%.
The survival rate for women diagnosed in 1991-95 stood at 77.9% while the survival rate of women diagnosed in 2001-2004 increased and stood at 86.4%.
Breast Cancer Mortality Rates:
938 women died of invasive breast cancer in 2009.
Mortality rates continue a downward trend. The mortality rates among Jewish women decreased from 20.2 per 100,000 in 2005, to 17.9 per 100,000 in 2009. Among Arab women, the mortality rates decreased from 16.2 per 100,000 in 2005 to 12.0 per 100,000 in 2009.
Among Jewish women there has been a decrease in mortality rates since the mid-90s, and over the past decade, mortality rates have decreased by about 30%. A monotonous increase was observed among Arab women over the years until recent years when a decrease in mortality rates became evident (a 26% decrease over the past 5 years).
According to International Agency for Research on Cancer (IARC) statistics which compare between countries with the highest incidence and mortality rates in the world, it emerged that Israel ranks high in incidence (5th highest), whereas, as far as mortality rates are concerned, Israel ranks the lowest (9th highest).
Up-to-date statistics on cancer incidence and mortality trends
Dr. Lital Keinan-Boker, Head of the Israel Cancer Registry and Deputy Director of the Health Ministry's Center for Disease Control (ICDC) reports:
In 2009, 27,927 new patients were diagnosed with a disease that requires reporting to the Israel Cancer Registry (malignant diseases, "borderline" tumors and certain benign tumors), 13,109 of them men and 14,818 women.
The most prevalent tumors by age and population group:
In Jewish men prostate cancer (21%), in Arab men - lung cancer (18%). In Jewish and Arab women the most prevalent cancer is breast cancer (31%, 30% respectively).
At the end of 2009, there were 240,047 people who survived cancer or who are coping with the disease (98,626 men and 141,421 women), and 9,923 cancer patients succumbed to the disease.
Lung cancer is a cancer that causes the most cancer-related deaths among men and breast cancer among women. Colorectal cancer is the second most common cause of cancer death among both men and women.
Using the currently available means, over 5,000 cancer-related deaths may be prevented each year
Prof. Eliezer Robinson, ICA Chairman, reported that in recent years there has been tremendous momentum in the development of many new drugs, some target-focused and some personalized.
This development has significantly contributed to the improvement in survival rates for various types of cancers.
However, he emphasized that with the means available to us today, over 5,000 cancer-related deaths a year as a result of prevalent types of cancer in Israel may be prevented by adopting a healthy lifestyle - avoiding smoking, obesity, maintaining a healthy diet, reducing alcohol and sodium consumption, engaging in physical exercise, and by undergoing screening tests which have proven to be effective.
The media plays a pivotal role in disseminating this potentially life-saving message.
Update on National Breast Cancer Early Detection Program Statistics 2012
The National Breast Cancer Early Detection Program statistics reported by Prof. Gad Rennert indicate narrowed gaps in mammography screening compliance rates between sub-populations in Israel.
Current compliance rates among new immigrant and ultra-Orthodox women are about 5%-10% lower than those among veteran Jewish female populations. The current compliance rate among Arab women is identical to that of Jewish women and in certain areas even higher.
In 2001 the percentage of compliance to undergo mammography screenings among Arab women stood at 49%, and today, the compliance rate is similar to that of Jewish women, and stands at 70%.
94% of women who were screened over the past year and showed no symptoms, complying to undergo the screening test recommended at the age of 50-74, had been tested in the past, meaning women returned for additional testing as required by the National Program.
Findings of New Research Study on Genetic Carriership in Israel
Prof. Efrat Levi-Lahad, Director of the Medical Genetics Institute at Shaarei Tzedek Hospital, in conjunction with physicians from the oncology network at the medical center, the Medical Survey Institute, and Prof. Eitan Friedman of the Oncogenetic Unit at Sheba Medical Center, conducted a study under the auspices of the ICA, which investigated the risk of carriership identified randomly, with no personal or family history.
8,000 healthy men of Ashkenazi origin were randomly examined in this study. 175 of the men were identified as BRCA1 or BRCA2 mutation carriers. Female relatives of these carriers were examined, and it emerged that the carriers who were randomly identified (via healthy men) had a 75-80% chance of developing breast or ovarian cancer.
The research study indicates that conducting a general screening for inherited breast and ovarian cancer susceptibility in the Ashkenazi population in Israel should be considered. Conducting such a screening requires an analysis of implementation possibilities, including psychosocial and economic ramifications.
Today only about 30% of women are entitled to genetic screening actually undergo the test.
Therefore, the unequivocal recommendation is to immediately increase this low percentage.
Are breast cancer patients at a higher risk of other types of cancer?
The Israel Cancer Registry of the Health Ministry's Center for Disease Control, researched this matter and presents new facts for the first time:
Upon overviewing the Center's database, women who were diagnosed with breast cancer were identified, and the statistics were compared with the Israel Cancer Registry's database, in order to identify cases of additional primary cancer that is not breast cancer, at least half a year after the basic diagnosis.
The research population consisted of 44,773 women who were diagnosed with breast cancer in 1991-2005, of whom 3,707 (8%) were diagnosed later on with an additional malignant tumor that is not breast cancer, 82% of whom were 50 years of age and older.
In 11% of (401) of the cases, the additional tumor was diagnosed within a year of the initial breast cancer diagnosis, a third (1,236) cases were diagnosed within a year to 5 years following the initial diagnosis, whereas the majority, (56% of the cases, 2070) were diagnosed from 5 to 10 years or more after initial diagnosis.
The cumulative risk of developing an additional malignant tumor among breast cancer patients (among survivors) increased as age at diagnosis for cancer of the breast increased. Most of the patients who developed an additional malignant tumor were 60 years of age and older when they were diagnosed with breast cancer.
The cumulative risk of developing an additional malignant tumor was directly connected to the stage of the breast cancer at diagnosis. For example: the risk of developing the disease ten years after initial diagnosis ranges from 9% in those who have been diagnosed with the disease at an early stage, to 36% in those who have been diagnosed with metastatic breast cancer.
The most common additional malignant tumor among breast cancer patients is colorectal cancer (18%). This is followed by uterine cancer, lung cancer, melanoma and ovarian cancer, similar to the distribution in the female population of Israel.
In comparison to same-age peers in the general population, breast cancer patients have a 24% higher risk of developing an additional malignant tumor of any kind, with the exception of breast cancer.
Mammography Screening Test: is this a potentially life-saving test, or a test which leads to over-diagnosis?
The evaluation of the efficacy of the mammography screening program is measured by the screening test's capacity to lower breast cancer mortality in a given population.
European researchers, experts in screening programs, have recently published (September 2012, Journal of Medical Screening) a series of articles which give an overview of this subject with the aim of obtaining a clearer picture of the efficacy of mammography screening, particularly in view of the arguments concerning over-diagnosis.
Researchers indicate the fact that many studies published in various European countries use disparate methodologies, which makes it difficult to compare them. The investigators opine that some of the arguments regarding the efficacy of the mammography screening program derive from the inappropriate use of research methods which sometimes make it difficult to establish the true efficacy of the program.
For example, in observational research studies, a decrease in mortality was observed, ranging from 25%-31% among women who were summoned to undergo a mammography screening and 38%-48% for women who underwent a screening in practice. Research studies of this kind are valid only when there is long-term information about women who are screened in the program, information which facilitates connecting the woman's screening history with her cause of death.
An additional research study surveyed the data of the research studies which examined the benefits of mammography as opposed to the disadvantages inherent in this screening test, which derive from over-diagnosis.
In order to demonstrate these data, the research investigators gave a sample of a tangible population consisting of 1000 women of the age of 50.
According to this example, in a small city which does not participate in the screening program, with a population of 1000 women between the ages of 50-51, it is anticipated that during a 30-year follow up period, 67 women will be diagnosed with breast cancer and about 30 of them will succumb to the disease.
In a different city, with a population of the same size, which participates in a controlled screening program that summons women to undergo a screening test once every two years, starting from the age of 50, for a period of 20 years, it is anticipated that 21-23 women will succumb to breast cancer over a 30-year period, and 4 women will be diagnosed due to false-positive results.
According to the calculations of scientists, for every 1000 women screened once every two years, starting from the age of 50, 7-9 cancer-related deaths shall be prevented, on the other hand, there will be 4 cases of over-diagnosis during the follow-up period.
Night Work and the Risk of Cancer among Men
Several research studies have discussed the link between night shifts and a higher risk of developing breast cancer among women. In a new research study recently published in the American Journal of Epidemiology, research scientists conclude that night work among men increases their risk of developing a number of cancers.
The research study conducted in Montreal, Canada involved men aged 35 to 70 years, residing in the Montreal metropolitan area, who have been diagnosed with a cancer.
In interviews conducted between 1970 and 1985, among 3,137 male cancer patients diagnosed with 11 of the most prevalent cancers, data was collected on their demographic and lifestyle characteristics, as well as their occupational history. These data were compared to a control group with background characteristics, such as age and place of residence, similar to those of the patient group.
The research study found evidence among men of a possible association between night work and a higher risk of lung, colorectal, pancreatic, bladder, and prostate cancer and non-Hodgkin's lymphoma. Among these men there was no evidence of a higher risk of developing melanoma, renal or esophageal cancer.
The research scientists indicate that among men who worked the night shift for more than 10 years, an increased risk for prostate, intestinal and bladder cancer, as well as non-Hodgkin's lymphoma, was observed.
The main reasons for the increased risk of developing cancer were related to exposure to light at night, sleep disturbances, shift work, as well as a lifestyle associated with an imbalanced diet, lack of physical exercise, a high BMI and Vitamin D deficiency. Scientists believe that reduced production of the sleep hormone melatonin is the main reason for the increased risk, due to this particular lifestyle.
In view of the fact that the frequency of night work is on the rise, investigators emphasize that further epidemiological studies are required to verify the research data. These studies should methodologically and accurately investigate the data relating to exposure to night jobs, exposure to artificial light at night and melatonin levels among this male population segment.
Ref: Night Work and Risk of Cancer among Men; American Journal of Epidemiology, October 3, 2012
ICA shows global cancer organizations how World Cancer Declaration targets are implemented using a cancer advocacy "Toolkit"
In 2011, the Union for International Cancer Control (UICC) represented by the ICA in Israel, initiated an international treaty, the "World Cancer Declaration" signed by millions of people across the globe and in Israel. This document contains 11 targets that are addressed to the decision makers in various countries, as a tool to help bring the growing cancer crisis to the attention of governments and health policymakers in order to significantly reduce the global cancer burden which takes an enormous human toll and incurs tremendous financial costs.
The UICC has published a detailed manual for the implementation of the Declaration targets in collaboration with the Association of European Cancer Leagues (ECL). In this manual the ICA was given the privilege of demonstrating how it has taken steps in implementing these guidelines.
Global cancer organizations may use the declaration as a gauge for their activity in the fight against cancer and may utilize the manual as a "toolkit" for implementing the declaration targets.
New! In view of the increase in breast cancer survival rates, ICA is now opening a unique breast cancer survivor workshop, aiming to enhance quality of life for survivors and their families, provide them with guidance for a healthy life, and encourage them to return to a full and active life. The workshop consists of several sessions relating to various topics, such as: nutrition for breast cancer survivors, the impact of treatments on sexual health, breast cancer treatment side-effects, "Conquering the Past, Connecting to the Present, and Creating the Future", "How to Continue?" and more.
Participation is free of charge, andf the sessions will be held at the "Together we are Strong" Support Center in Givatayim, as of 12 November.
Additional workshops will be held for other breast cancer survivors throughout the year.
A unique ICA project in collaboration with the women's website "Onlife" features leading female personalities from different areas of activity photographed holding a sign of their choice related to breast cancer. Immediately upon the distribution of the photos across the web, women will be called upon to upload their photos with signs relating to breast cancer. The collection of photos will be published on the ICA Facebook page, on "Onlife" and on all "Ha'aretz Group" websites, and will be accompanied by articles, research studies and articles relating to this subject.
"Celebrating Life" Seminar for Women Coping with Breast Cancer will be held 30 October 2012 at Kfar Hamaccabiya.
In keeping with annual tradition, the Estée Lauder Companies in Israel, in collaboration with the ICA, will illuminate well-known Israeli landmarks in pink lights in order to increase breast cancer awareness.
Annual ICA "Doorknock" Fundraising Campaign is held 22 October 2012.
Public donations enable the ICA to finance dozens of studies conducted by physicians and research scientists seeking a cure for cancer, as well as to fund informational activities aimed at increasing public awareness and prevention, financially support the initiation and construction of national early detection programs leading to higher cure rates, economically support cancer patients in need, lend a hand to child cancer patients in keeping up with their studies, run summer camps for cancer patients and their families, assist in the set-up of oncology departments at hospitals throughout Israel, finance posts for nurses, psychologists, dieticians and social workers who assist cancer patients at hospitals and in community clinics, and to endeavor on behalf of cancer patients in Israel and promote their rights. The ICA calls upon the general population to open their doors and hearts and to contribute for patients and against the disease.
The ICA's annual fundraising campaign is an important source of funds for the ICA, as its activity receives no government funding whatsoever.
We frequent households in Israel from north to south in this campaign, including Israeli embassies across the globe. Thousands of school-age children and members of youth movements, take part in the "Door Knock" campaign, in close collaboration with the education system and ICA volunteers who are active in over 70 branches throughout the country.
The ICA requests that the public verify that an official ICA receipt has been provided.