CANCER:

By: Joseph Jacobs, Maurice Fishberg

A malignant growth of new tissue; usually in the form of a tumor. Whether removed or not, it tends to give rise to secondary growths in near or distant parts of the body, and to prove fatal. The term "cancer" is usually applied to malignant tumors formed of epithelial tissue, as carcinoma and epithelioma; but in this article sarcoma is also included.

Cancer is considered a disease of civilization, or of civilized races, and the relative mortality of large cities from this cause is greater than that of small ones.

Occurrence in Italy and England.

Lombroso investigating the demography of the Jews in Italy, found that the mortality from cancer among the general population was 2 per cent; while the Jews showed a mortality from this disease of 3.30 per cent. He also shows that, as is the case with the general population, the disease of cancer more frequently attacks women than men.

In England Dr. James Braithwaite noticed that cancer of the uterus was seldom or never met with among the numerous Jewesses attending the gynecological out-patient department of the Leeds General Infirmary—only one case in ten years. The experience of the London Hospital, where there is a special Hebrew department, is the same—only one case in five years, against 178 among Gentile women. Dr. Braithwaite considers that the only explanations possible are difference of race or difference in diet, especially the absence of pork from the Jewish diet. On the other hand, a writer in the "British Medical Journal" (March 15, 1902, p. 681) states that, in his experience, cancer of the breast has often been met with among the Jewesses in London; and while examples of nearly every form of cancer have been seen, there has seemed to be a special tendency to development of intestinal malignant growths. Of the patients dying between 40 and 65 years of age, a large percentage have been sufferers from cancer. The writer then brings figures from the records ofthe United Synagogue Burial Society for three years—1898, 1899, 1900—showing that 525 deaths due to cancer occur annually among 1,000,000 Jews; while the cancer rate for England and Wales for 1896 was 764 per 1,000,000 of population. From the registrar-general's returns for London the rate for 1900 showed more than 800.

Cancer Among the Jews in London.

	Registrar-General's Returns.			United Synagogue Burial Society Returns.
	__________________			__________________
	1900	1899	1898	1900	1899	1898
Deaths from all causes.	86,007	89,689	83,936	1,612	1,725	1,649
Deaths stated to be from cancer	4,251	4,234	4,084	37	42	34
Percentage of deaths from cancer	4.9	4.7	4.8	2.3	2.4	2.06
Deaths of persons over 20 years of age from all causes	50,565	51,922	45,490	609	642	677
Percentage of deaths from cancer to deaths from all causes of persons over 20 years of age	8.4	8.8	8.9	6.1	6.5	5.02

Dr. John S. Billings has shown that in the United States cancer occurs among Jews just as often as in the general population, as can be seen from the appended table:

Cancer Death-Rates per 1,000 of Total Deaths from All Causes.

	Males.	Females.
Jews	13.58	21.65
General population of the United States (1880)	13.09	23.59

In New York City.

Statistics collected by Dr. Maurice Fishberg for the Russian and Polish Jews living in the seventh, tenth, and thirteenth wards of New York city show, on the other hand, that they are less liable to succumb to cancer than the other inhabitants of the same districts, as can readily be seen from the appended table:

Cancer Among the Russian and Polish Jews in New York City During the Six Years Ending May 30, 1890.

Mothers Born in:	Population.			Deaths Due to Cancer.			Cancer per 100,000 Population.			Total Three Wards.
	__________________			_______________________			_______________________			__________________________________________
	7th Ward.	10th Ward.	13th Ward.	7th Ward.	10th Ward.	13th Ward.	7th Ward.	10th Ward.	13th Ward.	Population.	Deaths Due to Cancer.	Cancer Death- Rate per 100,000 Population.
Russia and Poland (Jews)	16,295	30,476	13,190	15	33	24	92.05	108.28	181.95	59,961	72	120.07
Other countries (including United States)	41,071	27,120	32,694	126	108	94	306.78	398.23	287.51	100,885	328	325.12
Total	57,366	57,596	45,884	141	141	118	245.80	244.80	257.17	160,846	400	248.68

The cancer death-rate among those whose mothers were not born in Russia or Poland was 325.12 per 100,000; while that of the Russian and Polish Jews was only 120.07—less than one-half.

Inquiries among surgeons and gynecologists who have a large experience among Jews in New York city have elicited the result that Jews are comparatively less liable to be attacked by cancer than are other races. Dr. Abram Brothers states that of nearly 35,000 women examined by him (mostly Jewish) he has met with less than a half-dozen cases of cancer of the uterus in Jewish women; while he has had several dozen cases in the same time in non-Jewesses. Dr. H. J. Boldt, basing upon an experience gained by the examination of more than 1,000 Jewish women annually, states that although he has operated upon a large number of Jewish women for cancer of the uterus, the proportion of the disease in this race, compared with others, is very small. A rough estimate is about one-tenth or even less. The same holds good with cancer of the breast, so far as his experience goes.

As to the comparative morbidity of the Jews in the United States from cancer, the following statistics have been collected from the "Annual Reports" for 1898, 1899, 1900, of one Jewish hospital in New York city (Mount Sinai), and compared with the cancer cases from a hospital which admits few Jews (St. Luke's). These are given in the following table:

Parts Affected by Cancer.	Mount Sinai (Jewish), 9,497 Patients.		St. Luke's, 7,933 Patients.
	_____________________		______________________
	Number of Cancer Cases.	Per cent of Cancer.	Number of Cancer Cases.	Per cent of Cancer.
Uterus	18	6.98	59	15.98
Breast	32	12.40	91	24.59
Gastro-intestinal tract	81	31.40	48	12.98
Liver	19	7.37	14	3.78
Rectum	12	4.66	25	6.76
Other organs.	38	14.72	86	23.24
Sarcoma	58	22.47	47	12.70
Total	258	100.00	370	100.00

Results of Inquiry.

It appears from these figures that: (1) Malignant disease is by no means rare among Jews, althoughit is less frequently met with than in other races. (2) Carcinoma and epithelioma, or true cancer, are more frequent among the general population—4.07 per cent of the total number of patients sick from all causes were affected by these forms of cancer; while among Jews the percentage was only 2.10 or about one-half. (3) Sarcoma is somewhat more frequent in Jews than in others; 0.061 per cent of sick Jews were affected with this form of malignant disease as against 0.059 per cent of the general population; 22.47 per cent of all cases of malignant disease among Jews suffered from sarcoma; while of the patients from the general population suffering with malignant disease, only 12.70 per cent were afflicted with sarcoma. (4) Cancer of the uterus and breast is less frequent in Jewish women than in other races. (5) Jews are more liable than non-Jews to be affected with cancer of the gastro-intestinal organs. Nearly 45 per cent of all cases of malignant disease in Jews occurred in the stomach, intestines, liver, pancreas, rectum, etc.; while in non-Jewish patients only 23 per cent of patients suffering from malignant disease were affected with cancer of these organs. (6) The only part of the gastro-intestinal tract which is less often attacked by cancer in Jews than in non-Jews is the rectum, and this notwithstanding the fact that Jews are markedly sufferers from other rectal diseases, such as hemorrhoids, fistula, etc.

According to all available statistics, cancer is more than twice as frequent in women as in men, owing to the occurrence of the disease in the breast and womb. Among Jewesses, on the other hand, cancer of the breast and womb is less common than among the general population. As has been shown, these organs appear to be affected less than one-half as often as in the patients in the non-Jewish hospital. This explains why the total percentage of cancer is lower among Jews than in other races.

J. M. Fi.