Biomedical subjects

Micha Barchana

Publications and source records attributed to Micha Barchana.

16 recordsLinked to original sources

PubMed2007

The changing incidence and sites of colorectal cancer in the Israeli Arab population and their clinical implications.

Israeli Arabs have been at low risk for colorectal cancer (CRC) and had mainly proximal cancer, but increasing CRC is now noted. We examined this trend and CRC site and compared them to the total Jewish population and to the low-risk Jews of Asian-African origin. Israel Cancer Registry CRC data, 1982-2002, for Arabs and Jews was computed by gender, age and site: rectal cancer included recto-sigmoid junction; "right-sided" CRC included the proximal colon up to and also the splenic flexure. During 1982-2002, Arab CRC trends increased significantly in both sexes due to left-sided CRC (women, p = 0.01; men, p = 0.02) and rectal cancers (p = 0.05). Left-sided CRC increased significantly in both men and women aged > or = 65 years (p = 0.02). Comparing 1982-1984 to 2000-2002, the proportion of right-sided CRC decreased in both genders (p < 0.01) from 39.4 to 27.1% of male CRC, and from 44.8 to 31.3% in females. In general, this pattern of increasing rectal and left-sided CRC had been seen over a decade earlier in Jews of Asian-African origin and then their trend reversed during the last decade. In conclusion, there is a recent trend for left-sided CRC in Israeli Arabs, probably related to their changing life style. These results should influence their cancer preventive lifestyle recommendations, and CRC screening and diagnostic methodologies used.

Age Distribution↗

PubMed2007

The interval between cancer diagnosis among mothers and offspring in a population-based cohort.

BACKGROUND: Familial cancers may be due to shared genes or environment, or chance aggregation. We explored the possibility that ascertainment bias influences cancer detection in families, bearing upon the time interval between diagnosis of affected mothers and offspring. METHODS: The Jerusalem Perinatal Study (JPS) comprises all mothers (n = 39,734) from Western Jerusalem who gave birth 1964 -1976 and their offspring (n = 88,829). After linking identification numbers with Israel's Cancer Registry we measured the absolute time interval between initial cancer diagnoses in affected mother-offspring pairs. We tested the probability of obtaining intervals as short as those observed by chance alone, using a permutation test on the median interval. RESULTS: By June 2003 cancer had developed in 105 mother-offspring pairs within the cohort. Common sites among mothers were breast (47%), colorectal (9%), non-Hodgkin lymphoma (NHL) (8%) and cervix (7%), while for offspring in affected pairs common cancers were leukemia (12.4%), thyroid (13.3%), NHL (10.5%), breast (10.5%) and melanoma (7.6%). The median interval between diagnoses was 5.9 years, but for 33% of affected pairs the interval was < or =3 years. The probability of this occurring by chance alone was 0.03. This held true whether the offspring's or mother's diagnosis was first (P < 0.01). CONCLUSIONS: In a population-based cohort followed for three decades, the absolute interval between the diagnosis of cancer in mothers and their offspring is shorter than expected by chance. Explanations include shared environmental exposures or the possibility that cancer ascertainment in one pair member affects health behaviors in the other resulting in early diagnosis. The latter may bias the estimation of anticipation and survival in familial cancers.

Adult Children↗

PubMed2007

Changing sites of colorectal cancer in the Israeli Jewish ethnic populations and its clinical implications.

Countries at risk for colorectal cancer noted an increase in right-sided colorectal cancer. We examined this in the Israeli Jewish populations. Israel Cancer Registry data, 1982-2001, were computed by sex, age, ethnic group and colorectal cancer site: 'rectal cancer' included the recto-sigmoid junction, 'right-sided' colorectal cancer included proximal colon up to and including the splenic flexure. In both sexes, colorectal cancer trends increased significantly owing to colonic cancer (P<0.01) whereas rectal cancer decreased (P<0.01). Left and right colorectal cancer trends decreased in Israel born people (P<0.01), but in Asia-Africa born people increases were seen at both sites in the male (P=0.02 and 0.06, respectively) and female (P=0.03 and 0.01, respectively) population. In those > or =65 years old, right colorectal cancer trends increased in all men (P=0.05) and women (P=0.01). On comparing data from 1982-1986 with that from 1997-2001 right colorectal cancer showed an increase in both sexes (P<0.01): to 32.7% of male colorectal cancer and 57.6% of female colorectal cancer. In the period 1997-2001, the total male population > or =65 years had increased relatively by 7.5% (P<0.01), and women by 22.6% (P<0.01) and the proportion of right colorectal cancer in > or =65 years olds increased relatively by 10.9% in the male population, and 18.2% in the female population, with one-third of this increase occurring in Russian immigrants arriving after 1990. In conclusion, there is a trend for right colorectal cancer in Jews aged > or =65 years. The proportion and amount of colorectal cancer increased most significantly in older women, which was partially explained by their increasing numbers and by colorectal cancer occurring in recent immigrants from Russia, who were at high-risk for colorectal cancer. These results should influence colorectal cancer screening and diagnostic methodologies used.

Aged↗

PubMed2007

A comparison of trends in incidence and mortality rates of breast cancer, incidence to mortality ratio and stage at diagnosis between Arab and Jewish women in Israel, 1979-2002.

In Israel, breast cancer is the most common malignancy in women, but there are large intra-population differences. The aim of this study was to compare the incidence and mortality, incidence to mortality rate ratio and stage at diagnosis of breast cancer between Arab and Jewish women in Israel. Data on all cases of breast cancer, stage at diagnosis and mortality were obtained from the National Cancer Registry and the Central Bureau of Statistics. Trends in age-specific and age-adjusted incidence and mortality rates, rate ratios and stage at diagnosis were examined for Arab and Jewish women during 1979-2002. Five-year survival rates for 1995-1999 were compared by stage. Among Arab women, age-adjusted incidence rates increased by 202.1%, from 14.1 per 100,000 in 1979-1981 to 42.6 in 2000-2002. Among Jewish women, the rates increased by 45.7%, from 71.1 per 100,000 women in 1979-1981 to 103.6 in 2000-2002. Incidence to mortality rate ratio increased for both population groups, but it is still lower among Arab women. In every age group, Arab women were more likely to be diagnosed at a more advanced stage of the disease. The rise in breast cancer incidence and mortality rates and the later stage of diagnosis among Arab women emphasize the urgent need for increasing early detection of breast cancer in the Arab population by improving rates of compliance with screening mammography.

Arabs↗

PubMed2006

On ecological fallacy, assessment errors stemming from misguided variable selection, and the effect of aggregation on the outcome of epidemiological study.

In social and environmental sciences, ecological fallacy is an incorrect assumption about an individual based on aggregate data for a group. In the present study, the validity of this assumption was tested using both individual estimates of exposure to air pollution and aggregate data for 1,492 schoolchildren living in the in vicinity of a major coal-fired power station in the Hadera region of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT), and their parents completed a detailed questionnaire on their health status and housing conditions. The association between children's PFT results and their exposure to air pollution was investigated in two phases. During the first phase, PFT averages were compared with average levels of air pollution detected in townships, and small census areas in which the children reside. During the second phase, individual pollution estimates were compared with individual PFT results, and pattern detection techniques (Getis-Ord statistic) were used to investigate the spatial data structure. While different levels of areal data aggregation changed the results only marginally, the choice of indices measuring the children's PFT performance had a significant influence on the outcome of the analysis. As argued, differences between individual-level and group-level effects of exposure (i.e., ecological or cross-level bias) are not necessary outcomes of data aggregation, and that seemingly unexpected results may often stem from a misguided selection of variables chosen to measure health effects. The implications of the results of the analysis for epidemiological studies are discussed, and recommendations for public health policy are formulated.

Child↗

PubMed2006

Estimating the effect of air pollution from a coal-fired power station on the development of children's pulmonary function.

Using geographical information systems (GIS) tools, the present study analyzed the association between children's lung function development and their long-term exposure to air pollution. The study covered the cohort of 1492 schoolchildren living in the vicinity of a major coal-fired power station in the Hadera sub-district of Israel. In 1996 and 1999, the children underwent subsequent pulmonary function tests (PFT) (forced vital capacity (FVC) and forced expiratory volume during the first second (FEV(1))), and the children's parents completed a detailed questionnaire on their health status and household characteristics. A negative association was found between changes in the results of PFT and the estimated individual levels of air pollution. A sensitivity test revealed a FEV(1) decline from -4.3% for the average pollution level to -10.2% for the high air pollution level. The results of a sensitivity test for FVC were found to be similar. Association with the reported health status was found to be insignificant. As we conclude, air pollution from a coal-fired power station, although not exceeding local pollution standards, had a negative effect on children's lung function development. As argued, previous studies carried out in the region failed to show the above association because they were based on zone approaches that assign average concentration levels of air pollutants to all individuals in each zone, leading to a misclassification bias of individual exposure.

Adolescent↗

PubMed2006

Classic Kaposi sarcoma. Which KSHV-seropositive individuals are at risk?

BACKGROUND: Classic Kaposi sarcoma (CKS) is a relatively rare vascular disease primarily affecting human immunodeficiency virus (HIV)-uninfected elderly men. The infection with Kaposi sarcoma-associated herpesvirus (KSHV) is necessary for the establishment of Kaposi sarcoma (KS), although it is not sufficient. Thus, only a small fraction of KSHV-infected individuals develops KS. The cofactors that influence risk of KS among HIV-uninfected individuals are yet to be determined. The objective of the current study was to assess potential risk factors for CKS in the KSHV-infected Jewish population in Israel. METHODS: A case-control study involved 35 CKS cases and 48 matched KSHV-infected controls. Lifestyle and medical history data from case patients and controls were compared by logistic regression analysis. RESULTS: In a multivariate analysis, the authors identified an age-related small increased risk for CKS in subjects originating from Asia and Africa. The risk for CKS increased, although not significantly statistically, in subjects who reported alcohol consumption, diabetes mellitus, herpes simplex, and asthma. No relation was found with cigarette smoking, family size, number of lifetime sexual partners, or sexually transmitted disease. CONCLUSIONS: A borderline increase in CKS risk among elderly subjects originating from Africa or Asia was identified. These results need to be further evaluated by larger studies. The authors believe that genetic and immunologic parameters may alter risk for CKS and, therefore, should also be investigated.

Adult↗

PubMed2006

Time trends of incidence rates of thyroid cancer in Israel: what might explain the sharp increase.

BACKGROUND: Worldwide changes in the incidence, histological type, and prognosis of thyroid cancer (TC) have been observed. Regional differences in the spectrum of TC may be related to genetic factors, ionizing radiation, lifestyle, and nutritional iodine, as well as to the availability of medical services. METHODS: Analysis of records of 5864 TC patients (diagnosed between 1982 and 2001), retrieved from the Israel National Cancer Registry. RESULTS: The age-standardized incidence rate (ASR per 100,000 persons) of TC among Jewish women in 2001 was 12.45 (higher than generally reported in the world) and 3.68 among Jewish men. There was a significant increase in the ASR for TC between 1982 and 2001 in the Jewish population (by 101% among women and by 25% among men, p < 0.01 for both), mainly due to papillary carcinoma. TC incidence increased in the non-Jewish population from 2.33 to 6.02 in women (p < 0.05) and from 1.13 to 2.49 in men (p > 0.05). TC incidence was similar among immigrants from Europe and America arriving in Israel before 1990 or after 1990 for both genders. An improved 5-year survival was noted in patients diagnosed between 1992 and 1996 in comparison to patients diagnosed earlier: 1982-1986 (86% versus 78%, p < 0.01). CONCLUSIONS: A marked increase in TC incidence over the last two decades (mainly due to papillary carcinoma) has been noted in different Israeli subpopulations, being the highest in Jewish women. The increase trends were similar regardless of gender or ethnicity. The reasons for this rise in TC incidence and improvement in the survival are probably multifactorial and may relate partly to increased diagnostic vigilance and changes in clinical practice.

Africa↗

PubMed2006

A population-based study of hairy cell leukemia in Israel.

OBJECTIVES: Few population-based data exist on the incidence and prognosis of hairy cell leukemia (HCL). Our objectives were to study the effect of socio-demographic factors on this rare disease and the risk of second malignancies occurring in HCL patients. METHODS: We measured crude and age-adjusted incidence rates of HCL based on reporting to the Israel Cancer Registry (ICR) 1991-2001. Using Kaplan-Meier and multivariate analysis, we assessed survival by gender, ethnicity and geographic region. We ascertained additional primary tumors reported in this population and calculated standardized incidence ratios (SIRs) for tumors reported after the diagnosis of HCL. RESULTS: The ICR registered 147 cases of HCL among males and 34 in females between 1991 and 2001. Age-adjusted incidence rates were 1.62/10(6)/yr for women and 7.97/10(6)/yr for men, with rates 1.5 times higher in Jewish than in non-Jewish (mainly Arab) men. Mean overall survival also differed by ethnicity. In a multivariate model, increasing age at diagnosis (P < 0.001), as well as Arab origin (P = 0.008) were associated with poorer survival but gender did not significantly affect the survival after controlling for age and ethnicity. Other primary malignancies were reported in 20 (11%) individuals, with a predominance of genito-urinary tumors (65%) among males. Secondary genito-urinary tumors were significantly increased above the expected population rates (SIR 3.23, 95% confidence interval: 1.39-6.36, P = 0.008). CONCLUSIONS: In the Israeli population, age and ethnicity were associated with prognosis of HCL. Variations in disease characteristics, stage of disease at diagnosis or differential access to treatment may contribute to these findings. Patients with HCL appear to be at increased risk for genito-urinary malignancies.

Adult↗

PubMed2005

Cancer in schizophrenia: is the risk higher or lower?

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.

Adolescent↗

PubMed2005

Infection with Kaposi's sarcoma-associated herpesvirus among families of patients with classic Kaposi's sarcoma.

BACKGROUND: Classic Kaposi's sarcoma (CKS) primarily affects elderly Mediterranean or Eastern European men. Incidence rates of CKS in Israel are among the world's highest. In practically all cases, antibodies against Kaposi's sarcoma-associated herpesvirus (KSHV) can be detected. A relatively high seroprevalence rate of KSHV in Israel generally correlates with the incidence of CKS. A sexual mode of virus transmission is recognized among homosexual men, whereas the precise transmission routes in the heterosexual population and those with CKS are still unclear. OBJECTIVE: To better assess the transmission routes of KSHV in Israeli patients with CKS and their first-degree relatives as compared with a control group. DESIGN: Serum was collected from all study participants and tested for KSHV antibodies by means of latent and lytic immunofluorescence assays. An open reading frame 65 (ORF65) Western blot assay was applied as a confirmatory tool. SETTING: Three dermatological departments in Israel. PATIENTS: Sixty-four Jewish patients with CKS, 143 of their first-degree relatives, and 186 hospital-based control subjects. RESULTS: Seropositivity to KSHV was detected in 62 (96.9%) of the patients with CKS, in 56 (39.2%) of their first-degree relatives, and in only 21 (11.3%) of the hospital controls (P<.001). The specific relationship with the index patient (spouse, offspring, or sibling) had no significant effect on the prevalence of serpositivity in the family members. CONCLUSION: Our serologic evidence of familial clustering of KSHV infection suggests a predominantly nonsexual horizontal transmission route of the virus.

Adolescent↗

PubMed2004

Cancer after pre-eclampsia: follow up of the Jerusalem perinatal study cohort.

OBJECTIVE: To compare the incidence of cancer among women with and without a history of pre-eclampsia. DESIGN: Cohort study. SETTING: Jerusalem perinatal study of women who delivered in three large hospitals in West Jerusalem during 1964-76. PARTICIPANTS: 37 033 women. MAIN OUTCOME MEASURES: Age adjusted and multivariable adjusted hazard ratios for cancer incidence for the entire cohort and for women who were primiparous at study entry. RESULTS: Cancer developed in 91 women who had pre-eclampsia and 2204 who did not (hazard ratio 1.27, 95% confidence interval 1.03 to 1.57). The risk of site specific cancers was increased, particularly of the stomach, ovary epithelium, breast, and lung or larynx. The incidence of cancer of the stomach, breast, ovary, kidney, and lung or larynx was increased in primiparous women at study entry who had a history pre-eclampsia. CONCLUSIONS: A history of pre-eclampsia is associated with increases in overall risk of cancer and incidence at several sites. This may be explained by environmental and genetic factors common to the development of pre-eclampsia and cancer in this population.

Epidemiologic Methods↗

PubMed2004

Trends in colorectal cancer incidence and mortality in the Israeli Jewish ethnic populations.

BACKGROUND: Ashkenazi Jews, as compared to non-European Jews and non-Jews, are at increased risk for colorectal cancer (CRC), this is attributed to genetic susceptibility and/or lifestyle. AIMS: To follow Israeli long-term trends in CRC incidence and mortality and their associations with ethnicity. METHODS: All Israeli CRC data accumulated 1970-2001 was used, age standardized rates (adjusted to world standard population) was computed by cancer site, US Surveillance, Epidemiology and End Results Program (SEER) Stage and ethnic group (continent of birth: Europe-America, Asia, Africa, Israel). RESULTS: From 1970, CRC incidence increased 190% in males and 140% in females; mainly colon cancer (270% and 185% respectively) (P < 0.01), while rectal cancer incidence decreased and is now stable. Stage 3 CRC increased while stage 4 decreased significantly (P < 0.01 for both). In 2001, CRC incidence per 100,000 in European-American-born males was 48.3, Asian and African born 35.5 and Israeli born 32.7 (relative risk (RR) 1.36, P = 0.03), while European-American female rates were 35 and all the others 26 (RR 1.35, P < 0.01). Overall survival increased 9% over 30 years (P < 0.01), 5 years survival since 1988-1996 for European-American born was 43.1%, Asian 46.7%, African 47.5% and Israeli 55.8%. Stage-2 CRC 5 years survivals for 1970-1996 (most had no post surgical treatment) for European-American born were 41.7%, Asian and African 44.8% and Israeli 53.4% (P < 0.05). Stage-3 CRC survivals (most received adjuvant therapy in addition to surgery) for European-American born was 38.8%, Asian and African 43.3% and Israeli 45.1% (P < 0.01). CONCLUSIONS: Colon cancer has increased in Israel, mainly in males and European-American born. Israeli-born Jews (of 20 to 60% mixed ethnicity and lifestyle habits) have the lowest incidence and best survival data for stages-2 and -3 CRC. There is evidence of ethnic survival advantage and possibly in response to adjuvant oncological therapy.

Adult↗

PubMed2004

Birth weight and other risk factors for acute leukemia in the Jerusalem Perinatal Study cohort.

OBJECTIVES: To assess the effect of birth weight of children and their siblings and other perinatal/parental factors on the risk of acute leukemia. METHODS: We linked data from the Jerusalem Perinatal Study, a population-based research cohort (n = 88,829) of offspring born 1964 to 1976, with Israel's Cancer Registry. Risk factors for acute leukemia were assessed using univariate and multivariate proportional hazards models. RESULTS: Leukemias developed in 65 individuals [24 acute myeloid leukemias (AML) and 41 acute lymphoblastic leukemias (ALL)]. A positive linear relation was found between gender-adjusted birth weight and all leukemias [hazard ratio (HR) 1.85, 95% confidence interval (95% CI) 1.1-3.0] and AML (HR 2.9, 95% CI 1.3-6.4). The association between birth weight and AML was especially notable among infants (HR 8.14, 95% CI 1.8-38.9 for age 0 to 1 year) but was also observed among subjects ages >14 years at diagnosis. The relation was particularly strong among females (P = 0.001). Other risk factors for AML risk on univariate analysis were maternal origin, socioeconomic status, birth weight of sibling > 3,500 g, and family size. On multivariate analysis, only birth weight retained borderline significance (adjusted HR 2.38 per kg, 95% CI 1.0-5.7). Significant predictors for ALL in both univariate and multivariate analyses were male sex (adjusted HR 1.92, 95% CI 1.0-3.7) and birth weight categories > or = 3,000 g introduced into the model as nonlinear terms. CONCLUSION: Birth weight is associated with an increased risk of acute leukemia in infants, children, and young adults. Perinatal factors play a role in the development of childhood leukemias, but the patterns of association vary by leukemia type.

Acute Disease↗

PubMed2003

Second primary breast and thyroid cancers (Israel).

OBJECTIVE: To evaluate the risk for developing second primary thyroid cancer (TC) following breast cancer (BC) and second primary BC following TC on a nationwide basis. METHODS: All BC and TC Jewish females diagnosed in Israel during 1960-1998 were identified through the Israel Cancer Registry. The expected second primaries were calculated using cancer incidence rates stratified by age, country of birth and period of diagnosis among the Jewish population in Israel. Standardized incidence ratios (SIRs) were estimated using Poisson regression. RESULTS: A total of 49,207 breast and 4911 thyroid neoplasms were identified. After the exclusion of concomitant disease (diagnosed within 1 year), 59 and 70 second primaries TC and BC yielded SIRs of 1.34 (95% CI: 1.03, 1.72) and 1.07 (95% CI: 0.84, 1.34), respectively. Younger age and earlier calendar year of first primary diagnosis and shorter follow-up period were associated with increased risk for developing second primary neoplasm. CONCLUSIONS: Considering the long latency required for carcinogenesis, excess risk of second primary diagnoses soon after the first cancer, argues against the hypothesis of first primary treatment as an initiator for the second cancer. A detection bias of meticulously followed cancer patients, early exposure to common risk factors or genetic susceptibility of certain subpopulations for both malignancies seem plausible.

Adult↗

PubMedDate not supplied

Incidence of malignancies among patients with type I Gaucher disease from a single referral clinic.

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.

Adolescent↗