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This manuscript provides the available data on the burden of human papillomavirus (HPV) infections and HPV-related diseases in Israel. The incidence of cervical intraepithelial neoplasia grade 3 (CIN3) among Jewish women was 17.4 per 100,000 in 2007, showing an increase since 1997. The incidence of cervical cancer was 5.3 per 100,000 Israeli Jewish women and 2.3 per 100,000 Israeli non-Jewish women in 2007. This rate is relatively low compared to other developed countries, and could be explained by cultural and religious factors such as male circumcision or sexual behavior. Mortality rates were around 1.5 per 100,000 Israeli women in 2007. Incidences of other anogenital, oral cavity, and pharynx cancers are very low, below 1.0 per 100.000 Israeli women and men. Information is scarce on HPV prevalence and HPV type distribution among women with cervical cancer. HPV types 16 and 18 were the two most common types in both preneoplastic lesions and cervical cancer, representing 60% of total invasive cases. Data on genital warts show an incidence rate of 239 per 100,000 men and 185 per 100,000 women, similar to that found in other Western countries. Despite these low incidences, it is important to improve the information on the overall burden of HPV-related morbidity and on the HPV prevalence to evaluate an organized cervical cancer screening program and the introduction of the HPV vaccine in the national school-based vaccine program. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in Israel" Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

Background and aims The relationship between exposure to petroleum products and cancer is well-established in occupational studies carried out among employees of transportation and oil-producing industries. However, question remains whether living near petroleum storage facilities may represent a cancer risk. In the present study, we examined cancer incidence rates associated with residential proximity to the Kiryat Haim industrial zone in Northern Israel, using different analytical techniques and adjusting for several potential confounders, such as road proximity, population density, smoking rates and socio-demographic attributes. Methods Both traditional zonal approaches and more recently developed Double Kernel Density (DKD) tools were used to estimate relative risks of lung and NHL cancers attributed to residential proximity to the petroleum storage site. Results Zonal approaches based on comparing ASRs across small census areas (SCAs) did not detect any significant association between residential proximity to the industrial zone and the two types of cancers under study (P > 0.2). In contrast, the DKD approach revealed that the relative density of both lung and NHL cancers declined in line with distances from the industrial zone, especially among the elderly (Lung: t > − 12.0; P − 9.0; P

Objectives This study explored cancer incidence rates in a large cohort of Israeli (Jewish and Arab) opioid-dependent individuals receiving methadone maintenance treatment (MMT), and how the incidences vary by ethnicity and sex. Method The record linkage between the Israel National Addiction Registry (INAR) and the Israel National Cancer Registry (INCR) was performed. Information about the Israeli general population from the Central Bureau of Statistics was used for comparison to match sex and year of birth to the cohort under study. Age standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. Results Though the SIR values for aggregated cancer sites for both men and women on MMT did not differ significantly from the corresponding figures in the general population (0.88, 95% CI 0.76–1.00, and 1.06, 95% CI 0.76–1.36, respectively), the risks were substantially increased for lung (1.97, 95% CI 1.13–2.82), larynx (3.62, 95% CI 1.11–6.13) and liver (6.8, 95% CI 1.76–11.83) cancers among Jewish men and for cervix uteri cancer among Jewish women (2.41, 95% CI 0.99–3.84). By contrast, the SIR values for colorectal cancer among Jewish men (0.46, 95% CI 0.09–0.82) and for breast cancer among Jewish women (0.36, 95% CI 0.00–0.71) were significantly lower than expected. Conclusions The results suggest that the increased and reduced site-specific cancer risks are counterbalanced, resulting in the absence of the expected excess cancer risk for the entire cohort. The reduced risks for colorectal and breast cancers suggest a protective effect of MMT, warranting further investigation.

Objective Cancer risk in the elderly is about ten-fold higher than in younger age groups. Although several risk factors have been associated with cancer incidence among the general population, little is known about cancer risk factors among individuals entering old age without evidence of disease. Material and methods A historic cohort study of an age homogenous representative cohort of community-dwelling subjects born 1920–1921, enrolled in the Jerusalem Longitudinal Study. Subjects were aged 70 at baseline (1990) and underwent comprehensive assessment of numerous domains. Cancer incidence from age 70 to 88 (1990–2008) was ascertained from the Israel Cancer Registry. Results The cohort included 435 persons free from cancer at 1990 and the median follow-up was 16.1 years. Malignancies occurred among 59 persons (13.6%). Using Cox regression multiple analyses, diabetes mellitus (HR = 2.28, 95% CI: 1.27–4.09) and smoking pack years (HR = 1.01 per year, 95% CI: 1.001–1.022) were associated with increased risk of developing cancer after controlling for sex. On the other hand, gender, poor self-rated health, lower educational level and physical inactivity were not associated with cancer. Conclusions Diabetes mellitus and smoking pack years at age 70 are associated with an elevated risk of developing cancer. The possibility of detection bias in the association of diabetes mellitus with the risk cancers cannot be ruled out.

In the absence of patient-specific data, composite level data are often used in epidemiological studies. However, since individual exposure levels cannot accurately be inferred from aggregate data, such an approach may lead to erroneous estimates of health effects of potential environmental risk factors. In the present study, we attempt to address this information-loss problem by using the “kernel density function”, which estimates the intensity of events across a surface, by calculating the overall number of cases situated within a given search radius from a target point. The present paper illustrates the use of this analytical technique for a study of association between the geographical distributions of lung cancer cases and SO2 air pollution estimates in the Greater Haifa Metropolitan Area (GHMA). In the analysis, the results obtained by kernel smoothing are contrasted with those obtained by areal aggregation techniques more commonly used in empirical studies.

Background Several epidemiological studies explored the risk for cancer among both persons with schizophrenia and their first-degree relatives, and among patients with bipolar disorder. No studies have yet explored the risk among persons with schizoaffective disorders. Method Linkage analysis was conducted based on the psychiatric and the cancer national databases. Standardized incidence ratios (SIR) for aggregated cancer sites were calculated by comparing the incidence rates among patients in the psychiatric case register with schizoaffective disorders with the incidence rates in the Jewish–Israeli general population. Results No significant alteration in cancer risk was found for both genders: males, SIR = 1.11, 95% CI (0.48–1.73) and females, SIR = 1.38, 95% CI (0.96–1.80). Limitations Our sample was derived from patients with a history of psychiatric hospitalization. Putative factors such as diet, smoking and medications were not investigated. Conclusions Our study showed no significant increase in the risk for cancer in schizoaffective disorders. Those results appear to be positioned between the schizophrenia findings that show a lower risk for cancer and the bipolar disorder findings that show an increased risk.

Background It has been implied that the incidence of malignant disorders is increased in patients with non-neuronopathic (type I) Gaucher disease. The purpose of the study was to ascertain numbers of cancers in type I Gaucher disease since this is of considerable concern to patients and physicians. Methods Records of 505 patients with type I Gaucher disease seen at a large referral clinic since 1990 were culled in December 2004 to ascertain diagnosis of a cancer identified during follow-up. Age-matched data from the Israeli National Cancer Registry (INCR) database were used for comparison. Findings Patients diagnosed with cancer before 1990 were not included. Of the remaining 500 patients, 227 (45.4%) were male, mean age = 38.7 years; and 273 (54.6%) were female, mean age = 37.0 years (SD = 21.0 years for both). Twenty patients (4.0%) had developed a cancer through December 31, 2003: 6 were male and 14 were female. The most common were three cases each of lymphoma and myelodysplastic syndrome and two cases of multiple myeloma. There was no statistically significant excess of cancer rate among patients relative to age-matched rates reported in national Jewish Israeli and Ashkenazi Jewish Israeli registry records. Conclusions There appears to be no excess risk for hematological or other cancers among patients with type I Gaucher disease relative to the overall Jewish population matched for age. This study confirms recent international studies of patients with Gaucher disease for no excess risk for all cancers but multiple myeloma where these latter studies implicate a significantly higher incidence.

Studies exploring the relationship between schizophrenia and cancer have shown conflicting results. Our study explores this association in three Jewish-Israeli population groups defined by their continent/place of birth (Israel, Europe-America, and Africa-Asia). The identification of the patients was made through the linkage of the nationwide psychiatric and cancer registries. The incidence of cancer in patients diagnosed with schizophrenia was compared with the incidence in the general population. The results showed that the cancer standardized incidence ratios (SIRs) for all sites were significantly lower among men and women with schizophrenia, 0.86 [95% confidence interval (CI) 0.80-0.93] and 0.91 (95% CI 0.85-0.97), respectively. This reduced overall risk was clearest for those born in Europe-America, both men (SIR 0.85, 95% CI 0.74-0.97) and women (SIR 0.86, 95% CI 0.77-0.94). Among women diagnosed with schizophrenia, the SIR was statistically higher for cancer in the breast among those born in Asia-Africa (1.37, 95% CI 1.12-1.63) and in the corpus uteri among the Israel-born (2.75, 95% CI 1.69-3.81) than among their counterparts in the general population. Lung cancer was significantly higher in men born in Asia-Africa diagnosed with schizophrenia than in the respective comparison population group (1.58, 95% CI 1.13-2.2). Our findings, and those of the literature, justify conducting a multinational study that includes identification of cancer-related risk factors among patients with schizophrenia and their families, and information on the use of psychotropic medications. This effort may clarify an epidemiological puzzle that remains outstanding.