Rozen Paul, Liphshitz Irena, Rosner Guy, Barchana Micha, Lachter Jesse, Pel Sara, Shohat Tami, Santo Erwin
Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2009 Dec;11(12):710-3.
Pancreatic cancer is not a common malignancy in Israel, but it is the third most common cause of cancer mortality, attributable to a lack of screening tests, inaccessibility of the pancreas, and late cancer stage at diagnosis. We reviewed the epidemiology, known risk factors and screening methods available in Israel and describe the Israeli national consortium that was established to identify persons at risk and decide on screening methods to detect and treat their early-stage pancreatic cancer. In collaboration with the Israel National Cancer Registry, we evaluated the incidence and trends of the disease in the Jewish and non-Jewish populations. The consortium reviewed known lifestyle risk habits, genetic causes, and screening methodologies used and available in Israel. Overall, there are about 600 new patients per year, with the highest incidence occurring in Jewish men of European birth (age-standardized rate 8.11/10(5) for 2003-06). The 5 year survival is about 5%. The consortium concluded that screening will be based on endoscopic ultrasonography. Pancreatic cancer patients and families at risk will be enrolled, demographic and lifestyle data collected and a cancer pedigree generated. Risk factors will be identified and genetic tests performed as required. This concerted national program to identify persons at risk, recommend which environmental risk factors to avoid and treat, and perform endoscopic ultrasound and genetic screening where appropriate, might reduce the incidence of invasive pancreatic cancer and/or improve its prognosis.
胰腺癌在以色列并非常见的恶性肿瘤，但却是癌症死亡的第三大常见原因，这归因于缺乏筛查测试、胰腺难以触及以及诊断时癌症处于晚期。我们回顾了以色列现有的流行病学、已知风险因素和筛查方法，并描述了为识别高危人群以及确定检测和治疗早期胰腺癌的筛查方法而成立的以色列国家联盟。我们与以色列国家癌症登记处合作，评估了犹太人和非犹太人群中该疾病的发病率和趋势。该联盟审查了以色列已知的生活方式风险习惯、遗传原因以及所使用和可用的筛查方法。总体而言，每年约有600名新患者，欧洲出生的犹太男性发病率最高（2003 - 06年年龄标准化率为8.11/10⁵）。5年生存率约为5%。该联盟得出结论，筛查将基于内镜超声检查。将纳入胰腺癌患者及其高危家庭，收集人口统计学和生活方式数据，并绘制癌症家系图。将识别风险因素并根据需要进行基因检测。这个协调一致的国家计划旨在识别高危人群，推荐应避免和治疗哪些环境风险因素，并在适当情况下进行内镜超声检查和基因筛查，可能会降低侵袭性胰腺癌的发病率和/或改善其预后。
