Early cancer screening and prevention in Israel

Early detection of malignant disease is very important for the further successful treatment and life saving.

Since there are no general standards for detecting and preventing cancer, this evaluation is individual, and it begins with the doctor’s consultation, an experienced specialist in the early cancer diagnosis and prevention.

Preventive Screening

During the appointment, doctor will ask questions and take a family history to determine your personal cancer screening and prevention program.

Depending on the program, you may need to undergo the following tests:

Blood test: CBC, SMA (glucose level, lipid profile, thyroid function (TSH), CRP test, which can predict various types of cancer, and indicators of inflammation. Blood pressure and pulse test (on both hands).

Meet with a clinical dietitian for lifestyle changes and nutritional advice to prevent cancer. BMI, circumference and body fat percentage test.

Meet with cancer specialists and mapping of personal risk factors for different types of cancer.

Colon cancer prevention, meeting with a gastroenterologist, identifying possible risk factors and recommending the best test. This is usually a colonoscopy.

Blood tests for genetic changes (APC gene) that detect the development of cancer and especially gastrointestinal cancer.

Early detection of lung cancer (in heavy smokers) – low-dose chest CT (after discussing the advantages and disadvantages of the test with patients).

Early detection of breast cancer – determining a woman’s personal risk of developing breast cancer (Tyrer score). Manual examination by a surgeon, mammography, breast ultrasound (if necessary and separately). Referral for MRI of very high-risk patients.

Early detection of testicular cancer – manual examination by a urologist or surgeon and, if necessary, referral to an ultrasound of the testicles. 

Early detection of prostate cancer – PSA, free PSA and the correlation. Rectal examination by a urologist or surgeon.

Early detection of uterine and ovarian cancer – pelvic ultrasound. It will be performed by a qualified gynecologist. 

Prevention of cervical cancer – Pap smear and US in women. Conducted by a qualified gynecologist, if necessary – vaccination against HPV. 

Early detection of oral cancer – physical examination by the dentist using a head lamp.

Early detection of the thyroid gland – medical examination and, if necessary, referral for an ultrasound of the neck. 

Skin cancer prevention – Physical examination by a plastic surgeon using a dermoscope.

Follow up with a genetic counselor or add recommendations for genetic testing or additional medical tests, depending on family history.

If cancer is found, we will definitely carry out the necessary examination and refer you to the most appropriate specialist in this area.

Genetic testing

Our doctors perform genetic testing to identify high-risk malignancies.

In the case of suspicion of a congenital defect which can lead to a high probability of malignant disease in the family (several kinds of the same type of cancer in the family: a few relatives with malignant tumors, the incidence at a young age, and so on) our doctors perform study for the mutations in the genes responsible for malignant disease. Genetic testing can prevent or allow to identify malignant disease at an early stage, as well as to find the therapeutic decision.

Geneticist will determine the further steps, including DNA testing. Depending on the consultation results doctor also can recommend a definite program of examination and genetic tests for your first degree relatives if required.

Geneticist Appointment Online

Oncologist Appointment Online

In some cases, for performing a genetic test only sample the patient’s blood or saliva is needed. Laboratory test results are known, usually within two – six weeks.

⇒ Oncotests for heredity detection and precision treatment used in Israel

Diseases and genetic syndromes that cause a high risk of malignant diseases, for which genetic tests and early detection are a good solution:

Family breast and ovarian cancer (BRCA mutation)

Typical types of cancer:

BRCA 1 – cancer of the breast, ovary, pancreas.

BRCA 2 – breast cancer (including men), ovarian cancer, pancreatic cancer, melanoma, prostate cancer in men.

Family adenomatous polyposis (APC mutation)

Typical types of cancer:

Overgrowth of polyps in the colon, stomach and duodenum, which can degenerate into malignant tumors.

Mutations in APC can lead to retinal pigmentation, as well as benign tumors such as epidermoid cysts and desmoid tumors.

Lynch syndrome, also called hereditary colon cancer without familial polyposis (Hereditary non-polyposis colon cancer HNPCC) – MLH1, MSH2, PMS2, MSH6 mutations.

Typical types of cancer:

Cancer of the colon and rectum, endometrial cancer, ovary cancer, ureters, stomach, small intestine cancer.

The malignant transformation process is very fast, and is measured from months up to two to three years. Unique pattern for MSI cancers.

Polyposis associated with MUTYH gene mutation 

Typical types of cancer:

Colorectal cancer, duodenal cancer, increased risk of other malignant neoplasms as in Lynch syndrome.

Unlike other syndromes, the form of inheritance of polyposis in adults is autosomal recessive, that is, a person is at risk only if the mutation is inherited from each of his parents, and there are two defective copies of the MUTYH gene.

Retinoblastoma (RB1 mutation)

Typical types of cancer:

Retinal tumors, osteosarcoma, bone sarcoma.

Li-Fraumeni syndrome (SLF) TP53 mutation

Typical types of cancer:

Breast cancer, especially at a young age under 35, sarcoma (childhood) leukemia, lymphoma, brain tumors, adrenal cortex cancer, lung cancer.

Peutz-Jeghers Syndrome (STK11 / LKB1)

Typical types of cancer:

Small intestine polyps that can transform into malignant tumors.

Pigmented spots on the lips, around the mouth, on the palms and feet, an increased risk of developing breast cancer.

Von Hippel-Lindau syndrome (VHL mutation)

Typical types of cancer:

Kidney cancer, peochromocytoma, meningioblastoma of the brain.

Retinal angiomas (vascular proliferation)

Cowden’s syndrome (PTEN mutation)

Typical types of cancer:

Early breast cancer, thyroid cancer, endometrial cancer.

Increased head circumference, single skin lesions, especially on the face, rashes (benign tumors).

Multiple endocrine neoplasia 1 (MEN1 mutation)

Typical types of cancer:

Cancer of the parathyroid gland, thyroid gland, pituitary gland, tumors of cells secreting hormones in the pancreas (endocrine cells), duodenal cancer.

Skin lesions, lipomas (fatty tumors), most tumors are benign.

Multiple endocrine neoplasia 2 (RET mutation)

Typical types of cancer:

Medullary thyroid cancer, thyroid cancer, peochromocytoma, parathyroid adenoma, marfanoid structure of the body.

Single lesions around the mouth are very rare.

Information taken from Israeli Cancer Association 

General recommendations

2. Early diagnosis of breast cancer
Women aged 50 years are recommended to do mammography 1 every two years.
Women, aged 40 years, who had a history of benign breast disease with atypia, are recommended to do mammography every year.
For women at high risk screening test it is recommended breast MRI – in accordance with the recommendations of the Ministry of Health.
Clinical breast examination is not a test for the detection of breast cancer, it is part of a general physical examination. Breast self-examination is not an effective test for the early detection of breast cancer.

3. Early diagnosis of cancer of the colon and rectum
At the age of 50 years for patients with normal risk we recommend an annual highly sensitive test for the detection of fecal occult blood.
At the age of 40 cases of patients with a diagnosis of colon cancer first-degree relatives in the family, it is recommended to do colonoscopy once every five years.
Patients with the syndrome case of colon cancer is not Polifozi (HNPCC / Lynch syndrome) in first-degree relatives, are recommended to undergo annual colonoscopy at age 25 years and older.
Patients with the syndrome case of colon cancer Polifozi in first-degree relatives are recommended to undergo annual colonoscopy at age 15 years and older.
Patients with inflammatory bowel disease (Crohn’s disease, ulcerative colitis) are recommended to undergo periodic colonoscopy, in accordance with doctor’s advice.

4. Early detection of lung cancer
In total, there is no any specific indicators to perform standard screening and scanning for the early detection of lung cancer. Nevertheless, those who are exposed to asbestos, it is recommended conducting X-ray 1 time a year.

5. Early detection of ovarian cancer
Clear indications for routine screening for early detection of ovarian cancer does not exist.
Women belonging to vulnerable groups are recommended to consult with a physician-geneticist in cases of personal or family history of breast cancer diagnosed before the age of 50 years, in the case of a family history of ovarian cancer, as well as personal or family history of colon cancer and endometrial cancer diagnosed before the age of 50.
Foe women who are on the results of genetic tests identified high risk of developing ovarian cancer it is recommended to undergo periodic examination (every 6 months) at the age of 25, including a gynecological examination, vaginal ultrasound, with or without CA-125 test.

6. Early diagnosis of cervical cancer
There is no any specific recommendations for the early detection of cervical cancer. However, women need to perform smear test every three years, between the ages of 25 to 65.

7. Early detection of melanoma and skin cancer
There are no specific recommendations for the implementation of the common screening tests for the early detection of melanoma and skin cancer.
For people at high risk of skin cancer or melanoma it is important to inform family members about the disease, and to carry out periodic self-evaluation after the defeat of the skin disease, as well as perform periodic skin examinations by dermatologist or plastic surgeon.
Groups at high risk of melanoma or skin cancer exposure to ionizing radiation for the treatment of ringworm in childhood, history of melanoma in first-degree relatives, presence of atypical moles, including family members of the first-degree relatives.

8. Early detection of prostate cancer
There are no any specific recommendations for the implementation of the common screening tests for the early detection of prostate cancer. Digital rectal examination is an essential part of the general physical examination for the early detection of prostate cancer.