Over 300 skin check-up venues opened upon the initiative of the ICA, in clinics of all health care funds across Israel Dr. Lital Keinan-Boker, Deputy Director of the Center for Disease Control of the Ministry of Health presents up-to-date statistics as Skin Cancer Awareness week approaches:
Although, globally speaking, an increase in melanoma morbidity has been reported, in Israel, among the Jewish population stability in invasive melanoma incidence rates has been observed over the past decade, with the exception of a slight increase over the past year.
Melanoma in situ morbidity rates have risen over the past decade, which indicates an increase in the early detection rates of the disease. To a certain degree, this increase has come to a halt over the past two years.
Mortality rates have been stable over the past decade among Jewish males and have decreased by 32% among Jewish females.
Among Israeli Arabs, the melanoma mortality and morbidity rates are very low.
Invasive Melanoma
In 2010, 1,002 new patients were diagnosed in Israel with invasive melanoma. Among the Jewish population, the age-standardized invasive melanoma incidence rates were stable over the past decade, with a slight increase in the middle of this period and over the past year.
Among Jewish males, the rate was 12.2 per 100,000 men in 2000, compared with 13.9 per 100,000 men in 2010. A slight increase was also recorded among Jewish females.
According to Prof. Schachter, Director of the Ella Institute at Sheba Medical Center and an Advisor to the ICA, even in invasive melanoma, diagnosis at the early stages constitutes early detection, which enables higher cure rates. It is possible that this increase is due in part to the early detection of invasive melanoma.
Only a handful of cases (of invasive melanoma) were recorded among the Arab population.Melanoma in Situ
In 2010, 368 new patients were diagnosed with malignant melanoma in situ (a very early stage of the disease). This number is slightly lower than the number of new patients diagnosed in 2009. The trends up to 2008 attest to an increase in the incidence of melanoma in situ, however over the past two years, there has been a slight decrease.
In 2000, 5.3 per 100,000 men were diagnosed among Jewish males, as compared to 5.4 per 100,000 men in 2010. In 2000, 3.9 new cases per 100,000 women were diagnosed among Jewish females, as compared to 4.1 per 100,000 women in 2010. According to Prof. Schachter, this apparently follows the trend that shows stability in early detection rates. The upward trend in the incidence of melanoma in situ since 1992, the year in which ICA initiated activity in this area, indicates an increase in early detection of the disease, which enables extremely high cure rates. The high melanoma morbidity rates were observed among native-born Israelis aged 55 and older. There has been an upward trend in 5-year relative survival rates for melanoma. The survival rate rose to 85.9% among men and 89.7% among women.
Mortality rates
In 2010, 207 people died of melanoma in Israel.
The age-standardized mortality rates for melanoma among the Jewish population dropped over the past decade from 2.4 per 100,000 people in 2000, to 2.2 per 100,000 people in 2010, both among men and among women. The trends in melanoma mortality rates since 1992, the year in which ICA commenced initiated activity to promote early detection of the disease, indicate stability among males, and a 32% decline among Jewish females.
International Comparison
According to global cancer statistics 2009 issued by the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO), Israel ranked 18th in the incidence of invasive melanoma, after Australia, Scandinavia, countries in Western Europe, and the United States.
A joint committee comprised of the ICA, the Cosmetics Dept. of the Pharmacy Division (Ministry of Health), the Community Medicine Division of the Ministry of Health, expert physicians who serve as Advisors on Skin Cancer to the ICA, and additional health professionals, is currently formulating new and progressive standards on sunscreen products, according to the various recommendations for universally accepted standards (Australian, European, FDA), and is also in the midst of exploring the possibility of changing the labeling statements that appear on the products (advertising warnings, instructions for use, limiting labeling statements that may mislead the public, classifying and labeling products, and more).
New Research Studies
New immigrants who arrived to Israel from Europe prior to the age of 10 are subjected to double the risk of contracting melanoma.
A new large-scale Israeli research study reveals that those who immigrated to Israel from Europe prior to the age of 10 face nearly double the risk of developing melanoma as compared to those who immigrated from Europe after the age of 10. Additionally, there is a difference in risk of developing the disease according to country of origin; among those of European descent who participated in the study, the risk of developing melanoma was fourfold as compared to participants of African/Asian descent. This research study was conducted by Dr. Hagai Levine and Prof. Jeremy Kark of the School of Public Health of the Hebrew University-Hadassah, in collaboration with the Medical Corps and the National Cancer Registry of the Ministry of Health. Risk factors for developing melanoma were detected in this research study as part of a 40 year follow up on over one million Israeli men, who were examined at the age of 17 in the IDF Recruitment Office.
Researchers' Conclusion: The research findings emphasize the importance of protecting children from sun exposure, particularly those who are fair-skinned. This research study was published in 2013 in the International J. of Cancer
Those diagnosed with non-melanoma skin cancer are at risk of developing a different type of cancer.
In a new large-scale research study scientists in Boston, U.S., and in China, discovered that women and men who were diagnosed with one of the two types of non-melanoma skin cancer (NMSC): Basal Cell Carcinoma - BCC and Squamous Cell Carcinoma - SCC, are at risk of developing other types of cancer. Those who compiled the research analyzed the findings of two large-scale prospective studies that were conducted in the United States. The NHS research study was conducted from 1976-2008, among 121,700 nurses between the ages of 30-44, in 11 states across the U.S.
The HPES research study was conducted from 1986-2008 among 51,529 men, medical professionals, such as dentists, veterinarians, pharmacists and optometrists, aged 40-75.
In both studies, the participants completed questionnaires once every two years about their lifestyle, diet and medical condition in order to examine the link between lifestyle and risk factors for cancer. As NMSC incidence varies among people of different ethnic origins, upon analysis of the research findings, the scientists focused only on Caucasians. The researchers examined the link between NMSC morbidity and the risk of developing cancer in a different organ, indicating that those who developed NMSC were older and received more sunburns; additionally, they were also more frequently red headed or light-skinned and resided in countries where the sun's rays are stronger. 36,102 cases of NMSC and 29,447 cases of cancers other than NMSC were reported. Among those who had a history of NMSC, the scientists found an increased risk of 15% among men and 26% among women, of developing a second cancer of a different type, as compared to those who did not develop NMSC at all. Women were at risk of developing breast and lung cancer and melanoma, and men were at risk of developing melanoma. The explanation behind the link between NMSC and melanoma may lie in sun exposure, however the explanation behind other types of cancer may be inherent in the link that researchers found in the past between genetic signs and these types of cancers. Meaning, defects in the DNA reparative mechanisms in skin tissue, or the response of the immune system to these defects, may indicate a systemic flaw which plays a role in the development of a different type of cancer in the body. The researchers emphasize that only on the condition that additional significant facts validate this research, will it be recommended that individuals who have developed NMSC be kept under close observation, in view of their heightened risk of developing a second type of cancer.
This research study was published on 23 April, 2013 in PLOS Medicine
Does Omega 3 help provide protection from the sun's harmful rays and skin cancer?
Skin cancer is particularly prevalent among the populations of warm, sunny countries - such as Israel. Ultraviolet radiation (UVR) which damages the skin during sun exposure plays a key role in cancer development. Beyond the direct damage which causes damage to DNA and immune cell regulation as well as an increased risk for cancer, UVR damages the skin's immune system, and consequently, the skin loses its capacity to remove defective/mutant cells, which rapidly divide and become a cancerous growth. Previous studies have shown that Omega 3 fatty acids provide protection against immune damage and the development of cancer among mice. 79 female volunteers aged 22-60 participated in a randomized controlled trial led by scientists from different centers in England. These volunteers were divided into 2 groups, the trial group and control group. All the participants received a dose of UVR from an artificial source (about 70% from radiation that would cause skin rash/redness).
Similarly, all the subjects were nickel-sensitive. This sensitivity develops as a result of body piercings and wearing jewelry. Seeing as nickel allergy may be measured and is evidenced by a hyper responsiveness of the skin's immune system, the scientists planned to test the responsiveness of the skin's immune system with the help of the nickel sensitivity indicator. The women in the trial group received 5 grams of EPA & DHA, Omega-3 fatty acids, for 3 months. The control group received a placebo. Following exposure to radiation, the skin's responsiveness following nickel exposure was examined in 3 areas of the body. The scientists found a direct link between the oppression of the skin's immune system and the dose from artificial radiation. For example, among the trial group the concentration of Omega-3 in the red blood cells was fourfold of that among the control group, and the oppression of the skin's immune system was about 6.9% less. To sum up, the research concludes that increasing the consumption of Omega-3 fatty acids contributes to reducing the oppression of the skin's immune system under the influence of UVR and reinforces the understanding that the harm incurred by the skin's immune system constitutes an integral part of the skin cancer development process, as well as the understanding that nutrition has the potential to significantly impact the prevention of cancerous processes.
The fact that Omega-3 supplements have contributed to the reduction of the immune damage underlines the importance of the consumption of these fatty acids from food sources such as - fish, algae, enriched eggs which provide fatty acids that have a direct impact and/or flax seeds, canola oil, and sage as well as green leaves that provide short-chain fatty acids. The effectiveness of these [nutrients] increases in their natural food environment, which protects them from oxidation.
This research study was published online in The American Journal of Clinical Nutrition in January 2013, and in the printed edition in March 2013. (This research is provided courtesy of Dr. Niva Shapira, a clinical nutritionist of the Institute of Nutritional Research at Beilinson Medical Center - Rabin Center and Advisor to the ICA)
Can a urine sample taken from individuals who work outdoors indicate that skin damage has occurred?
Researchers from the noteworthy Karolinska Institute in Sweden with the help of other researchers of Gutenberg University, conducted a research study in which they requested to evaluate the relationship between exposure to UV rays and the level of the biological marker Thymine Dimer among individuals who work outdoors. High levels of Thymine Dimer indicate that DNA damage has been incurred, which in turn, has an impact on the cell's general ability to repair damaged DNA, thereby hindering normal cell division. The scientists have hypothesized that this marker, which may be identified in a simple urine sample, may constitute a bio-marker of exposure to UVR. As part of this research study, the daily UVR exposure of subjects aged 18-54, 16 lifeguards and 6 agricultural workers employed in beet sugar and hothouse fields, was analyzed. This research study measured the level of the Thymine Dimer bio-marker in urine and also calculated the sun-exposed area of the body during exposure time. The researchers discovered a link between the level of UVR exposure and the level of the bio-marker in the urine. This is the first-ever demonstration of the link between occupational exposure to UVR and the urinary bio-marker level that indicates DNA damage. The scientists propose that the bio-marker level serve as an indicator of sun exposure among outdoor workers.
This article was published online in the journal Mutagenesis in January 2013 and in the printed edition in March 2013
Marking Skin Cancer Awareness Week, the ICA held many activities, to increase public awareness of the importance of skin cancer prevention and early detection:
The "Live Forum" held on 16 May at 11 am, featuring experts who answered YNET surfers' calls regarding skin cancer. The expert panel featured an oncologist, a dermatologist, an oncology nurse and a social worker.
ICA recently launched a new and unique brochure aimed at teens entitled "Sister, brother sun smart is where it's at!". This new brochure is full of tips and explanations on how to protect oneself from the sun's harmful rays, and features cool photos that appeal to young people, as well as a flowing writing style tailored especially for teens. The brochure was printed courtesy of Opticana.
A seminar on melanoma and BCC is scheduled to take place on 17 June 2013, led by Dr. Michal Lotem, Head of the Center for Melanoma and Cancer Immunotherapy at Hadassah Medical Center, Ein Karem, and an Advisor to ICA, and with senior experts in attendance. This seminar is tailored to patients, survivors and their families and will take place at Beit Mati, ICA Headquarters in Givatayim.
The ICA will be launching a public information campaign featuring ads in newspapers as well as a radio and TV campaign.
There will also be joint activity with the Ananei Tikshoret Channels Group on prevention and "sun smart" behavior, with the aim of increasing awareness of the sun's harmful effects among children, teens and adults. The activity will extend over several media channels and will be featured on different programs.
As summer approaches, the health care funds will be holding discount campaigns on sunscreen products. The ICA recommends entering websites of the health care funds to receive up-to-date information.
Super Pharm joins the ICA in the fight against cancer, and has announced that it will donate one shekel to the ICA for each LIFE sunscreen product that is sold. The "Sunscreens" information booklets were also printed this year, and distributed to schools, provided for seminars and conferences, and distributed to anyone who requested information. These booklets were printed courtesy of Super Pharm Pharmacy Chain.
Skin Cancer Awareness Week Campaign
Upon the initiative of the ICA, and in collaboration with the health care funds, the Israel Society of Plastic Surgery, and the Israel Society of Dermatology and Venerology, 300 skin check-up venues will open from 19-24 May, to examine skin lesions free of charge, across Israel.
To make an appointment, please contact your health care fund.
For a list of the skin cancer check-up venues, please visit the ICA website at: www.cancer.org.il
Please visit us on Facebook under the category - Steps to a Health Life (in Hebrew). The list of (check-up) venues will be printed in the local newspapers this coming weekend.