There has been a sharp increase in the number of young Israelis being diagnosed with Hodgkin's lymphoma, a type of cancer of the immune system, according to researchers from the Health Ministry and from Soroka Medical Center in Be'er Sheva. The incidence of the disease in Israel is among the highest in the world. Although there is no clear explanation for the rise, one theory suggests that exposure to the virus which causes mononucleosis or exposure to measles are both potential sources for the increase in those contracting Hodgkin's lymphona.
The findings, which were based upon data gathered from 1960 to 2005, showed the incidence of the disease among Jewish men in Israel had risen by 60 percent, reaching a rate of 3.6 patients per 100,000 population, as well as an increase of 67 percent among Jewish women, at a rate of 3.36 per 100,000. In terms of numbers of patients in 2005, 841 men and 813 women were diagnosed with Hodgkin's lymphoma.
The study, published in the Israel Medical Association Journal, examined the cases of 4,812 Jewish patients who'd been diagnosed with the disease since 1960. The researchers said the incidence of Hodgkin's lymphoma was greatest in the 20- to 24-year-old age group, with a rate of 6.6 per 100,000 population of men and 9.13 per 100,000 women.
The general prevalence of the disease in Israel is similar to that in Italy, the United States and Spain, where this type of cancer is most common in the 18 to 24 age group. A similar rise in Hodgkin's lymphoma cases has been documented in recent years in the U.S. state of Connecticut in the 20 to 44 age range, and in Canada among patients aged 10 to 29. On the other hand, Britain has seen a drop over the past decade in patients up to age 24.
Researchers are not sure how to explain the increases, although it is suggested that it might be caused by exposure at a late age to childhood diseases such as measles, German measles, mumps and whooping cough. It has also been suggested that the disease is caused by the Epstein-Barr virus, which causes mononucleosis among other illnesses, although there are no records on the incidence of this disease in Israel.
Though a link between the virus and Hodgkin's lymphoma has been established, the extent of the link is a matter of dispute, according to Micha Barchana, the director of the Health Ministry's cancer registry. He said the virus is widespread in Israel and 80 percent of young people develop antibodies against it. "There are individual clinical reports in Israel of situations in which a few months after an outbreak of mononucleosis, Hodgkin's lymphoma is diagnosed," he added. A possible link between Hodgkin's and another virus that causes mononucleosis, cytomegalovirus, has also been suggested. Another assumption is that there is a link between mumps and Hodgkin's lymphoma.
There was a mumps outbreak in Israel between August 2007 and March 2008 which involved 902 cases, mostly in the Jerusalem area. A similar outbreak four years ago was thought to have been followed by incidents of Hodgkin's lymphoma, but Barchana said "wide collection of data is needed to better establish such a connection."
Hodgkin's disease involves a cancerous growth which can be diagnosed through a biopsy. Treatment for the disease is relatively successful, with ten-year survival rates of 80 to 93 percent among young patients. The disease was recently linked to the high incidence of cancer at an Israel Defense Forces base near Arad. Last December, it was reported that 17 soldiers who had trained there from 1994 to 2004 had been diagnosed with lymphomas, or tumors. A committee appointed by the IDF to examine the matter found no clear link between the cases and any environmental factors in the area. In a dissenting opinion, however, four experts concluded there was in fact a reasonable connection between the two. The case is to be considered by the Israeli Supreme Court, with a hearing expected after the Sukkot holiday.
The British physician Thomas Hodgkin, who first described the disease some 160 years ago, died on a trip to the Land of Israel and is buried in the Protestant cemetery in Jaffa.
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