The Holocaust Is a Significant and Independent Risk Factor of Late-Onset Cancers: A Systematic Review of the Literature and Original Data on Jewish Israeli, Jewish Non-Israeli and Non-Jewish Non-Israeli Survivors

Abstract

Background/Aim: Seventy-six years after Auschwitz Liberation, the Holocaust keeps on persecuting its surviving victims. As witnessed by the psychiatric and medical literature in the last decades, in fact, the Holocaust survivors (HS) appear to suffer from several Shoah-related late-onset diseases impacting their survival, such as internal illnesses and posttraumatic stress disorder (PTSD). Cancer represents a further severe pathology which seems to be connected with the Holocaust experience. Our aim was to review the existing knowledge of Holocaust-related cancer in HS in order to assess its real incidence and clinicoprognostic significance. Materials and Methods: We systematically reviewed the literature dealing with Israeli Jewish and non-Jewish non-Israeli HS developing cancer. We also reviewed and analyzed the cancer data of noted Jewish HS not resident or having resided in Israel available as public information. Results: We found 16 and 15 studies on Israeli Jews and non-Jewish non-Israeli survivors, respectively.A statistically significant association between the Holocaust and development of late-onset cancer in HS was seen in most studies with cancer adversely impacting the survival. We also selected 330 noted Jewish non-Israeli HS: genocide-related late-onset cancer resulted to be a significant and independent risk factor of poor prognosis (p<0.0001) imparting shorter survival in affected versus non-cancer subjects (57 versus 64 years, respectively, p=0.0001). Conclusion: Although 76 years have passed, our review shows how the Holocaust keeps on burdening its survivors. Moreover, we offered the first analysis of Jewish HS not resident or having resided in Israel in terms of genocide-related late-onset diseases focusing on cancer. Further studies on Jewish non-Israeli HS are needed in order to corroborate our findings on late-onset cancer occurring in this targeted population.The Holocaust undoubtedly represents one of the darkest pages in the history of mankind: still today, European concentration and extermination camps, the ghettos and all the Memorial sites are steeped in horrors and crimes perpetrated by the Nazi Germany (1). Interestingly, differently from other past or current genocides, only the Shoah was characterized by a systematic and dehumanized medicalization of the sufferings (1, 2). To the physicians and medical students of today, in fact, it is emotionally and rationally shocking to know that the atrocities inflicted in anus mundi were realized with the active complicity of the German medical community and that, with very few notable exceptions, history has ignored 2745 This article is freely accessible online.

Holocaust survivors: Health and longevity 70 years later

“…In addition to all‐cause mortality, recent research has examined both disease‐specific mortality, as well as specific morbidities among Holocaust survivors. Thus, for example, evidence suggests that older survivors have an increased cancer risk 12 . Similarly, increased cancer‐specific mortality among survivors was observed among both women and men, 13 in a study of 5042 survivors, which also found that while all‐cause mortality was slightly increased among women, no difference was observed among men, when compared to non‐exposed matched controls.…”