A worrying increase in the incidence of mesothelioma in Israel

Background: Exposure to asbestos is the main established cause of mesotheli oma; the incidence of this tumor is thus often interpreted as an index of p ast exposure. Asbestos has been widely used in Israel in industry and build ing, exposing certain population groups to the risk of developing mesotheli oma. Objectives: To analyze the incidence of mesothelioma in Israel during the y ears 1960-96, and to project its trend for, the following years. Methods: We conducted a population-based study of incidence of mesothelioma reported to the Israel Cancer Registry during 1960-96. Time trends were an alyzed from data on the annual import of asbestos to Israel, which may indi cate the magnitude of past exposure. Based on these findings, trends in the incidence of mesothelioma in Israel were projected for the subsequent year s. Results: A total of 327 cases of mesothelioma were reported to the Israel C ancer Registry during the study period; The incidence in Jews was higher th an in Arabs (age-standardized incidence rate 2.64 vs. 1.35 per million/year , respectively). Among the Jewish population, Israeli-born males and males born in Europe and America showed the highest incidence (ASR 4.23 and 4.15 per million/year, respectively). Israeli-born males were 20 years younger t han Jewish males born elsewhere. The incidence was twice as high among male s than females and increased sevenfold from its nadir (1.17 per million/yea r) in 1978-80 to its peak (8.5 per million/year) in 1993-96. During a simil ar period the incidence among females increased from 0.33 to 2.56 per milli on/year. The incidence in both sexes does not appear to level off. The larg e wave of immigration from the former Soviet Union that began in 1989 only time trend in the incidence of mesothelioma in both accounts fbr the increa sed incidence in 1993-96. sexes parallels the use of asbestos in Israel, wh ich peaked in the years 1976-78. Conclusions: The incidence of mesothelioma in Israel has increased sharply in recent years, unrelated to a wave of immigration from East Europe, and i s predicted to continue to rise for another 10-15 years.