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Prostate Cancer Awareness Day 2014

17/09/2014

The Israel Cancer Association and the Ministry of Health present new and up-to-date statistics for prostate cancer in Israel:  

Big-Bullet-SQR.gif The prostate gland - click here to know when to get screened (in Hebrew).

Big-Bullet-SQR.gif Summary of findings from the report of Dr. Lital Keinan-Boker - Deputy Director, Israel Center for Disease Control (ICDC), Ministry of Health:

bul3 Prostate cancer is the most common type of cancer among men in Israel.

bul3 There are currently over 16,000 men who have been diagnosed with invasive prostate cancer in Israel.

bul3 In 2011, 2,407 new patients were diagnosed with invasive prostate cancer.

bul3 There has been a downward trend in prostate cancer incidence rates among Jewish men and rates have been stabilized among Arab men.

bul3 There has been an upward trend in the 5-year relative survival rate, which currently stands at 93.3%.

bul3 In 2011, 432 men died of invasive prostate cancer in Israel.

bul3 There has been a downward trend in mortality rates among Jewish and Arab men alike.

bul3 In a global comparison, while the prostate cancer incidence rate among Israeli men is similar to that of European countries with a high prevalence of the disease, the prostate cancer mortality rate in Israel is low.

bul3 A Prostate Cancer Seminar for patients, survivors, and their families was held on 10 September 2014, led by Dr. Raanan Berger, Director of the Institute of Oncology and Radiotherapy, Sheba Medical Center, Tel Hashomer.

Detailed Statistics:

Big-Bullet-SQR.gif Incidence Rates:

bul3 In 2011, 2,407 new patients were diagnosed with invasive prostate cancer, of whom 2,161 were Jews (90%), 132 were Arabs (5%) and 114 were non-Arab Christians and 'religiously unaffiliated' ("others") (5%).

bul3 There has been an upward trend in prostate cancer incidence rates since the early 90s, when the Prostate Specific Antigen (PSA) test became available in Israel.  In recent years, incidence rates have dropped among Jewish men and have stabilized among Arab men.

Big-Bullet-SQR.gif Morbidity Rates by Age:

bul3 Prostate cancer incidence rates increase markedly after age 50 and morbidity has mainly been observed among persons aged 65 years and above.  Among both the Jewish and Arab male population, morbidity levels peaked in the age group of 70-74.

bul3 Prostate cancer morbidity rates by place of birth are contained in the attached report (in Hebrew).

Big-Bullet-SQR.gif Prostate Cancer Survival Rates:

bul3 The 5-year relative prostate cancer survival rate for men diagnosed during 2001-2006, stands at 93.3%, compared to a rate of 85.2% among those diagnosed from 1996-2000.  In other words, there has been an upward trend in survival rates.

Big-Bullet-SQR.gif Prostate Cancer Mortality Rates:

bul3 Prostate cancer is the third leading cause of cancer deaths among Jewish men in Israel; among Arab men, it is the sixth leading cause of cancer mortality. 

bul3 In 2011, 432 men died of prostate cancer in Israel.

bul3 The average age of those who died of invasive prostate cancer was 80.3.

bul3 Trends in mortality rates show a decline among Jewish and Arab men alike.

Big-Bullet-SQR.gif Global Comparison:

bul3 According to the International Agency for Research on Cancer (IARC) 2012 statistics, which compare the prostate cancer incidence rates and mortality rates in Israel to those of the top 20 countries with the highest rates in Europe, it emerges that the incidence rates rank 11th highest (in the middle) in Israel, whereas, the morality rates are lower than those of all the countries that were studied in this statistical comparison.  

Big-Bullet-SQR.gif Please click here for up-to-date morbidity and mortality statistics for prostate cancer in Israel (in Hebrew).

The Israel Cancer Association Information Center Presents New Studies:

Big-Bullet-SQR.gif Is Obesity Associated with Risk of Progression for Prostate Cancers?

Studies show that obesity is associated with a significantly increased risk of progression for advanced prostate cancer.   However, the impact of obesity, among early prostate cancer patients, on progression of the disease has not been sufficiently explored.

Researchers from the University of Toronto, Canada sought to explore the link between obesity and the progression of prostate cancer among men who developed the disease and were undergoing 'active surveillance' (AS).  According to this method, those who are diagnosed at an early stage with low-risk prostate cancer are closely monitored, as long as the disease has not progressed beyond the critical stage at which active treatment is initiated; this method is aimed at preventing or deferring treatment side-effects.

In this cohort of 565 men, with a mean age of 63, the subjects took part in the 'active surveillance' program for 4 years on average.     Demographic, clinical and pathological data were collected regarding each one of the participants, in addition to height and weight data for the calculation of Body Mass Index (BMI).  "Obesity" was a BMI value greater than or equal to 30, overweight was a BMI value of 25-30, and normal weight - BMI of less than 25.  124 men were classified as obese, 289 as overweight, and 152 fell within the healthy weight range.

Progression of the disease was measured using two methods: 'Pathologic progression' as observed in biopsies only, and 'therapeutic progression' which reflects the overall clinical condition of the patient, as a result of which the patient moves from 'active surveillance' to active treatment for the disease.  During the course of this study, progression of the disease was observed among 340 patients: pathologic progression among 168 men and therapeutic progression among 172 men.

The study results demonstrated that the higher the BMI, the more rapid the progression of the disease: each 5-unit increase in BMI (5kg/h) was associated with a 1.5 fold increased risk of 'pathologic progression', and a 1.4-fold increased risk of 'therapeutic progression'.

In short, the researchers assert that this is the first-ever study in this field which proves that a weight increase increases the risk of progression of prostate cancer for patients who are undergoing active surveillance.  The researcher scientists indicate that in view of these results, there is a need for additional research studies to investigate the possibility of reducing the risk of disease progression by lowering body weight by adopting a healthy diet, engaging in physical exercise and/or undergoing medicinal treatment.

Published online in the June 2014 edition of the European Urology Journal

Big-Bullet-SQR.gif Can male BRCA mutation carriers reduce their risk of developing prostate cancer?

BRCA1 BRCA2 gene mutations have long been known to increase the risk of developing breast and ovarian cancer among women and breast cancer among men.  In recent years, studies have shown that men who carry either of these gene mutations also stand at increased risk of developing prostate cancer: an 8.6-fold risk for BRCA2 carriers and 3.7-fold risk for BRCA1 carriers.

The most significant risk factors for prostate cancer are non-modifiable, and include genetics and age.  In an attempt to explore the modifiable risk factors for prostate cancer, over which subjects have control, researchers from Creighton University in Nebraska, US, examined several behavioral factors among 745 men who were part of families with a BRCA gene mutation; however, not all subjects were carriers themselves and not all developed cancer.  The subjects were divided into 4 groups: male BRCA1 and BRCA2 mutation carriers who developed prostate cancer; healthy male BRCA1 and BRCA2 mutation carriers; male non-carriers who developed prostate cancer; healthy male non-carriers.

The subjects completed questionnaires addressing their lifestyle and medication use: physical activity of 30 minutes or more, 4 times a week, drinking one glass of alcohol once a week, smoking history, coffee use - one cup or more a day, statin use (drug that lowers cholesterol level), daily aspirin use of any strength for five years and more, finasteride use (to treat hair loss), and vitamin use.

Based on the research results, it emerges that daily aspirin use benefitted carriers of BRCA1 and BRCA2 mutations, by reducing the risk of prostate cancer by 8.4%, as opposed to those who do did not have a history of aspirin use.  This information confirms that daily aspirin use demonstrates a protective effect against prostate cancer, a fact which has been observed in previous studies of the general population.  

Vigorous exercise and daily coffee use were also found to be behavioral factors that reduce the risk of prostate cancer among BRCA1 and BRCA2 carriers; however these results did not achieve statistical significance. 

The researchers emphasize the need for additional broad-scale studies to reinforce the data of this particular study.

This study was published in the April 2014 edition of the Journal of Genetic Counseling