cancer cells 88.
(photo credit: )
There is no justification in Israel for conducting geographical studies on cancer incidence, as "we are a small country with a wide variety of populations," so any results will not be relevant, said Prof. Gad Rennert, the country's leading cancer epidemiologist, on Monday.
Rennert was commenting to The Jerusalem Post on a 180-page Health Ministry "draft report" released on Sunday by Dr. Micha Barchana, a statistician who is head of the ministry's National Cancer Registry. The draft was widely reported by the Hebrew-language media with banner headlines that falsely claimed there has been a "40 percent increase" in cancers in various parts of the country where there is more environmental pollution.
In fact, said Rennert, who is also director of Clalit Health Servicesâ€š National Cancer Control Center at Carmel Medical Center in Haifa, the accepted estimate of the contribution of pollution to cancer in the Western world without the influence of the sun and occupational exposures is a maximum of 1.5%.
Cancer rates have actually decreased in Israel, compared to Europe, where they have risen during the same period, Rennert said.
Rennert, who is a professor in his field at the Technion-Israel Institute of Technology's Rappaport Medical Faculty and had no involvement in the report, said: "The most common cancers have no connection to environmental pollution. These are breast, colorectal, prostate and lung [which is caused mostly by smoking].
"I can't explain why there was such an exaggeration in this draft. It is a hysterical culture here. In Israel, I have often said, people burn down cellular antennas while holding cigarettes in their mouths."
It was apparently the first time that the ministry has allowed the release of draft report without first carrying out any in-depth discussion by its executive. The report is published on the ministry's Web site (at www.health.gov.il) in Hebrew only, with "DRAFT" marked on all the pages. The Yediot Aharonot daily received a "leak" of information two weeks ago about a small section of the draft, apparently putting pressure on the ministry to allow it to be released Sunday even though it was not a final version or analyzed, explained or corroborated by the ministry.
Epidemiologists note that the cancer rate in various geographical regions in Israel varies according to smoking rates, the share of immigrants from the former Soviet Union (who were untreated or poorly treated in their native country), the rate of haredi and Arab women (who do not smoke), the age of the population and other factors not connected to geography. When large numbers of high-risk people live in a certain region, it can raise the number of cases but not be caused by living in that region.
Barchana, who presented statistics from his report at the Israel Cancer Association pre-"Knock on the Door" fundraising campaign press conference on Sunday, wrote in its first paragraph that "presenting theoretical information in the framework of ecological surveys regarding the geographical breakdown of malignant diseases constitutes in many countries a basis for continued individual studies."
However, he added, "it is important to note that an ecological survey on its own does not make possible the reaching of conclusions that one causes the other."
Asked to comment on the release of the draft, Health Ministry Director-General Prof. Avi Yisraeli told the Post: "It was a survey of cancer cases in various parts of the country. We have not studied and examined it yet. It is a draft. It was not meant to prove any causal relationship between environmental pollution and cancer."
Yisraeli added that "smoking is the largest single cause of cancer - responsible for 30 percent of all cases. Any environmental cause such as air pollution from industry takes at least 10 years and often many more to cause cancer. We will look at the survey findings. But we also have to educate the public about the major causes of cancer and the need to stop smoking, to eat right and to exercise, a lifestyle that prevents many cancers."
Yisraeli said he could not say how the draft report leaked out.
"It was sent to many people for comments. There is no reason for panic or an investigatory commission. The public can see the raw data on the Web site. We will study it and encourage the public to live healthful lifestyles. It is of course beneficial to reduce air pollution, but this does not mean that the prevalence of cancer will drop significantly as a result."
Hadash MK Dov Hanin, having read the Hebrew newspaper headlines, on Monday issued a statement calling for the establishment of a "state investigatory commission to look into the serious increase in the rates of cancer, its causes and how to deal with it."
The Hadash MK stated that "this is the direct result of continued irresponsibility in the environmental field in Israel."
Israel Cancer Association Director-General Miri Ziv said on Monday that "every report is important, but it has to be studied in depth to understand what it is referring to and to put the findings in proportion. With 30% of all cancer cases caused by smoking, 35% prevented by proper nutrition and exercise and a third of cancer patients recovering after treatment, especially with early detection, the role of the environment is very small - about 2% in the whole world. The role of tobacco has been proven without doubt, unlike the environment, and a geographical study cannot reflect the causes."