Israel

Global Health ResearchGlobal Health Research
projectproject

Contents:Contents:
GeographicGeographic
PoliticalPolitical
Infrastructure and EconomyInfrastructure and Economy
Cultural/EthnicCultural/Ethnic
Healthcare systemHealthcare system
StatisticsStatistics

GeographicGeographic
World mapWorld map
Climate and geographic terrainClimate and geographic terrain

World mapWorld map
Israel is at the eastern end of theIsrael is at the eastern end of the
Mediterranean Sea, bounded byMediterranean Sea, bounded by
Lebanon to the north, Syria to theLebanon to the north, Syria to the
northeast, Jordan to the east, andnortheast, Jordan to the east, and
Egypt to the southwest. It liesEgypt to the southwest. It lies
between latitudes 29° and 34° N,between latitudes 29° and 34° N,
and longitudes 34° and 36° E.and longitudes 34° and 36° E.

Climate and geographic terrainClimate and geographic terrain
Temperatures in Israel vary widely, especially during theTemperatures in Israel vary widely, especially during the
winter. The more mountainous regions can be windy, cold,winter. The more mountainous regions can be windy, cold,
and sometimes snowyand sometimes snowy
Meanwhile, coastal cities, such as Tel Aviv and Haifa, haveMeanwhile, coastal cities, such as Tel Aviv and Haifa, have
a typical Mediterranean climate with cool, rainy winters anda typical Mediterranean climate with cool, rainy winters and
long, hot summers.long, hot summers.
The area of Beersheba and the Northern Negev has aThe area of Beersheba and the Northern Negev has a
semi-arid climate with hot summers, cool winters and fewersemi-arid climate with hot summers, cool winters and fewer
rainy days than the Mediterranean climate.rainy days than the Mediterranean climate.
The Southern Negev and the Arava areas have desertThe Southern Negev and the Arava areas have desert
climate with very hot and dry summers, and mild wintersclimate with very hot and dry summers, and mild winters
with few days of rain.with few days of rain.
The highest temperature in the continent of Asia (53.7The highest temperature in the continent of Asia (53.7
°C/128.7 °F) was recorded in 1942 at Tirat Zvi kibbutz in°C/128.7 °F) was recorded in 1942 at Tirat Zvi kibbutz in
the northern Jordan river valley. From May to September,the northern Jordan river valley. From May to September,
rain in Israel is rare.rain in Israel is rare.
January is the coldest month, with temperatures from 5 CJanuary is the coldest month, with temperatures from 5 C
to 10 C, and August is the hottest month at 18 C to 38 C.to 10 C, and August is the hottest month at 18 C to 38 C.

PoliticalPolitical
System of governmentSystem of government
Any recent or current civil, political unrestAny recent or current civil, political unrest
or wars and effects on countryor wars and effects on country

System of governmentSystem of government
Israel is a parliamentary democracy, dividedIsrael is a parliamentary democracy, divided
into six administrative districts.into six administrative districts.
There is no formal constitution; instead, there isThere is no formal constitution; instead, there is
the Declaration of Establishment, from 1948,the Declaration of Establishment, from 1948,
the Basic Laws of the parliament (the Basic Laws of the parliament ( KnessetKnesset ),),
and the Israel citizenship law.and the Israel citizenship law.
The head of government is the prime minister,The head of government is the prime minister,
elected by popular vote for a four-year term.elected by popular vote for a four-year term.
Executive power is exercised by theExecutive power is exercised by the
government.government.
The 120 members of the Knesset also areThe 120 members of the Knesset also are
elected for four years. The Knesset selects theelected for four years. The Knesset selects the
president, who serves as chief of state.president, who serves as chief of state.
The political system of the State of Israel and itsThe political system of the State of Israel and its
main principles are set out in 11 Basic Laws.main principles are set out in 11 Basic Laws.

Any recent or current civil, political unrest orAny recent or current civil, political unrest or
wars and effects on countrywars and effects on country
The Israeli–Palestinian conflictThe Israeli–Palestinian conflict isis
the ongoing struggle between Israelisthe ongoing struggle between Israelis
and Palestinians that began in theand Palestinians that began in the
early 20th century.early 20th century.
Arab–Israeli conflictArab–Israeli conflict refers to therefers to the
political tension and military conflictspolitical tension and military conflicts
between the Arab League and Israelbetween the Arab League and Israel
and between Arabs and Israelis. Theand between Arabs and Israelis. The
roots of the modern Arab–Israeliroots of the modern Arab–Israeli
conflict lie in the rise of Zionism andconflict lie in the rise of Zionism and
Arab nationalism towards the end ofArab nationalism towards the end of
the 19th century.the 19th century.
Iran–Israel relationsIran–Israel relations:: Iran may launchIran may launch
pre-emptive strike on Israel, conflictpre-emptive strike on Israel, conflict
could grow into WWIIIcould grow into WWIII
Green color shows countries, that are in Arab leagueGreen color shows countries, that are in Arab league
YitzhakYitzhak RabinRabin and Yasser Arafatand Yasser Arafat
shake hands at the signing ofshake hands at the signing of
the Oslo Accords, with Billthe Oslo Accords, with Bill
ClintonClinton behind them, 1993them, 1993

Infrastructure and EconomyInfrastructure and Economy
Major industriesMajor industries
Level of personal incomeLevel of personal income
Level of development:Level of development:
1. Safe Food and Water availability1. Safe Food and Water availability
2. Water/Sewer/Waste management system2. Water/Sewer/Waste management system
3. Transportation and communication system3. Transportation and communication system
4. Education system4. Education system
5. protection system5. protection system

Major industriesMajor industries
Israel has a well-developedIsrael has a well-developed chemicalchemical
industryindustry with many of its products aimed atwith many of its products aimed at
the export market.the export market.
The Dead Sea Works in Sdom is the world'sThe Dead Sea Works in Sdom is the world's
fourth largest producer and supplier offourth largest producer and supplier of
potashpotash products.products.
Israel is one of the world's three majorIsrael is one of the world's three major
centers for polishedcenters for polished diamondsdiamonds..
During the past two decades Israel'sDuring the past two decades Israel's
industrial sector has made a major shift toindustrial sector has made a major shift to
the areas ofthe areas of medical electronicsmedical electronics,, agro-agro-
technologytechnology,, telecommunicationstelecommunications,,
computercomputer hardwarehardware andand softwaresoftware..

Level of personal incomeLevel of personal income
BasisBasis - Israeli residents are taxed on their worldwide income,- Israeli residents are taxed on their worldwide income,
while non-residents are taxed only on their Israeli sourcedwhile non-residents are taxed only on their Israeli sourced
income.income.
Taxable IncomeTaxable Income - All income from employment and business- All income from employment and business
is taxable. Passive income from bank deposits and savings,is taxable. Passive income from bank deposits and savings,
both in Israel and abroad are also taxable.both in Israel and abroad are also taxable.
Capital GainsCapital Gains - Capital gains may arise on the sale of assets;- Capital gains may arise on the sale of assets;
for individuals this is generally 25%.for individuals this is generally 25%.

Level of developmentLevel of development
Tap water is safe and drinkable in Israel, except at The Dead Sea.Tap water is safe and drinkable in Israel, except at The Dead Sea.
Jews are bound by a set of dietary laws calledJews are bound by a set of dietary laws called kashrutkashrut , which,, which,
among other restrictions, forbid the consumption ofamong other restrictions, forbid the consumption of pork andpork and
shellfishshellfish, as well as the consumption of both meat and milk products, as well as the consumption of both meat and milk products
at the same meal. Not all Israelis observe these rules, but manyat the same meal. Not all Israelis observe these rules, but many
restaurants do.restaurants do.
The system, called Meitavit, is an end-to-endThe system, called Meitavit, is an end-to-end water and sewagewater and sewage
services management systemservices management system. Meitavit includes various SAP-based. Meitavit includes various SAP-based
components including financial, logistics, procurement, inventory,components including financial, logistics, procurement, inventory,
control, billing and collections, customer relationship managementcontrol, billing and collections, customer relationship management
(CRM), project management and human resources.(CRM), project management and human resources.
Transportation in IsraelTransportation in Israel is based mainly on private motor vehicles and busis based mainly on private motor vehicles and bus
service and an expanding railway network. Demands of population growth,service and an expanding railway network. Demands of population growth,
political factors, the Israel Defense Forces, tourism and increased traffic setpolitical factors, the Israel Defense Forces, tourism and increased traffic set
the pace. All facets of transportation in Israel are under the supervision ofthe pace. All facets of transportation in Israel are under the supervision of
the Ministry of Transport and Road Safety.the Ministry of Transport and Road Safety.
The Communications systemThe Communications system in Israelin Israel is the most developed in theis the most developed in the
Middle East, although it is not the biggest. Israel's system consists ofMiddle East, although it is not the biggest. Israel's system consists of
Coaxial cables, Optical fibers, and Microwave radio relay.Coaxial cables, Optical fibers, and Microwave radio relay.

Level of developmentLevel of development
Education in IsraelEducation in Israel refers to the comprehensive education system of Israel. Expenditurerefers to the comprehensive education system of Israel. Expenditure
on education accounts for approximately 10% of GDP, and most schools are subsidizedon education accounts for approximately 10% of GDP, and most schools are subsidized
by the state. The education system consists of three tiers: primary education (grades 1-6,by the state. The education system consists of three tiers: primary education (grades 1-6,
approx. ages 6–12), middle school (grades 7-9, approx. ages 12–15) and high schoolapprox. ages 6–12), middle school (grades 7-9, approx. ages 12–15) and high school
(grades 10-12, approx. ages 15–18).(grades 10-12, approx. ages 15–18). In 2012, Israel was named the second mostIn 2012, Israel was named the second most
educated country in the world according to the Organization for Economic Cooperationeducated country in the world according to the Organization for Economic Cooperation
and Development's Education at a Glance report.and Development's Education at a Glance report.
Protection systemProtection system Based on its latestBased on its latest
combat experiences, the Israel Defensecombat experiences, the Israel Defense
Forces (IDF) is moving forward with theForces (IDF) is moving forward with the
development and fielding of activedevelopment and fielding of active
protection systems (APS) for tanks andprotection systems (APS) for tanks and
armored infantry fighting vehicles (AIFV).armored infantry fighting vehicles (AIFV).

Cultural/EthnicCultural/Ethnic
Main ethnic groups within countryMain ethnic groups within country
Major religion of country and their beliefsMajor religion of country and their beliefs
(any ritual, ideas or practices that may influence health)(any ritual, ideas or practices that may influence health)
CultureCulture

Main ethnic groups within countryMain ethnic groups within country
Jewish 76.4% (of which Israel-bornJewish 76.4% (of which Israel-born
67.1%, Europe/America-born 22.6%67.1%, Europe/America-born 22.6%
Africa-born 5.9%, Asia-born 4.2%)Africa-born 5.9%, Asia-born 4.2%)
non-Jewish 23.6% (mostly Arab) (datanon-Jewish 23.6% (mostly Arab) (data
from 2004)from 2004)

Major religion of country and their beliefsMajor religion of country and their beliefs
(any ritual, ideas or practices that may influence health)(any ritual, ideas or practices that may influence health)
Religion in IsraelReligion in Israel is a central feature of the country and plays ais a central feature of the country and plays a
major role in shaping Israeli culture and lifestyle, and religion hasmajor role in shaping Israeli culture and lifestyle, and religion has
played a central role in Israel's history.played a central role in Israel's history.
Israel has no entrenched constitution, but freedom of religion isIsrael has no entrenched constitution, but freedom of religion is
anchored in law.anchored in law.
Most citizens in the State of Israel are Jewish, and most Israeli JewsMost citizens in the State of Israel are Jewish, and most Israeli Jews
practice Judaism in some form. In the last two centuries the largestpractice Judaism in some form. In the last two centuries the largest
Jewish community in the world, in the United States, has dividedJewish community in the world, in the United States, has divided
into a number of Jewish denominations.into a number of Jewish denominations.
The largest and most influential of these denominations areThe largest and most influential of these denominations are
Orthodox Judaism, Reform Judaism, and Conservative Judaism. AllOrthodox Judaism, Reform Judaism, and Conservative Judaism. All
of the above denominations exist, to varying degrees, in the State ofof the above denominations exist, to varying degrees, in the State of
Israel. Nevertheless, Israelis tend to classify Jewish identity in waysIsrael. Nevertheless, Israelis tend to classify Jewish identity in ways
that are strikingly different from American Jewry.that are strikingly different from American Jewry.

WhatWhat JewsJews BelieveBelieve
Jews believe that one person cannot die for the sins of another.Jews believe that one person cannot die for the sins of another.
We do not need a blood sacrifice for the forgiveness of sins.We do not need a blood sacrifice for the forgiveness of sins.
Jews believe that Jesus was not the messiah.Jews believe that Jesus was not the messiah.
Jews believe that God hates human sacrifices.Jews believe that God hates human sacrifices.
Jews believe that one is born into the world with original purity.Jews believe that one is born into the world with original purity.
Jews do not believe in original sin.Jews do not believe in original sin.
Jews believe that God is one and indivisible.Jews believe that God is one and indivisible.
Jews do not believe in a trinity.Jews do not believe in a trinity.
Jews believe in The Satan, but not in a devil.Jews believe in The Satan, but not in a devil.
There is a difference between The Satan and the devil.There is a difference between The Satan and the devil.
Jews believe that God is God, and humans are humans.Jews believe that God is God, and humans are humans.
God does not become human nor do humans become God.God does not become human nor do humans become God.
Jews believe that "Jews for Jesus," "Messianic Jews," and "HebrewJews believe that "Jews for Jesus," "Messianic Jews," and "Hebrew
Christians" are no longer Jews, even if they were once Jews.Christians" are no longer Jews, even if they were once Jews.
The "Jewish roots" of Christianity?The "Jewish roots" of Christianity?

CultureCulture
Israeli literatureIsraeli literature is primarily poetry and prose written in Hebrew, asis primarily poetry and prose written in Hebrew, as
part of the renaissance of Hebrew as a spoken language since thepart of the renaissance of Hebrew as a spoken language since the
mid-19th century, although a small body of literature is published inmid-19th century, although a small body of literature is published in
other languages, such as English.other languages, such as English.
Israeli musicIsraeli music contains musical influences from all over the world;contains musical influences from all over the world;
Sephardic music, Hasidic melodies, Belly dancing music, GreekSephardic music, Hasidic melodies, Belly dancing music, Greek
music, jazz, and pop rock are all part of the music scene.music, jazz, and pop rock are all part of the music scene.
Ten IsraeliTen Israeli filmsfilms have been final nominees for Best Foreignhave been final nominees for Best Foreign
Language Film at the Academy Awards since the establishment ofLanguage Film at the Academy Awards since the establishment of
Israel. The 2009 movieIsrael. The 2009 movie AjamiAjami was the third consecutive nominationwas the third consecutive nomination
of an Israeli film.of an Israeli film.
Israeli cuisineIsraeli cuisine includes local dishes as well as dishes brought toincludes local dishes as well as dishes brought to
the country by Jewish immigrants from around the world. Since thethe country by Jewish immigrants from around the world. Since the
establishment of the State in 1948, and particularly since the lateestablishment of the State in 1948, and particularly since the late
1970s, an Israeli fusion cuisine has developed.1970s, an Israeli fusion cuisine has developed.

Healthcare systemHealthcare system
Level of development and structure ofLevel of development and structure of
health care delivery systemshealth care delivery systems
Safety and qualitySafety and quality
Health care providersHealth care providers
DoctorsDoctors
Emergency servicesEmergency services

Level of development and structureLevel of development and structure
of health care delivery systemsof health care delivery systems
Health care in IsraelHealth care in Israel is universal and participation in ais universal and participation in a
medical insurance plan is compulsory.medical insurance plan is compulsory.
Health careHealth care coverage is administered by a small numbercoverage is administered by a small number
of organizations, with funding from the government.of organizations, with funding from the government.
Generally,Generally, health carehealth care in Israel is of high-quality and isin Israel is of high-quality and is
delivered in an efficient and effective manner. Partly as adelivered in an efficient and effective manner. Partly as a
result of this, at an overall 82 years, Israelis enjoy theresult of this, at an overall 82 years, Israelis enjoy the
fourth-longest life expectancy in the world as of 2012.fourth-longest life expectancy in the world as of 2012.

Safety and qualitySafety and quality
Israel has one of the most technologically advanced and highest-Israel has one of the most technologically advanced and highest-
quality healthcare systems in the world.quality healthcare systems in the world.
Hospitals in Israel are equipped with modern facilities and high-Hospitals in Israel are equipped with modern facilities and high-
quality medical technologyquality medical technology
Medical staff are trained from four to six years in one of theMedical staff are trained from four to six years in one of the
country's five university medical schools.country's five university medical schools.
The country is a world leader in advanced infrastructure of medicalThe country is a world leader in advanced infrastructure of medical
and paramedical researchand paramedical research

Health care providersHealth care providers
Providers in the Israeli healthcare system consist of aProviders in the Israeli healthcare system consist of a
mixture of private, semi-private and public entitiesmixture of private, semi-private and public entities
Generally, family and primary medicine facilities are runGenerally, family and primary medicine facilities are run
directly by Clalit Health Care Services for its membersdirectly by Clalit Health Care Services for its members
while the other HMOs operate their own family practicewhile the other HMOs operate their own family practice
clinics in the larger cities and contract with privatelyclinics in the larger cities and contract with privately
operated family practice clinics in smaller communities.operated family practice clinics in smaller communities.

DoctorsDoctors
In 2010, there were 25,542 doctors inIn 2010, there were 25,542 doctors in
Israel - 3.36 doctors for every 1,000Israel - 3.36 doctors for every 1,000
people. This ratio is one of the highest ofpeople. This ratio is one of the highest of
all industrialized countries.all industrialized countries.

Emergency servicesEmergency services
Emergency medical services in Israel are provided byEmergency medical services in Israel are provided by
the Magen David Adom (MDA) organization, which staffsthe Magen David Adom (MDA) organization, which staffs
approximately 1,200emergency medicalapproximately 1,200emergency medical
technicians, paramedics, and emergency physicians,technicians, paramedics, and emergency physicians,
and 10,000 volunteers.and 10,000 volunteers.
The organizations operates 95 stations and a fleet ofThe organizations operates 95 stations and a fleet of
over 700 ambulances.over 700 ambulances.
The majority of the fleet consists of Basic Life SupportThe majority of the fleet consists of Basic Life Support
(is the level of medical care which is used for victims of(is the level of medical care which is used for victims of
life-threatening illnesses or injuries until the victims canlife-threatening illnesses or injuries until the victims can
be given full medical care at a hospital. ) ambulances.be given full medical care at a hospital. ) ambulances.

CANCER RANK BY TYPECANCER RANK BY TYPE
0
5
10
15
20
25
30
1
1 Breast Cancer
2 Lung Cancers
3 Colon-Rectum Cancers
4 Pancreas Cancer
5 Lymphomas
6 Stomach Cancer
7 Leukemia
8 Prostate Cancer
9 Skin Cancers
10 Ovary Cancer

ISRAEL TOTAL DEATHS BY CAUSEISRAEL TOTAL DEATHS BY CAUSE
NUMBER OF DEATHSNUMBER OF DEATHS
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
1
1 Coronary Heart Disease
2 Diabetes Mellitus
3 Stroke
4 Lung Cancers
6 Kidney Disease
7 Breast Cancer
8 Alzheimers/Dementia
9 Influenza & Pneumonia
10 Lung Disease

ISRAEL TOTAL DEATHS BY CAUSEISRAEL TOTAL DEATHS BY CAUSE
PERCENTAGEPERCENTAGE
0
2
4
6
8
10
12
14
16
18
1 2 3 4 5 6 7 8 9 10
CAUSE
Percentage
1 Coronary Heart Disease
2 Diabetes Mellitus
3 Stroke
4 Lung Cancers
6 Kidney Disease
7 Breast Cancer
8 Alzheimers/Dementia
9 Influenza & Pneumonia
10 Lung Disease

Compare summaryCompare summary
Diabetes:Diabetes: In High-income counties percentage of diabetes deaths
is 2.6%, in Israel it’s 8.42% (3,2 times higher). Israel is a high-
income country and this statistics shows, that people of Israel can
have a genetic predisposition for this disease.
Kidney:Kidney: Israel has kidney’s diseases on 6-th place, although
average statistic of High-income countries doesn’t include this
disease in top 10. It may mean, that not all water is good for drink or
other diseases can occur kidney illness.
Colon and rectal cancersColon and rectal cancers:: there are different causes: geneticsthere are different causes: genetics
(less then 5-15% of all causes), older age, male gender, high intake(less then 5-15% of all causes), older age, male gender, high intake
of fat, alcohol or red meat, obesity, smoking and a lack of physicalof fat, alcohol or red meat, obesity, smoking and a lack of physical
exercise. In Israel these diseases are higher then in averageexercise. In Israel these diseases are higher then in average
statistics.statistics.
Breast cancer:Breast cancer: in Israel this disease 2.2 times higher then in avg
stat-s. The main cause may be genetics.

Smoking StatisticsSmoking Statistics
6000 people6000 people die each year in Israel from cigarettes, that's aboutdie each year in Israel from cigarettes, that's about 1616
people a day!people a day!
28%28% of Israel populationof Israel population are smokers. In 1973 smokers wereare smokers. In 1973 smokers were 42%42%
of the population.of the population.
Although the decrease in the amount of smokers, the starting age ofAlthough the decrease in the amount of smokers, the starting age of
the smokers is decreasing. Today eventhe smokers is decreasing. Today even 11 years old11 years old start to smoke.start to smoke.
4.5%4.5% of theof the boysboys andand 1%1% of theof the girlsgirls agedaged 11-1211-12 claim to be regularclaim to be regular
smokers.smokers.
9.5%9.5% of theof the boysboys andand 6.4%6.4% of theof the girlsgirls agedaged 14-1514-15 claim to beclaim to be
regular smokers.regular smokers.
16%16% of theof the boysboys and 9% of theand 9% of the girlsgirls aged 16-17 claim to be regularaged 16-17 claim to be regular
smokers.smokers.
90% of all smokers90% of all smokers starts smoking before they are 18.starts smoking before they are 18.
90% of the Israelis90% of the Israelis support No-Smoking areas in work places.support No-Smoking areas in work places.

Top 10 causes of death inTop 10 causes of death in
High-income countriesHigh-income countries
(average statistics)(average statistics)
0
0.08
0.16
0.24
0.32
0.4
0.48
0.56
0.64
0.72
0.8
0.88
0.96
1.04
1.12
1.2
1.28
1.36
1.44
1.52
Deaths in millions % of deaths
Ischaemic heart disease
Stroke and other cerebrovascular disease
Trachea, bronchus, lung cancers
Alzheimer and other dementias
Lower respiratory infections
Chronic obstructive pulmonary disease
Colon and rectum cancers
Diabetes mellitus
Hypertensive heart disease
Breast cancer

MEN IncidenceMEN Incidence
0
2000
4000
6000
8000
10000
12000
Prostate
(18.6%)
Colorectum
(15.7%)
Lung (10.8) Other
(54.9%)
Incidence (number)
Incidence (number)
Cancer Incidence (number)
Prostate (18.6%) 2326
Colorectum (15.7%) 1965
Lung (10.8) 1345
Other (54.9%) 10265

MEN MortalityMEN Mortality
0
200
400
600
800
1000
1200
1400
1600
1800
Prostate
(7.9%)
Colorectum
(13.5%)
Lung
(21.1%)
Others
(57.5%)
Mortality (number)
Mortality (number)
Cancer Mortality (number)
Prostate (7.9%) 415
Lung (21.1%) 1110
Others (57.5%) 1619

Women IncidenceWomen Incidence
0
1000
2000
3000
4000
5000
6000
7000
8000
Breast (31.8%) Colorectum
(14.9%)
Lung (6.1%) Others (47.2%)
Incidence (number)
Incidence (number)
Breast (31.8%) 4203
Lung (6.1%) 807
Others (47.2%) 7863

Women MortalityWomen Mortality
0
500
1000
1500
2000
2500
3000
3500
Breast (18.5%) Colorectum
(12.8%)
Lung (9.8%) Others (58.9%)
Incidence (number)
Incidence (number)
Breast (18.5%) 968
Lung (9.8%) 511
Others (58.9%) 3083

MENMEN
Israel vs. USAIsrael vs. USA

WomenWomen
Israel vs. USAIsrael vs. USA

Pancreatic Cancer in Israel
Statistics, rankStatistics, rank
SymptomsSymptoms
Risk factorRisk factor
Early detection, screening and preventionEarly detection, screening and prevention
Treatment and futureTreatment and future

Statistics, rankStatistics, rank
Cancer
Incidence Mortality 5-year prevalence
Number (%) ASR (W) Number (%) ASR (W) Number (%) Prop.
Pancreas 487 3.9 11.7 443 8.5 10.2 362 1.1 14.6
Pancreatic cancer is not a common malignancy in Israel,
but it is the third most common cause of cancer mortality
In contrast, it ranks 6th in the United States and 13th
worldwide. But pancreatic cancer ranks third in cancer
mortality in Israel, fourth in the U.S. and eighth worldwide.
Incidence rates and trends 1980–2006 The incidence rates
were significantly higher in European-born Jews of both genders and
in both the European and non-European-born males. Among Jewish
male immigrants who arrived after 1990, the incidence is
insignificantly higher than among other Israelis

SymtomsSymtoms
CBD
MPD
MaP
MiP
(it hidden)
MiPMiP-Minor Papilla;-Minor Papilla; MaPMaP-Major Papilla;-Major Papilla; MPDMPD-Major Pancreas Duct;-Major Pancreas Duct; CBDCBD-Common Bile Duct-Common Bile Duct

SymptomsSymptoms
Pancreatic cancer does not cause symptoms in its
earliest stages. By the time symptoms are noted, theBy the time symptoms are noted, the
disease has already been growing for some time.disease has already been growing for some time.
Initial symptoms of pancreatic cancer tend to be ratherInitial symptoms of pancreatic cancer tend to be rather
vague, so patients often ignore them for a certain lengthvague, so patients often ignore them for a certain length
of time.of time.
Decreased appetiteDecreased appetite - Most patients experience a greatly decreased- Most patients experience a greatly decreased
appetite (This may be one of the first symptoms of pancreaticappetite (This may be one of the first symptoms of pancreatic
cancer).cancer).
Unintended weight lossUnintended weight loss - Over time, up to 100% of patients with- Over time, up to 100% of patients with
pancreatic cancer tend to fall about 10% below their ideal bodypancreatic cancer tend to fall about 10% below their ideal body
weight.weight.

SymptomsSymptoms
PainPain - About 95% of all patients with pancreatic cancer have pain- About 95% of all patients with pancreatic cancer have pain
JaundiceJaundice - Jaundice consists of a yellow discoloration of the skin,- Jaundice consists of a yellow discoloration of the skin,
mucus membranes (tissue including that which lines the mouth),mucus membranes (tissue including that which lines the mouth),
and whites of the eyes.and whites of the eyes. (When pancreatic cancer strikes the head of the(When pancreatic cancer strikes the head of the
pancreas, jaundice may occur earlier in the disease because the tumor putspancreas, jaundice may occur earlier in the disease because the tumor puts
pressure on the common bile duct, the tube that connects the pancreas,pressure on the common bile duct, the tube that connects the pancreas,
liver, and gallbladder to the intestine. When the cancer is located in theliver, and gallbladder to the intestine. When the cancer is located in the
body or tail of the pancreas, however, jaundice may occur later in thebody or tail of the pancreas, however, jaundice may occur later in the
course of the disease)course of the disease)
Nausea and vomitingNausea and vomiting - About 30% of patients with pancreatic cancer- About 30% of patients with pancreatic cancer
experience nausea and vomiting.experience nausea and vomiting.
Dark urine, light-colored stoolDark urine, light-colored stool – Reasons like with jaundice– Reasons like with jaundice
aforesaidaforesaid
Depression, mood swingsDepression, mood swings - Depression and mood swings occur in- Depression and mood swings occur in
nearly 30% of patients.nearly 30% of patients.
Itching generalizedItching generalized - Itching, which is difficult to treat, is a common- Itching, which is difficult to treat, is a common
symptom in patients.symptom in patients.

Risk factorsRisk factors
Epidemiological studies have identified
environmental and familial risk factors for the
disease:
male gender
aging
obesity
diabetes (type 2 or hyperglycemia occurring as a
paraneoplastic phenomenon)
tobacco smoking

high consumption of fried/grilled/processed meats
chronic pancreatitis
Genetic risk factors are believed responsible for 5–
10% of pancreatic cancer cases They include both
genetic disorders where pancreatic involvement is
not the usual target organ and also pancreas-
specific genetic mutations causing cancer
Risk factorsRisk factors

ScreeningScreening
There are no sensitive non-evasive screening
modalities or early diagnostic tests. These
include:
Blood tests
Standard and high resolution pancreas-dedicated
abdominal computed tomography
Ultrasonography
Advanced imaging techniques using magnetic
resonance might be useful but are not readily
available in Israel.

PreventionPrevention
Preventive advice on lifestyle habits will be given to
patients and family members at risk for pancreatic
cancer
The meeting in August 2009, called by the Pancreas
Subcommittee of the Israel Gastroenterology Society
decided that EUS (endoscopic ultrasound sonography)
would be their standard test for pancreatic cancer
They adopted the following standard protocol as used in
an American multicenter study for examination,
documentation and follow-up of these lesions and/or
patients at high risk for the disease. Similar protocols are
used in Europe.

Treatment and futureTreatment and future
A clinical trial withA clinical trial with TL-118TL-118--a new treatment for--a new treatment for
metastatic pancreatic cancer--that has been ongoing atmetastatic pancreatic cancer--that has been ongoing at
the Hadassah University Medical Center and three otherthe Hadassah University Medical Center and three other
oncology centers in Israel, has been expanded to theoncology centers in Israel, has been expanded to the
United States.United States.
TL-118TL-118. produced by Tiltan Pharma Ltd., belongs to the. produced by Tiltan Pharma Ltd., belongs to the
family of angiogenesis-inhibiting drugs, which means itfamily of angiogenesis-inhibiting drugs, which means it
inhibits new blood vessel formation in tumors and thusinhibits new blood vessel formation in tumors and thus
cuts off their blood supply and growth.cuts off their blood supply and growth.
AngiogenesisAngiogenesis, the process by which new blood vessels, the process by which new blood vessels
are formed, is a hallmark capability of cancer cells. Anti-are formed, is a hallmark capability of cancer cells. Anti-
angiogenic therapy has, therefore, emerged as a mostangiogenic therapy has, therefore, emerged as a most
promising strategy with solid tumors, which rely onpromising strategy with solid tumors, which rely on
aggressive angiogenesis for their growth.aggressive angiogenesis for their growth.

TL-118TL-118 was initially tested in a mouse model ofwas initially tested in a mouse model of
pancreatic cancer. In these pre-clinical studies,pancreatic cancer. In these pre-clinical studies, TL-118TL-118
monotherapy inhibited tumor growth significantly, asmonotherapy inhibited tumor growth significantly, as
compared to the standard-of-care chemotherapy.compared to the standard-of-care chemotherapy.
Moreover, whenMoreover, when TL-118TL-118 therapy was combined withtherapy was combined with
standard-of-care chemotherapy, the tumors werestandard-of-care chemotherapy, the tumors were
eliminated in all the treated animals.eliminated in all the treated animals.
To date, over 100 cancer patients have been treatedTo date, over 100 cancer patients have been treated
withwith TL-118TL-118 for up to four years, according to Tiltanfor up to four years, according to Tiltan
Pharma, jointly owned by Yissum, the HebrewPharma, jointly owned by Yissum, the Hebrew
University's Technology Transfer Company, and otherUniversity's Technology Transfer Company, and other
investors from Israel and Canada.investors from Israel and Canada.

http://www.slideshare.net/lyubachka121/jewish-religious-beliefs-and-practhttp://www.slideshare.net/lyubachka121/jewish-religious-beliefs-and-pract
http://www.mongabay.com/history/israel/israel-the_economy.htmlhttp://www.mongabay.com/history/israel/israel-the_economy.html
http://www.worldlifeexpectancy.comhttp://www.worldlifeexpectancy.com
http://www.pas-online.org/stats.htmlhttp://www.pas-online.org/stats.html
http://globocan.iarc.fr/http://globocan.iarc.fr/
http://www.haaretz.com/print-edition/news/israeli-researchers-http://www.haaretz.com/print-edition/news/israeli-researchers-
identify-protein-that-may-slow-down-pancreatic-cancer-1.372930identify-protein-that-may-slow-down-pancreatic-cancer-1.372930
http://www.bidmc.org/YourHealth/ConditionsAZ/KneeSprain.aspx?http://www.bidmc.org/YourHealth/ConditionsAZ/KneeSprain.aspx?
ChunkID=32772ChunkID=32772
http://www.hadassah.org/site/apps/nlnet/content2.aspx?http://www.hadassah.org/site/apps/nlnet/content2.aspx?
c=keJNIWOvElH&b=7730783&ct=12524079&notoc=1c=keJNIWOvElH&b=7730783&ct=12524079&notoc=1
http://www.cancer.gov/http://www.cancer.gov/

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