Abstract 3714: Breast cancer trends in Israeli Jewish and Arab women 1996-2007
Authors: Keinan-Boker Lital , Baron-Epel Orna , Fishler Yehudit , Liphshitz Irena , Barchana Micha , Dichtiar Rita , Goodman Michael 
Published: June 2012

Abstract
Background: Breast cancer is the most common malignancy in Israeli Jewish and Arab women, but the disease trends in these two population groups have not been re-examined in recent years. The Israel National Cancer Registry (INCR) and the Israel Center for Disease Control (ICDC) collaborate to provide periodic population-based summary data on cancer incidence, mortality and survival.
Methods: Data were obtained from the INCR, the ICDC and the National Bureau of Statistics. The rates presented are age-adjusted to the world standard population. Time trends are presented using the moving average method. Relative survival (i.e., observed survival among cancer patients divided by the expected survival in the general population with the same age, sex and ethnicity distribution) was calculated for the diagnosis years 1996-2003. Data from the Knowledge, Attitudes and Practices (KAP) surveys carried out in 2000, 2002, 2004, 2006 and 2008 were analyzed to determine proportions of women that reported undergoing a screening mammogram in the previous two years.
Results: From 1996 through 2007, age-adjusted breast cancer incidence rates (per 100,000) increased from 96.7 to 99.8 (3%, ns*) in Jewish women and from 38.6 to 79.2 (105%, p=0.0001) in Arab women. The p-value for between-populations trend differences (p-value ‘between′) was &lt;0.0001. For invasive tumors only, the corresponding change estimates are -3% (p=0.035) for Jewish women and 98% (p=0.0001) for Arab women (p-value ‘between’ &lt;0.0001). In 1996, 10% and 7% of all newly diagnosed breast tumors in Jewish and Arab women, respectively, were in-situ. In 2007 the corresponding proportions were 17% and 11%, respectively (p=0.61). Data from the KAP surveys in the 50- to 74-year age group indicated that between 2000 and 2008, reports of having had a screening mammogram in the last two years increased by 29% and by 40% in Jewish and Arab women, respectively (p=0.58). Mortality rates (per 100,000) from breast cancer decreased for Jewish women from 24.7 in 1996 to 19.0 in 2007 (p=0.001). In Arab women the rates were stable with a non significant change: 17.1 in 1996 and 17.9 in 2007 (p-value ‘between’ = 0.041).
Five-year relative survival among Jewish breast cancer patients increased from 83% in 1996 to 88% in 2003 (p=0.006). The corresponding survival measures for Arab patients increased non-significantly from 66% in those diagnosed in 1996 to 78% in those diagnosed in 2003 (p-value ‘between’ =0.42).
Conclusions: Breast cancer incidence is stable in Jewish women but rapidly increasing in Arab women throughout 1996-2007; the well-documented incidence gap in these groups is narrowing. Significant time trend differences were observed for the diagnosis of invasive tumors (greater increase in Arab compared to Jewish women) and breast cancer mortality (no decrease in Arab women compared to a moderate decrease in Jewish women) but not for relative survival, mammography use and early stage diagnosis.
*ns=non-significant
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3714. doi:10.1158/1538-7445.AM2011-3714