Do Ashkenazi Jews have a higher than expected cancer burden? Implications for cancer control prioritization efforts.

BACKGROUND: Recent genetic susceptibility findings in Jews of Eastern European descent, commonly called Ashkenazi Jews, have led to concerns that they may be stigmatized as being more cancer prone than other groups.
OBJECTIVE: To examine the hypothesis that site-specific or all-cancer incidence and mortality rates are higher than expected in Ashkenazi Jews worldwide when compared with referent populations.
METHODS: A MEDLINE search was performed using keywords "Jews," "cancer," "incidence" and "mortality" to identify studies directly relevant to the primary study question.
RESULTS: Little evidence suggested that all-cancer incidence or mortality is higher in Ashkenazi Jews than in North American non-Hispanic whites. Ashkenazi Jewish men appear to have relatively low cancer rates, which may be due to lower tobacco use. Colorectal cancer was shown to disproportionately overburden Ashkenazi Jews, who may also be at increased risk for ovarian, pancreatic and stomach cancer, and non-Hodgkin's lymphoma. Little evidence was found supporting an elevated risk of breast cancer in Ashkenazi Jewish women. Rates of lung, cervical, penile and prostate cancers appear low in this population. Rate disparities were generally attributed to lifestyle differences, particularly diet and tobacco use, rather than to genetic predisposition.
CONCLUSIONS: Ashkenazi Jews do not appear to have a higher total cancer burden than comparable North American populations. Any cancer rate differentials in this group are more likely to be related to lifestyle and dietary factors than to genetics. However, colorectal cancer rates in Ashkenazi Jews may be the highest of any ethnic group in the world and cancer controllers should consider this when developing future screening, diagnostic and policy strategies.