Cancer Risk May Be Higher Among Holocaust Survivors

Key Points

  • Cancer was diagnosed in 22% of those who were granted compensation for suffering persecution during the war vs 16% of those who were denied compensation.
  • Survivors who were granted compensation had a 6% higher risk of developing any type of cancer than those who were denied compensation, and they had a 12% increased risk for colorectal cancer and a 37% increased risk for lung cancer.
  • Those born in occupied countries had an 8% increased risk of developing any cancer than those born in nonoccupied countries, as well as 8% and 12% increased risks of colorectal cancer and lung cancer, respectively.

A new study indicates that survivors of the Holocaust have experienced a small but consistent increase in the risk of developing cancer. Published by Sadetzki et al in Cancer, the findings offer an example of how extreme population-level tragedies can have an impact on health.

Holocaust survivors were exposed to a variety of factors that have been linked with cancer. Siegal Sadetzki, MD, MPH, of the Chaim Sheba Medical Center in Israel, and her colleagues wondered whether the starvation, overcrowding, infectious diseases, and psychological stress that survivors endured might have contributed to the development of cancer in some individuals.

To investigate, the team studied 152,622 Holocaust survivors who were followed for more than 45 years. Two separate definitions of exposure were used. One definition was based on the individual's entitlement for compensation according to a set of laws. The other was based on the country of origin, using a classification of countries during the war into those that were directly governed by Nazi Germany and other nonoccupied countries.

Study Findings

Cancer was diagnosed in 22% of those who were granted compensation for suffering persecution during the war vs 16% of those who were denied compensation. Survivors who were granted compensation had a 6% higher risk of developing any type of cancer than those who were denied compensation, and they had a 12% increased risk for colorectal cancer and a 37% increased risk for lung cancer. Those born in occupied countries had an 8% increased risk of developing any cancer than those born in nonoccupied countries, as well as 8% and 12% increased risks of colorectal cancer and lung cancer, respectively. The investigators observed no elevated risks for breast cancer and gynecologic cancers among female survivors.

“The data emphasize the importance of learning about the combined effect of several exposures occurring intensely and contemporaneously on cancer risk, such as those that unfortunately occurred during World War II,” said Dr. Sadetzki. “Such inspection cannot be conducted by experimental studies, and could only be evaluated by using observational epidemiologic surveys.”

Editorial

An accompanying editorial by Thompson et al in Cancernotes that the associations reported by Dr. Sadetzki and colleagues between the extreme deprivation experienced by Holocaust survivors and cancer may also have parallels with other extreme population-level events, including in racial/ethnic minority groups who experience severe social deprivation over time.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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