Lung Cancer Numbers, Women Smokers Catching Up to Men Who Puff Away

November 5, 2018

6 min read

Women around the world have justly earned the right for equality with men in employment, salary and civil and political rights, among others. But unfortunately, Israeli women are smoking and getting lung cancer – and dying of it – like men.

The Israel Cancer Association (ICA) announced that Monday, November 5 would be the Day of Awareness to Promote the Fight Against Lung Cancer. A red light was turned on when the ICA noted in the last 10 years a 33% jump in the number of lung cancer patients (in absolute numbers) – in Israel despite the decline in most of the world in smoking. Within the last two decades, the number of patients has almost doubled.

Looking at actual figures, in 1995, 906 of those newly diagnosed with lung cancer were men and 407 women. Of these, 782 were Jewish men; 389 were Jewish women; 109 were Arab men; and 11 were Arab women. In 2015, of the 2,482 new lung cancer patients diagnosed in Israel 1,575 were men and 907 were women. Of these, 1,239 were Jewish men; 825 Jewish women; 237 Arab men and 48 Arab women.

As more women began to smoke in recent decades, the rate of females with lung cancer has risen; women who smoke like men die like men, the ICA said. According to data from the Health Ministry’s National Cancer Registry, lung cancer rates among Jewish women in 1995 were “only” 11.64 per 100,000 and among Arab women, 3.81. As smoking rates increased among women, the proportion of women with lung cancer increased, and by 2015, the rate was 15.62 per 100,00 for Jewish women and 7.61 among Arab women, who smoke less than their Jewish counterparts.

More than 200 new patients with lung cancer are diagnosed in Israel every month, with about 175 of them smokers. Tobacco accounts for 85% of lung cancer cases this country; a minority of cases come from exposure to secondhand smoke (non-smokers exposed to the smoking of those who do), being near asbestos, air pollution and radon gas emanating from the ground.

The Talmud – the huge compendium comprising the source from which the code of Jewish law is derived – deals with the simple and obvious instruction that a person must protect his life and the prohibition against endangering oneself unnecessarily. Anyone who puts himself in danger may be harmed – and even if he is not harmed, it is a miracle that negates and detracts from his rights to heaven. Thus, according to Jewish law, it is forbidden to smoke, as tobacco has been proven without a doubt to endanger one’s health and life.

The main factors in the rise of smoking and lung cancer here are that taxes on packaged tobacco that smokers roll to make cigarettes is much lower than that on ready-made cigarettes due to opposition to raising them by Finance Minister Moshe Kahlon. In addition, Deputy Health Ministry Ya’acov Litzman has allowed heated tobacco products to be sold freely to adults, even though they are barred in the US and elsewhere, and liquid nicotine vaping devices, albeit with an approved concentration of nicotine, are sold.

Many high school pupils illegally get their hands on these devices, which look like disk-on-keys, even while in class; they do not produce smoke or odors. Litzman also opposes requiring cigarette packs to display illustrations of dirty lungs or teeth, which are known to deter young people from smoking; the deputy health minister argues that such images are “not aesthetic.”

The global scientific fact that smoking is responsible for 85% of lung cancer cases was also validated recently by a new Israeli study by Dr. Avi Magid of the department of health systems management at the Peres Academic Center. He found that avoiding tobacco could have prevented 2,104 Israelis from getting lung cancer out of the 2,482 new cases diagnosed in 2015.

The likelihood of developing lung cancer is higher among people who started smoking at an early age, said Miri Ziv, ICA’s director-general.

“I call on young people not to start with the addictive and deadly habit and to stay away from tobacco. Don’t be shy about telling others: ‘Quit smoking and significantly reduce your risk of lung cancer and other diseases.’ It is important to know that the human lungs have the ability to regenerate and clean themselves up. If they do not suffer permanent damage, rehabilitation begins almost immediately when you kick the habit.”

Dr. Dudi Biton, a senior ICA doctor and information coordinator, added: “In the past year, some smokers have switched to electronic cigarettes and other nicotine evaporation and vaporization products, thinking they are a detoxification tool to reduce the risk of lung cancer. In addition to the fact that recent studies have shown that electronic cigarettes reduce the chance of stopping regular cigarette smoking, recent lab studies have found a link between any type of nicotine and lung cancer. Who knows what will be found in human clinical trials?”

Unlike nicotine replacements that are sold in the pharmacy to give up smoking, which include patches and chewing gum in which the dose is measured and limited in time, in the case of electronic cigarette, there is no restriction. These can be consumed in very high and dangerous amounts of nicotine,” Biton said.

Lung cancer symptoms include continuous coughing for three weeks or more; shortness of breath and wheezing; cough and discharge of bloody mucus; hoarseness; chest or shoulder pain; a dull or sharp pain in your chest when you cough or take a deep breath; loss of appetite and weight; difficulty swallowing; extreme fatigue, exhaustion and sleepiness; fingertips become larger and rounded; and inflammation of the lymph nodes in the neck area. If you suffer from one of these symptoms for more than three weeks, go immediately to your doctor. All of these symptoms may also be caused by smoking or other diseases other than cancer. Sometimes lung cancer is diagnosed randomly in people who have no symptoms at all, but are tested in a photo or a lung scan to find out another problem.

Among world-famous people who have exposed their personal struggle against lung cancer were US actor Yul Brynner, who had lung cancer and before his death at the age of 65 in 1985 recorded a service message for the American Cancer Society urging people not to smoke.

Other celebrities included the legendary animation and entertainment man Walt Disney, who was a heavy smoker and died at age 65 of lung cancer, as did singer Donna Summer, who died at the age of 63 after a long struggle with lung cancer. King George VI, the father of Queen Elizabeth II, died prematurely in February 1952 at the age of 56 from lung cancer. Princess Margaret, the Queen’s younger sister, who smoked more than 60 cigarettes a day, died in 2002 at the age of 71 after undergoing a partial lung resection. And there are many, many more.

Why don’t all smokers get lung cancer? There are risk factors, and because of them, some are more susceptible to disease than others. Among the factors studied are environmental and occupational risks, which in themselves increase the risk of lung cancer or when combined with smoking. There is also evidence that a family history of lung cancer is also a risk factor. In addition, the possibility that genetic factors can affect the risk of a smoker may be diagnosed with lung cancer.

The ICA supports a pilot program for the early detection of lung cancer. In recent years, there has been a scientific discussion here and abroad about the early detection of lung cancer in people at high risk but no visible symptoms of the disease. The association favors the implementation of a screening program, provided that it is done in a way that would lead to more benefit to the public. Family physicians should be able to send smokers for a test only after being presented with their pros and cons.

Studies in the US and Europe show that the test can reduce the death rate, but there is also a high rate of false positive results – leading to invasive procedures, such as biopsies. To date, contrary to what has been said by various sources, no country in the world has implemented such a public screening program. In the US, the test it is offered severe restrictions so that only a few percent perform it.

A large-scale new meta-analysis that links the consumption of fruit, exercising and a lower risk of lung cancer has been carried out. The researchers used extensive information on lifestyle and risk factors of 364,411 participants aged 51 and over out of seven studies conducted in Australia over the past 30 years. Smoking had the strongest effect on lung cancer. The consumption of two or more servings of fruit daily reduced the risk of lung cancer by13%, compared to people who consumed less fruit per day. Regular physical exercise cut the risk of contracting lung cancer by 18%. A combination of consuming fruit, exercising and reducing smoking can prevent up to 63% of lung cancers over 40 years and 31% of lung cancers over a decade.

The researchers, writing in the International Journal of Epidemiology, concluded that tobacco is the leading cause of future lung cancer, and preventive and health promotion measures should be taken to reduce smoking, increase fruit intake and engage in physical activity to reduce deaths from the malignant tumor.

It was also shown that the risk of lung cancer decreases as more years pass without smoking; there is a significant reduction in the risk of former heavy smokers getting sick within five years of withdrawal, compared to current smokers. However, the risk of a former smoker getting lung cancer, even 25 years after kicking the habit, is three times greater than people who have never smoked.

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