Differences in trends of lung carcinoma by histology type in Israeli Jews and Arabs, 1981-1995.

Between 1981 and 1995 the national cancer register in Israel received reports on 13,600 new cases of lung cancer. We evaluated the trends in total lung cancer and the histologic subtypes, in Jewish and Arab Israelis. During this period, the age-adjusted incidence of lung cancer increased in the male Arab population, while for male Jews there was a non-significant decrease, for women in both population groups the rates were stable. When analyzed by age group, there was a significant decrease in incidence rates in Jewish males aged 75 years and older. An analysis by histologic subtypes showed two different trends. In the Jewish population, the age adjusted incidence rates of squamous cell carcinoma (SQCC) decreased and the incidence rates of adenocarcinoma (AC) increased, whereas in the Arab population the incidence rates of both subtypes increased, although statistically significantly only for SQCC. The changes found in the Jewish population are similar to those found in other western countries, where the rates of AC are increasing and the rates of SQCC are decreasing. The trends in the Arab population in Israel are different. This may be due to different trends in the prevalence of smoking in the two populations.

Childhood and adolescent ovarian malignant tumors in Israel. A nationwide study.

OBJECTIVES: To determine the incidence of ovarian malignant tumors in childhood and adolescence, to ascertain the frequency distribution of the various tumor types and to assess time trends in Israel on a nationwide basis. METHODS: The study group included all Israeli Jewish patients < or = 19 years old with histologically confirmed ovarian malignancies, diagnosed in Israel from 1970 to 1994. Data were obtained from the Israel Cancer Registry. The effects of age at diagnosis and period of diagnosis were analyzed using the Poisson regression. RESULTS: Among the 82 patients identified, the most frequent tumors (72.0%) were of germ cell origin and among those about one third were dysgerminomas. Epithelial tumors were diagnosed in 26.6% of the patients and most of these were borderline malignancies. The incidence rate (IR) for the total group of ovarian malignancies in the 0-19 age group was 0.52 and for ages 5-19 it was 0.71 per 100,000. After adjustment for age, a significant linear trend for a decrease of germ cell tumors over time was found, stemming from a decrease of dysgerminomas. A significant trend for increase in the IRs with age was also found. In addition, a steep rise in the age specific IRs of epithelial borderline tumors was noted in the last 5 year period. CONCLUSIONS: The IRs of ovarian malignancies in childhood and adolescence in Israel, as in other countries, is very low as compared to adults and the most common tumors are of germ cell origin while malignant epithelial tumors are very rare. A time period effect in the germ cell tumors that resulted from an inexplicable significant decrease in the age specific IRs of dysgerminomas, was observed. A significant increase in borderline tumors was also noted and may be attributed to greater awareness of pathologists to this entity.

Selected epidemiological time trends of vulvar carcinoma in Israel.

Recently, considerable demographic changes have occurred in Israel. The purpose of the present population-based nationwide epidemiological study of carcinoma of the vulva was to assess changes over time in incidence, relative frequency, age pattern and ethnic distribution. The study group included all 257 Jewish females with histologically confirmed neoplasms of the vulva diagnosed in Israel during the ten year period from 1985 to 1994. Data were obtained from the Israeli Cancer Registry and compared with data from a previous study covering a 13 year period (1961 to 1973). The relative frequency of carcinoma in situ (CIS) of the vulva increased significantly during the later period (from 5.4% to 12.8%), while that of invasive vulvar carcinoma declined significantly (from 80.6% to 69.6%). Regarding invasive vulvar carcinoma, a significant decrease in the age-adjusted standardized rates and in the mean annual incidence rate in the 70+ age group was found. The ethnic distribution pattern of invasive vulvar carcinoma did not change and remained similar to that of cervical carcinoma, namely a trend for higher incidence among women born in North Africa. The increased frequency of vulvar CIS is attributed mainly to a greater propensity to perform vulvar biopsies. The possibility of a consequent decline of vulvar carcinoma cannot be ruled out.

[Smoking and incidence of lung cancer, 1981-1995].

Smoking is the dominant risk factor for lung cancer. We compared trends in smoking with those of the incidence of lung cancer in Israel. The proportion of smokers has declined during the past 20 years; the decrease is greater in men than in women, and more marked in the elderly. Since 1980 the age-adjusted incidence of lung cancer in Jewish men has decreased slightly, but in women it has remained constant. Among Arab men there was an increase in age-adjusted incidence of lung cancer and since 1986 it has been higher than in Jewish men. The largest decrease in lung cancer incidence was among Jewish men aged 75 and over. This may be explained by data on the age of smoking cessation in the population. It was observed that the main decrease in smoking occurred among men over the age of 55 in the past 20 years, which correlates with the decline in lung cancer observed in the older age group. Lung cancer rates in Israel are lower than in other western countries despite the similar prevalence of smoking, for unknown reasons.

An epidemiological study of posterior uveal melanoma in Israel, 1961-1989.

Trends in the incidence rate of uveal melanoma in Israel during the period 1961-1989 among Jews of various geographical origins and among non-Jews were examined, and found to be stable over time. Based on data of the Israel Cancer Registry, 515 cases were included in the final study population after an independent case-finding ascertainment survey. The average annual incidence rate per million for all Jews was 5.7 for both males and females; the rates for non-Jews were: males 1.6, females 1.3. Incidence rates within the Jewish sub-populations show significant differences. The highest rates by sub-population were for Jews born in Europe or America (7.5 for males and for females), followed by Jews born in Israel (males 6.8, females 6.7); and lowest in Jews born in Africa (males 2.1, females 2.3) and Asia (males 1.6, females 2.8). Jews born in Israel had rates lower than Jews born in Europe and America during the 1960s, but in the 1980s the situation was reversed. Results suggest that rate differences between population groups and over time stem from constitutional factors or from the direct or indirect effect of sunlight radiation, whether early in life or from cumulative exposure.

Incidence of cutaneous malignant melanoma in Israel, 1960-1989.

BACKGROUND: The cutaneous malignant melanoma (CMM) incidence rate in most affluent countries has increased over the last three or four decades. Despite specific attention, evidence for a role of factors other than sun and ultraviolet exposure is weak. OBJECTIVE: To update time trends of CMM in Israel. METHOD: A population-based cancer registry data base of CMM among Jews and non-Jews by age and gender was analyzed. A quality control survey was conducted to insure complete coverage and data validation for the period 1960-1989. RESULTS: The incidence rate of CMM in All Jews increased throughout the study period, with a monotonic annual increase of 4.8% for males and 4.3% for females. There was a steep increase in incidence until the mid-1970s, with an a posteriori levelling-off. Also, incidence was higher in females than in males. There were variations in incidence among Jewish subpopulations. Israel-born Jews are the highest incidence subgroup (average age-adjusted incidence rate (AAIR) 7.8 and 9.4 per 100,000 for males and females, respectively), followed by Jews born in Europe and America (AAIR, 6.1 and 7.3 per 100,000 for males and females, respectively). The lowest rate was for Jews born in Africa and Asia (AAIR, 1.3 per 100,000 for both males and females). Analysis of age-truncated rates reveals that Jews born in Europe, America, and Israel, mainly at age 45-64, have increasing CMM incidence. Non-Jews have a stable rate which could either be real or an artifact of underdiagnosis. CONCLUSIONS: The different time trend incidence patterns between subpopulations could be due to differing cumulative sun exposure over the last 40-50 years, mainly in those at age 45 and over. The levelling-off of the invasive CMM incidence rate, mainly in native Israeli Jews under age 45, could be attributed to increasing awareness and early diagnosis.

Descriptive epidemiology of malignant tumors in Ethiopian Jews immigrating to Israel, 1984-89.

This descriptive epidemiological study analyzes the frequency of cancer after the arrival of Ethiopian immigrants as reported to the Israel Cancer Registry from 1984 to 1989. The study cohort comprised 8,272 individuals (estimated 4,253 males and 4,019 females) with 27,966 and 26,848 person-years observed for males and females, respectively. Overall cancer incidence in this migrant cohort was low for both genders compared to cancer incidence among Jews born in Israel. The standardized incidence ratio (SIR) (in percentage) for cancers at all sites was 39 [95% confidence interval (CI) = 22-64] and 63 (95% CI = 41-92) for males and females, respectively. Male primary liver cancer and female thyroid cancer had high SIRs. All other sites had either average or low SIRs. No cases of neoplasms were reported in the respiratory system. Except for primary liver cancer, digestive neoplasms had an inverse male: female ratio.