Search

Background: Colorectal cancer is one of the most common malignancies in the Western World and in Israel. Most patients with colon cancer are older than 50 years of age. There is no consensus in the literature regarding the behavior of this disease in young patients., Aim: The aim of the present study is to compare clinical and ic pathological features of colon cancer between young and sold patients., Methods: All clinical and pathological characteristics of 200 patients with colon cancer treated at our center during the period 2001-2006 were retrospectively reviewed., Results: Twenty five patients (12.5%) were <50 years age (young patients) at diagnosis (mean age 41 years) and 175 were >50 years (mean age 68 years). Males were 56% of the young group and 60.1% of the old one. Arab patients were 52% of the young group, although their total number was 35 of the 200 patients. No significant difference was found in the stage of tumor at diagnosis between the two groups. Histopathological grade 3 tumors were found in 33.3% of young versus 7.7% in old patients. Surgery and chemotherapy were performed in 96% and 88% versus 95.4% and 69.7% in the two groups respectively. In a median follow-up period of 96 months, 35% of young patients died of their disease compared to 33.1% of the old patients., Conclusions: Other than histological grade, no difference was found in colon cancer features and survival of young compared to old patients. Further studies with higher numbers of patients are suggested to clarify our findings.

Druze individuals rarely marry outside their faith (often practicing consanguinity) and are thus believed to form a genetic isolate. To comprehensively characterize the genetic structure of the Druze population, we recruited and genotyped 40 parent-offspring trios from the Upper Galilee in Israel and the Golan Heights, attempting to capture different extended families (clans) across various geographical locations. Principal component (PC) and ADMIXTURE analyses demonstrated that Druze are close to, yet distinct from, other Middle-Eastern groups (Bedouins and Palestinians), supporting the Druze's Middle-Eastern origin and their recent genetic isolation. Reconstruction of the Druze demographic history using identical-by-descent (IBD) segments suggested an ≈15-fold reduction in population size taking place ≈22-47 generations ago, close to the documented time of the foundation of the Druze faith at the 11th century. Combining the Galilee and Golan Druze genotypes with previously published data on Druze from the Carmel (Israel) and Lebanon demonstrated that all four Druze communities are genetically distinct. The Lebanese group shared less IBD segments (within the group and with other groups) compared with the Israeli Druze and showed higher heterozygosity (suggesting less consanguinity), but was less diverse in PC space. These findings suggest complex recent and ancient demographic history of the Druze population.

Breast cancer (BC) does not affect ethnic groups equally. BC mortality is higher in Israeli Palestinian Arab women than among Israeli Jewish women. This study aims to compare clinical, biological and pathological characteristics of breast cancer in the two populations. Records of 1,140 women with BC treated at Northern Israel between 2002 and 2007 were reviewed: 872 Jews and 268 Arabs. Age at diagnosis, tumor stage, pathological differentiation, estrogen receptor (ER) and HER-2 expression were evaluated. The main age at diagnosis was 49.9 years for Arabs and 59.4 years for Jews (p < 0.0001). Mean tumor size was < 2 cm in 25% of Arabs and 53% of Jews (p < 0.0001). Lymph node metastases presented in 64.6% of Arabs and 37.2% of Jews (p < 0.0001). Stage I disease was 19% in Arab and 49.2% in Jewish women while Stages III and IV disease was 42% and 11.3% respectively (p < 0.001). ER was positive in 69% of Arabs and in 78.5% of Jews (p < 0.001). Poorly differentiated tumors were found in 28.8% of Arabs vs. 12.8% in Jews (p < 0.0001). Overexpression of HER-2 was present in 35.4% of Arab and 22% of Jewish women (p < 0.001). We found that race is an important predictive factor for breast cancer. Arab women are diagnosed at younger age, with more advanced stage and biologically more aggressive disease than in Jewish women. Socioeconomic factors alone are not sufficient to explain significant effects of race on tumor characteristics. Findings suggest a different genetic susceptibility in the two populations which needs further research., (Copyright © 2011 UICC.)

Background: Cultural perceptions and norms affect individuals' psychological reactions to cancer and quality of life, but very few studies have assessed reactions to breast cancer in specific cultural groups. Such assessments are especially rare for Arab women with breast cancer., Aims: To assess the effect of spousal support, sharing household tasks, and body image in relation to emotional distress in Arab breast cancer survivors compared with matched healthy controls., Method: Fifty-six Israeli Arab breast cancer survivors (stages I-III), and 66 age- and education-matched women answered Brief Symptoms Inventory-18, Perceived Body Image, Perceived Spousal Support and Division of Household Labor scale questionnaires., Results: Breast cancer patients experienced higher psychological distress, especially anxiety and somatization. They reported receiving more support from their spouses and higher sharing of household tasks than did matched healthy controls, but were not different regarding body image. Twenty-eight percent of the variance of psychological distress was explained, with group, perceived support, and group × body image interaction. Thus, higher psychological distress was more likely to occur in participants receiving lower support and in breast cancer survivors with lower body image., Conclusions: The study described the effects of breast cancer on Arab women compared to healthy women. It highlights the need for culture-sensitive care for Arab breast cancer patients, as well as other patients from minority groups residing in other Western countries.

The Incidence of colorectal cancer (CRC) differs in different ethnic groups. The aim of this study is to investigate clinical and pathological features of CRC in Arab as compared to Jewish patients in Northern Israel. Clinical and pathological characteristics of 480 patients with CRC treated between 1999 and 2006 were retrospectively reviewed. Eighty-five percent of the patients were Jews and 15% were Arabs. Mean age at diagnosis was 67.1 years in Jews and 58.3 years in Arabs (P < 0.001). Stage I CRC was 17.5% versus 7.2% (P < 0.05), Stage II was 35.5% versus 27.5% (P < 0.01), Stage III was 26% versus 33.3% (P:0 < 0.01) and Stage IV 21% versus 31% (P < 0.01) in Jewish and Arab patients respectively. In 40.6% of Jewish patients, cancer was well differentiated compared to 27.1% of Arab patients (P < 0.01) and poorly differentiated in 5.5% versus 10,4% (P < 0.05). Abdominal pain, constipation and weight loss were more common in Arabs than in Jews (P < 0.05). In conclusion CRC is more advanced, more aggressive and more symptomatic in Arab than in Jewish patients. Arab patients are younger at the time of diagnosis. Screening for CRC should be started at earlier age in the Arab population than the population at large.

Germline mutations in DNA mismatch repair (DNA-MMR) genes, mainly MLH1, MSH2, and MSH6, underlie Hereditary non-polyposis colorectal cancer (HNPCC) and are mostly family-specific, with few reported founder mutations in MSH2 (Ashkenazim) MLH1 (Finnish). No mutations in colon cancer susceptibility genes have ever been reported in Druze individuals, a Moslem related faith encompassing approximately 1,000,000 individuals worldwide. A novel MSH2 mutation is described in a Druze HNPCC family: a multigenerational family with 10 members in 4 generations affected with colorectal cancer (mean age of diagnosis 46.5 years), two with gastric cancer and one--endometrial cancer. Mutational analysis of the MSH2 gene using denaturing gradient gel electrophoresis (DGGE) and direct sequencing revealed the c.702delA mutation in codon 234 of exon 4 of the MSH2 gene leading to a premature early stop in codon 245, p.Thr234fsX245. Analysis of mutation-carrying or presumed carriers individuals' offspring, revealed 11/42 asymptomatic mutation carriers, age range 17-50 years. The mutation was not present in two additional Druze HNPCC families and 20 Druze sporadic colon cancer patients. This is the first mutation ever reported in a colon cancer susceptibility gene in a Druze family and it appears not to be a founder mutation in Druze individuals with HNPCC.