Goldman School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
Siaal Research Center for Primary Care, Division of Health in the Community, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
Eur J Cancer. 2018 May;95:85-92. doi: 10.1016/j.ejca.2018.03.011. Epub 2018 Apr 11.
The purpose of this study was to examine the incidence of malignant diseases among Holocaust survivors in Israel compared with European and American immigrants who did not experience the Holocaust.
Study subjects included Holocaust survivors born in European countries under Nazi occupation before 1945, who immigrated to Israel after 1945 and were alive as of the year 2000. Living survivors were identified based on recognition criteria in accordance with the Holocaust Survivor Benefits Law. The comparison group consisted of Clalit enrollees who were born before 1945 in European countries not under Nazi occupation and were alive in 2000 or were born in any European country or America, immigrated to Israel before 1939 and were alive in 2000. The incidence of malignant diseases was compared in univariate and Poisson regression models analyses, controlling for age, smoking, obesity, diabetes and place of residence.
The study included 294,543 Holocaust survivors, and the mean age at the beginning of follow-up was 74 ± 8.7 years; 43% males. In multivariable analyses, the rate ratio (RR) values for males and females were 1.9 and 1.3 for colon cancer, 1.9 and 1.4 for lung cancer, 1.6 and 1.4 for bladder cancer and 1.2 and 1.3 for melanoma, respectively. For prostate cancer in males, the RR was 1.4, while for breast cancer in females, it was 1.2.
The incidence of malignant diseases among Holocaust survivors residing in Israel was higher than that among non-Holocaust survivors. These associations remained statistically significant in a multivariable analysis and were stronger for males.
本研究旨在比较以色列的大屠杀幸存者与未经历大屠杀的欧洲和美国移民中恶性疾病的发病率。
研究对象包括 1945 年前在纳粹占领下的欧洲国家出生、1945 年后移民到以色列并在 2000 年仍在世的大屠杀幸存者。在世幸存者是根据《大屠杀幸存者福利法》的认定标准确定的。对照组由 1945 年前在未被纳粹占领的欧洲国家出生、2000 年仍在世的 Clalit 参保者或 1939 年前出生于任何欧洲国家或美国、移民到以色列并在 2000 年仍在世的参保者组成。采用单变量和泊松回归模型分析比较恶性疾病的发病率，同时控制年龄、吸烟、肥胖、糖尿病和居住地等因素。
研究共纳入 294543 名大屠杀幸存者，随访开始时的平均年龄为 74±8.7 岁，其中 43%为男性。多变量分析中，男性和女性的结肠癌、肺癌、膀胱癌和黑色素瘤的率比（RR）值分别为 1.9 和 1.3、1.9 和 1.4、1.6 和 1.4、1.2 和 1.3。男性前列腺癌的 RR 值为 1.4，而女性乳腺癌的 RR 值为 1.2。
居住在以色列的大屠杀幸存者恶性疾病的发病率高于非大屠杀幸存者。这些关联在多变量分析中仍具有统计学意义，且男性更为显著。
