Jul 25, 2021

Israel is a very sunny country most days of the year, and excessive exposure to ultraviolet radiation can produce melanoma, the most dangerous type of skin cancer. Israel is ranked 30th and last (with a mortality rate of 1.4 out of every 100 residents) among the 30 countries with the highest rates in the world. 


This success is due mostly to increasing awareness of the dangers of exposure, the need for protective sunscreens, information campaigns by the Israel Cancer Association (ICA), and that the ozone layer over Israel is not very thin like that over Australia and New Zealand, for example, where the melanoma rate is very high. 


The ICA is holding Skin Cancer Awareness Week from June 14th to June 20th, during which hundreds of skin examination stations will open at health maintenance organization clinics around the country, free of charge, for the early diagnosis of skin cancer. The ICA is in 2021 marking tje 29th year of this unique campaign at clinics, which will be staffed by dermatologists and plastic surgeons who will perform tests for early diagnosis of skin cancers of all types and especially of melanoma.


Despite this good news, an average of 163 new melanoma patients are diagnosed in Israel – 98 percent of them among Jews – and 15 die from the disease every month. Even though many Arabs work outdoors, their risk of melanoma is much lower because they do not sunbathe as much and tend to cover themselves up in the sun. They also generally have darker skin that protects them and rarely go to tanning parlors, where UV exposure is dangerous.


Melanoma is a malignant tumor that originates in the melanin cells in the skin. The main risk factors for the disease are exposure to ultraviolet radiation, especially from solar radiation (or artificial tanning facilities); A personal history of sunburn, especially in childhood; a multiplicity of moles; light skin, fair eyes; a family and personal history of the disease; a weakened immune system; advanced age; being male; having certain genetic diseases and more all pose a higher risk for melanoma. 


ICA director-general Moshe Bar-Haim said that now the COVID-19 pandemic has passed in Israel, limitations that kept most people indoors and not at the beach, playgrounds or in nature and open spaces have been canceled. This means that Israelis will now be exposed to more sunlight. “We call on the public, at any age, to take all recommended precautions to reduce the risk of getting skin cancer,” he said. 


According to Prof. Lital Keinan-Boker, director of Israel’s National Center for Disease Control. 1,959 new cases of skin melanoma were diagnosed in Israel in 2018. This year, melanoma of the skin accounted for 7.5% of all new cases of cancer that require reporting to the Israel Cancer Registry/ 


The mean age at diagnosis was 66.2 in Jewish men and 61.1 in Jewish women. The age-specific rate of invasive melanoma was higher in men compared to women aged 50 and over, and the highest disease rates were observed in those over the age of 75. 


According to the latest data from the World Health Organization in 2020 324,635 new cases of cutaneous melanoma were diagnosed worldwide and 57,043 people died from the disease. The highest incidence rates (adjusted for age, per 100,000) were reported from Australia (36.6) and New Zealand (31.6), 


The highest death rates from melanoma (standardized for age, per 100,000) were reported from New Zealand (4.7) and Norway (3.2). 

In the 1990s, Israel was ranked third in the world after Australia and New Zealand in the annual number of new patients with malignant melanoma of the skin. Thanks to the vigorous and consistent activities of the ICA, there has been a dramatic change for the better. 


A self-examination of the body for skin cancer, front, and back, should be in a well-lit room. You can use a hand mirror aimed in front of a large mirror. It is important to examine the entire skin area including the scalp, body folds, and between the fingers and toes. For the scalp examination, it is necessary to enlist the help of another person, and for the back examination it is advisable to enlist the help of others


It is recommended to remember the number of moles anywhere and perform the test again every three to six months. For those who have a large number of moles, it is recommended to photograph with magnification the area of ​​the moles for comparison. The photograph should be in color, with the edge of a ruler to show the size of the mole. It is important to indicate the date of the photo and the area of ​​the body on which the moles are located. The five signs to pay attention to when there is a mole on the skin are a change in height, color, size, border, and geometry.  


Sports activities performed outdoors without adequate protection of the skin are dangerous. A new study published in the International Journal of Environmental Research and Public Health examined whether professional athletes in water sports (especially surfing/windsurfing and sailing), who may be role models for young people but who are less aware of sun damage take appropriate measures to protect their skin.


A total of 240 world-class water sportsmen aged 16 to 30 (171 men, 64 women) from 30 different countries answered a questionnaire on their sun exposure habits and behaviors (use of sunscreen, wearing a hat, long clothing, sunglasses, and being in the shade as much as possible between workouts), and on sunburns, they experienced during the last sports season. 


The findings showed that the average exposure time of the participants in the sun during sports training was four hours daily. About half of the respondents did not use adequate protection against sun damage. Those whose sun protection was adequate were characterized by being older (23.2) compared to those who did not (20.6). This difference is significant as it indicates that the younger the athletes, the less adequate their protection from the sun. 


The sunburn rate was very high (76.7%), especially among surfers (over 83%); 27.5% reported three or more skin burns and 22.5% failed to use sunscreens at all. This was described as careless behavior. The researchers also stressed the importance of frequent reapplication of sunscreen, which is easily washed off with water and during long training hours. Even when surfers wear suits that protect all parts of their body in winter, the face and hands, and feet remain exposed to the sun, so sunscreen is needed. 


More than 4.2 billion people or more than half of the world’s population use Internet social media, and many web surfers do this to search for health information. Therefore, US researchers investigated the impact of social networks on skin cancer prevention. They reviewed 20 relevant studies published between the years 2014 and 2021, collecting information from Instagram, Twitter, Facebook, YouTube, and Tiktok and their impact on the degree of knowledge about skin cancer and sun damage. 


The study, published in the International Journal of Environmental Research and Public Health, found that social media are indeed increasingly used to increase awareness of skin cancer prevention and that preventive interventions through them can be very effective. 


They found that Twitter and Facebook are the networks where health information is most sought, but the disadvantage of social networks is their inability to refute incorrect information, which can lead to dangerous behaviors. Dermatologists can use these networks to promote more responsible behavior regarding skincare, and they must do so in a way that takes into account the unique characteristics of each social network. It is important to emphasize ideals of appearance that emphasize health and not just beauty, and the most effective messages are educational, image-based, and fighting myths and the use of celebrity sponsorship aimed at self-examination of the skin. 


The use of tanning beds was examined in a new retrospective at the University of Pittsburgh. They found and published in the journal Cancer, that the use of tanning beds is significantly associated with an increased risk of developing multiple cases of primary melanoma at diagnosis and the second case of primary melanoma after diagnosis. According to the researchers, the findings underscore the importance of avoiding the use of tanning beds and regular medical follow-ups, especially for patients with known risk factors.