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Background: The Arab population of Israel is a separate ethnic group from the Jewish population, embracing a different lifestyle and different nutritional habits and environmental exposures. These variations may lead to dissimilar expressions of certain diseases in the Arab Israeli as compared with the Jewish population. In recent years, the Arab population in Israel has experienced rapid and marked changes toward westernization in lifestyle, and significant increases in the incidence rate of both diabetes mellitus (DM) and cancer This is combined with an increase in known risk factors common to both illnesses., Methods: Review of recent publications and official health statistics provided the sources of information for this review., Results: Studies show that in recent decades the incidence rate of DM in the Israeli Arab population has increased by 9.1 per 1000 persons annually and of cancer by 1.3 per 1000 person annually among males and by 1.2 per 1000 person among females. In contrast, these rates have decreased in the Jewish population., Conclusions: Lifestyle change in recent decades (westernization) in the Israeli Arab population has led to a marked increase in the incidence rate of DM and cancer in this group. The most influential risk factors are unhealthy diet, physical inactivity and tobacco smoking. By understanding these processes, effective intervention efforts can be initiated in order to reverse these trends.

Background: Merkel cell carcinoma (MCC) has been associated with a high incidence of other skin tumors and hematological malignancies. The purpose of this study was to analyze data from the Israel Cancer Registry regarding the incidence of second neoplasms in patients with MCC and their impact on survival., Methods: Sixty-seven patients in whom MCC was diagnosed between 1983 and 1999 were included. Data were collected on age, gender and ethnic origin, dates of diagnosis of MCC and any other neoplasm, and date and cause of death, if applicable. Comparison of MCC-specific survival, estimated by the Kaplan-Meier product limit method, between patients with no other neoplasm and those with second primary tumors was performed by log rank test. Age-specific standardized incidence ratio (SIR) was calculated using 5751 age- and ethnic-matched malignant melanoma patients as a control group., Results: Seventeen patients (25%) had a second neoplasm before, concomitant with, or after the diagnosis of MCC; 2 of them also had a third primary tumor. The SIR was 2.8 (95% CI; range, 1.38-4.22), significantly higher than the control group. Almost half the tumors were squamous cell carcinomas, either skin or head and neck, and most of the remainder were hematological malignancies or breast and ovarian adenocarcinomas. On univariate analysis, the presence of another neoplasm, regardless of its chronology, was associated with higher MCC-specific mortality (65% vs. 40% for patients with MCC only; P = 0.022). Analysis of only those patients in whom a second neoplasm developed during follow-up after treatment for MCC yielded an estimated actuarial risk of developing a second primary of 2.1% for each year of observation., Conclusions: There is a high incidence of second neoplasms, including noncutaneous solid tumors, in patients with MCC. The presence of these neoplasms, whether they appear before, after, or simultaneously with MCC, is associated with a higher MCC-specific mortality., (Copyright 2001 American Cancer Society.)

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.