Smoking, obesity and education of Icelandic women by rural-urban residence

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)OBJECTIVE: To assess the prevalence of obesity and the association with smoking and education among young Icelandic women residing within and outside the capital area. MATERIALS AND METHODS: A self-administered questionnaire was sent to 28.000 Icelandic women, 18-45 years-old, in the period November 2004 to June 2005. The sample was randomly selected from The National Registry, response rate being 54.6%. The study was part of a large Nordic population-based cross-sectional study. Logistic regression was used for assessing the odds ratio of obesity (BMI > or = 30) in a multivariate analysis according to smoking and education, taking also into account age and alcohol consumption. The chi-square test was used for comparing percentages. RESULTS: Thirteen percent of women residing in the capital area were obese compared with 21% outside the capital. In the multivariate analysis obesity was increased among women living outside the capital (OR = 1.66; 95% CI 1,50-1,83), among smokers (OR=1,13; 95% CI 1.01-1.28), and among women who did not have university education (OR=1.53; 95%CI 1.36-1.71). Daily smokers within the capital area were more likely to be obese (OR=1.27; 95%CI 1.07-1.49) but not smokers outside the capital (OR=1.0). . CONCLUSIONS: Residence outside the capital area, daily smoking and non-university education are associated with an increased risk of obesity among young Icelandic women. The relationship between these factors is complex and differs between women residing within and outside the capital area.Tilgangur: Að kanna algengi offitu og tengsl hennar við reykingar og menntun meðal ungra kvenna innan og utan höfuðborgarsvæðisins. Efniviður og aðferðir: Spurningalisti var sendur til 28.000 íslenskra kvenna, 18-45 ára, frá nóvember 2004 til júní 2005. Lagskipt slembiúrtak var fengið úr Þjóðskrá, heildarsvörun var 54,6%. Könnunin er hluti af stórri, norrænni lýðgrundaðri þversniðsrannsókn. Beitt var lógistískri aðhvarfsgreiningu og reiknað gagnlíkindahlutfall (OR) fyrir offitu (BMI³30) og 95% öryggisbil (CI) þar sem tekið var tillit til búsetu, menntunar, aldurs, reykinga og áfengisneyslu. Notað var kí-kvaðratspróf til að bera saman hlutföll. Niðurstöður: 13% kvenna af höfuðborgarsvæðinu flokkuðust með offitu borið saman við 21% utan svæðisins. Fjölbreytugreining sýndi að líkur á offitu voru marktækt hærri meðal kvenna utan en innan höfuðborgarsvæðis (OR=1,66; 95% CI 1,50-1,83), meðal reykingakvenna (OR=1,13; 95% CI 1,01-1,28) og þeirra sem ekki voru með háskólamenntun (OR=1,53; 95% CI 1,36-1,71). Á höfuðborgarsvæðinu voru auknar líkur á offitu meðal kvenna sem reyktu daglega (OR=1,27; 95% CI 1,07-1,49), en ekki utan höfuðborgarsvæðis (OR=1,0). Ályktanir: Búseta utan höfuðborgarsvæðis, dag- legar reykingar og minni menntun tengjast auknum líkum á offitu meðal kvenna á Íslandi. Samspil þessara þátta er flókið og ólíkt eftir búsetu

Thyroid cancer in Iceland in the period 1955-2004 : a clinico-pathological and epidemiological study

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Introduction: Thyroid cancer has been unusually common in Iceland. Histological classification and TNM-staging has altered somewhat in the last decades. The aim of this study was to investigate the epidemiology of thyroid cancer in Iceland over half a century and identify factors affecting survival. Material and methods: Information on all thyroid cancers diagnosed in Iceland from 1955 to 2004 was obtained from the Icelandic Cancer Registry. Tumours diagnosed post-mortem were excluded. The date of diagnosis, sex and age at diagnosis was registered. All histopathology material was re-evaluated to reclassify tumours and TNM-stage was determined. The effect of registered parameters on prognosis was determined both in uni- and multivariate analysis. Results: Out of 805 thyroid cancer cases in the study 588 were in women. The mean age was 51 years in women and 58 years in men. The oscillation of incidence was marked in the study period although it did not increase in the last decades of the study. The overall proportion of papillary carcinoma was around 80% and the proportion of T0-T2 tumours was 66%. Neither number has changed significantly in the last 40 years of the study. The overall disease specific 5 year survival was 88% and increased significantly in the study period. In a multivariate analysis patient's age, year of diagnosis, tumour type and TNM-stage were independent significant prognostic variables. Conclusion: Thyroid cancer incidence in Iceland is no longer different to that in many neighbouring countries. Sex was not an independent prognostic parameter. The year of diagnosis was an independent prognostic factor which might indicate a more efficient treatment in later years. Key words: thyroid cancer, histological classification, TNM-staging, incidence, epidemiology. Correspondence: Jon Gunnlaugur Jonasson, [email protected]: Krabbamein í skjaldkirtli eru fremur sjaldgæf æxli þó þau hafi verið óvenju algeng á Íslandi. Meinafræðiflokkun og TNM-stigun æxlanna hefur breyst á undanförnum áratugum. Tilgangur rannsóknarinnar var að endurskoða öll skjaldkirtilskrabbamein á 50 ára tímabili, meta horfur sjúklinga og kanna breytingar. Efniviður og aðferðir: Upplýsingar fengust hjá Krabbameinsskrá Íslands um skjaldkirtilskrabbamein greind á Íslandi 1955-2004. Greiningardagur, kyn og aldur sjúklinga var skráð. Öll vefjasýni voru endurmetin, æxlin endurflokkuð og TNM-stig ákvarðað. Einungis æxli greind í lifandi sjúklingum komu inn í þessa rannsókn. Athugað var hvaða þættir höfðu áhrif á lifun sjúklinga og hverjir þeirra reyndust sjálfstætt marktækir. Niðurstöður: Alls greindust 805 skjaldkirtilskrabbamein á tímabilinu, þar af 588 í konum. Meðalaldur kvenna var 51 ár en karla 58 ár. Marktækar sveiflur á nýgengi komu fram en nýgengið jókst þó lítið á síðustu áratugum rannsóknartímans. Hlutfall totumyndandi krabbameins var í heild um 80% og T0-T2 stig æxla um 66%. Þessi hlutföll breyttust lítið, einkum síðustu fjóra áratugina. Æxli í konum greindust almennt á lægra TNM-stigi. Sjúkdómssértæk fimm ára lifun var 88% og jókst marktækt á rannsóknartímanum. Við fjölbreytugreiningu var aldur við greiningu, greiningarár, vefjagerð og TNM-stig allt sjálfstæðir þættir sem höfðu áhrif á horfur sjúklinga. Ályktun: Nýgengi skjaldkirtilskrabbameins hérlendis er ekki lengur hátt miðað við ýmis nágrannalönd. Kyn reyndist ekki sjálfstætt marktækur áhættuþáttur varðandi lifun. Hins vegar var greiningarár sjálfstæður þáttur sem getur bent til að meðferð hafi orðið árangursríkari

Use of hormone replacement therapy by Icelandic women in the years 1996-2001

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenINTRODUCTION: Since the late seventies the use of hormone replacement therapy by peri- and postmenopausal women has been steadily increasing. This was shown in a former study of hormonal use among Icelandic women who had responded to a questionnaire when attending cancer screening at the Cancer Detection Clinic (CDC) of the Icelandic Cancer Society in the years 1979-1996. This current study is an independent extension of the former study with the goal of investigating menopausal hormone use among Icelandic women during the period of 1996-2001 and comparing the results with the former study period of 1979-1995. MATERIAL AND METHODS: We used data from the CDC for the period of 1996-2001 and reviewed the responses from Icelandic women aged 40-69 years to questions regarding hormonal use. We investigated changes in the proportion of women using hormones, the proportion of women using combined hormone replacement therapy, the proportion using long-time hormone replacement therapy, and also the relationship between hormonal use and smoking. We also compared our results to the former study results. RESAULTS: During the period 1996-2001, 16.649 women aged 40-69 years responded to the questionnaire on hormonal use. There was an increase in use during that period, and also an increase compared to the period 1979-1995. Women born 1941-1945 were more likely to have ever used hormones (68%) than women born 1931-35 (42%). Present use of hormones was most prevalent among 52-57 year old women (57%). The proportion of women aged 50-55 years reporting present use did not change over the period (~50%). Long term use increased steadily during the period. During 1996-98 the proportion of women who had used hormones for more than 5 years was 49%, compared to 67% of women 1999-2001. This is also a considerable increase compared to the former study period. In the years 1996-2001, 19% of the women reported hormone use for 14 years or more. Smoking was more common among ever users of hormone replacement therapy (63%) than among never users of hormone replacement therapy (53%). CONCLUSIONS: The proportion of women who had used hormones and the duration of hormone use increased steadily during the period of 1996-2001. There was also a considerable increase compared to the former study period.Inngangur: Frá lokum áttunda áratugarins hefur notkun kvenhormóna (tíðahvarfahormóna), hjá kon­um á breytingaskeiði og eftir tíðahvörf, aukist stöðugt. Þetta kom vel fram í fyrri rannsókn sem gerð var á hormónanotkun íslenskra kvenna sem höfðu svarað heilsusöguspurningum á vegum Leitarstöðvar Krabbameinsfélags Íslands árin 1979-1996 (1). Nú­­­ver­­andi rannsókn er sjálfstætt framhald af fyrri rannsókn og var tilgangur hennar að kanna notkun tíðahvarfa­hormóna á Íslandi árin 1996-2001 og bera saman við tímabilið 1979-1995. Efni og aðferðir: Notuð voru gögn Heilsusögubanka Leitarstöðvar Krabbameinsfélags Íslands frá árunum 1996-2001 og könnuð svör kvenna á aldrinum 40-69 ára við spurningum um hormónanotkun. Athugaðar voru breytingar á hlutfalli kvenna sem nota horm­ón, hlutfalli samsettra hormóna miðað við estrógen eingöngu, hlutfalli kvenna sem taka hormón í lang­an tíma og athuguð tengsl hormónanotkunar og reykinga. Samanburður var gerður við niðurstöður fyrri rannsóknar (1). Niðurstöður: Á árunum 1996-2001 svöruðu 16.649 konur (40-69 ára) spurningum um notkun tíðahvarfa­hormóna. Notkun jókst á tímabilinu og einnig varð aukning miðað við árin 1979-1995. Hærra hlutfall kvenna sem fæddar voru 1941-45 hafði einhvern tíma notað hormóna (68%) en kvenna fæddra 1931-35 (42%). Hormónanotkun við komu í Leitarstöð var algengust á aldrinum 52 til 53 ára (57%). Hutfall kvenna á aldrinum 50 til 55 ára sem tóku hormón við komu (~50%) var óbreytt á rannsóknartímabilinu. Langtímanotkun jókst stöðugt yfir tímabilið og árin 1996-98 höfðu 49% kvenna notað hormón lengur en í 5 ár, en 67% árin 1999-2001 sem er einnig mikil aukning miðað við fyrri rannsókn. Á tímabilinu 1996-2001 höfðu 19% kvennanna notað hormón í 14 ár eða lengur. Tíðni reykinga var hærri hjá konum sem höfðu einhvern tíma notað tíðahvarfahormón (63%), en þeim sem aldrei tóku hormón (53%). Ályktanir: Hlutfall kvenna sem höfðu notað hormón og tímalengd hormónanotkunar jókst á tímabilinu 1996-2001 og jókst í samanburði við fyrra tímabil

Survival trends for patients diagnosed with cutaneous malignant melanoma in the Nordic countries 1990-2016 : The NORDCAN survival studies

Background: The survival in patients diagnosed with cutaneous malignant melanoma (CMM) has improved in the Nordic countries in the last decades. It is of interest to know if these improvements are observed in all ages and for both women and men. Methods: Patients diagnosed with CMM in the Nordic countries in 1990–2016 were identified in the NORDCAN database. Flexible parametric relative survival models were fitted, except for Iceland where a non-parametric Pohar-Perme approach was used. A range of survival metrics were estimated by sex, both age-standardised and age-specific. Results: The 5-year relative survival improved in all countries, in both women and men and across age. While the improvement was more pronounced in men, women still had a higher survival at the end of the study period. The survival was generally high, with age-standardised estimates of 5-year relative survival towards the end of the study period ranging from 85% in Icelandic men to 95% in Danish women. The age-standardised and reference-adjusted 5-year crude probability of death due to CMM ranged from 5% in Danish and Swedish women to 13% in Icelandic men. Conclusion: Although survival following CMM was relatively high in the Nordic countries in 1990, continued improvements in survival were observed throughout the study period in both women and men and across age.Peer reviewe

Trends in lung cancer survival in the Nordic countries 1990–2016 : The NORDCAN survival studies

Objectives: The aim of this study was to evaluate if the previously reported improvements in lung cancer survival were consistent across age at diagnosis and by lung cancer subtypes. Materials and methods: Data on lung cancers diagnosed between 1990 and 2016 in Denmark, Finland, Iceland, Norway and Sweden were obtained from the NORDCAN database. Flexible parametric models were used to estimate age-standardized and age-specific relative survival by sex, as well as reference-adjusted crude probabilities of death and life-years lost. Age-standardised survival was also estimated by the three major subtypes; adenocarcincoma, squamous cell and small-cell carcinoma. Results: Both 1- and 5-year relative survival improved continuously in all countries. The pattern of improvement was similar across age groups and by subtype. The largest improvements in survival were seen in Denmark, while improvements were comparatively smaller in Finland. In the most recent period, age-standardised estimates of 5-year relative survival ranged from 13% to 26% and the 5-year crude probability of death due to lung cancer ranged from 73% to 85%. Across all Nordic countries, survival decreased with age, and was lower in men and for small-cell carcinoma. Conclusion: Lung cancer survival has improved substantially since 1990, in both women and men and across age. The improvements were seen in all major subtypes. However, lung cancer survival remains poor, with three out of four patients dying from their lung cancer within five years of diagnosis.Peer reviewe

Smoking, obesity and education of Icelandic women by rural-urban residence

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)OBJECTIVE: To assess the prevalence of obesity and the association with smoking and education among young Icelandic women residing within and outside the capital area. MATERIALS AND METHODS: A self-administered questionnaire was sent to 28.000 Icelandic women, 18-45 years-old, in the period November 2004 to June 2005. The sample was randomly selected from The National Registry, response rate being 54.6%. The study was part of a large Nordic population-based cross-sectional study. Logistic regression was used for assessing the odds ratio of obesity (BMI > or = 30) in a multivariate analysis according to smoking and education, taking also into account age and alcohol consumption. The chi-square test was used for comparing percentages. RESULTS: Thirteen percent of women residing in the capital area were obese compared with 21% outside the capital. In the multivariate analysis obesity was increased among women living outside the capital (OR = 1.66; 95% CI 1,50-1,83), among smokers (OR=1,13; 95% CI 1.01-1.28), and among women who did not have university education (OR=1.53; 95%CI 1.36-1.71). Daily smokers within the capital area were more likely to be obese (OR=1.27; 95%CI 1.07-1.49) but not smokers outside the capital (OR=1.0). . CONCLUSIONS: Residence outside the capital area, daily smoking and non-university education are associated with an increased risk of obesity among young Icelandic women. The relationship between these factors is complex and differs between women residing within and outside the capital area.Tilgangur: Að kanna algengi offitu og tengsl hennar við reykingar og menntun meðal ungra kvenna innan og utan höfuðborgarsvæðisins. Efniviður og aðferðir: Spurningalisti var sendur til 28.000 íslenskra kvenna, 18-45 ára, frá nóvember 2004 til júní 2005. Lagskipt slembiúrtak var fengið úr Þjóðskrá, heildarsvörun var 54,6%. Könnunin er hluti af stórri, norrænni lýðgrundaðri þversniðsrannsókn. Beitt var lógistískri aðhvarfsgreiningu og reiknað gagnlíkindahlutfall (OR) fyrir offitu (BMI³30) og 95% öryggisbil (CI) þar sem tekið var tillit til búsetu, menntunar, aldurs, reykinga og áfengisneyslu. Notað var kí-kvaðratspróf til að bera saman hlutföll. Niðurstöður: 13% kvenna af höfuðborgarsvæðinu flokkuðust með offitu borið saman við 21% utan svæðisins. Fjölbreytugreining sýndi að líkur á offitu voru marktækt hærri meðal kvenna utan en innan höfuðborgarsvæðis (OR=1,66; 95% CI 1,50-1,83), meðal reykingakvenna (OR=1,13; 95% CI 1,01-1,28) og þeirra sem ekki voru með háskólamenntun (OR=1,53; 95% CI 1,36-1,71). Á höfuðborgarsvæðinu voru auknar líkur á offitu meðal kvenna sem reyktu daglega (OR=1,27; 95% CI 1,07-1,49), en ekki utan höfuðborgarsvæðis (OR=1,0). Ályktanir: Búseta utan höfuðborgarsvæðis, dag- legar reykingar og minni menntun tengjast auknum líkum á offitu meðal kvenna á Íslandi. Samspil þessara þátta er flókið og ólíkt eftir búsetu

Screening for cancer of the colon and rectum. A review on incidence, mortality, cost and benefit.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadNýgengi krabbameina í ristli og endaþarmi hefur aukist hjá bæði konum og körlum síðustu áratugina en dánartíðni hefur heldur lækkað frá sjötta áratugnum og lifun batnað vegna betri greiningar og meðferðar. Fjöldi þeirra sem látast úr ristil- og endaþarmskrabbameini er þó meiri en úr brjósta- og leghálskrabbameinum samanlagt. Viðfangsefni greinarinnar eru nýgengi og dánartíðni krabbameina í ristli og endaþarmi hérlendis. Fjallað er um tvær algengustu skimunaraðferðirnar, leit að blóði í hægðum og ristilspeglun. Þá er lagt mat á ætlaðan kostnað og ávinninning íslensks samfélags af því að skima fyrir krabbameinum í ristli og endaþarmi. Líklegt er að á Íslandi geti skipulögð lýðgrunduð skimun fyrir krabbameinum í ristli og endaþarmi komið í veg fyrir að minnsta kosti 6 dauðsföll af þeim 28 á ári sem verða úr sjúkdómnum meðal fólks á skimunaraldri, ef skimunaraldur verður 50-74 ára. Umframkostnaður fyrir samfélagið vegna skimunar fyrir krabbameinum í ristli og endaþarmi er talinn mjög ásættanlegur í ljósi þess að sparnaður verður vegna einfaldari meðferðar, lækkunar nýgengis og fækkunar dauðsfalla.In this article the incidence and mortality for cancer of the colon and rectum in Iceland is discussed. The two most common screening methods, faecal immunochemical test (FIT) and colonoscopy are compared and an estimate of cost and benefits for the Icelandic society will be made. The incidence of cancer of the colon and rectum has been increasing in Iceland in last decades but mortality has decreased and survival improved. However, more individuals die from cancer of the colon and rectum than from both breast- and cervical cancer added together. It is likely that screening for cancer of the colon and rectum, could prevent at least 6 of the 28 deaths related to those cancers, occurring yearly in Iceland in screening age, given a screening ages of 50-74 years. The extra cost for the Icelandic community due to the implementation of screening for cancer of the colon and rectum will be acceptable due to the lower cost of simpler treatments, lower cancer incidence and reduced mortality

Avoidable cancer cases in the Nordic countries - The impact of overweight and obesity

Background: Several types of cancers are causally linked to overweight and obesity which are increasing in the Nordic countries. The aim of this study was to quantify the proportion of the cancer burden linked to overweight and obesity in the Nordic countries and estimate the potential for cancer prevention. Methods: Under different prevalence scenarios of overweight and obesity, numbers of cancers in the Nordic countries in the coming 30 years (2016-2045) were estimated for 13 cancer sites, and compared to the projected number of cancers if the prevalence stayed constant. The Prevent macrosimulation model was used. Results: Over the period 2016-2045, 205,000 cancer cases out of the 2.1 million expected for the 13 studied cancer sites (9.5%) could be avoided in the Nordic countries.by totally eliminating overweight and obesity. The largest proportional impact was found for esophageal adenocarcinoma (24%), and the highest absolute impacts was observed for colon (44638) and postmenopausal breast cancer (41135). Conclusion: Decreased prevalence of overweight and obesity would reduce the cancer burden in the Nordic countries. The results from this study form an important step to increase awareness and priorities in cancer control by controlling overweight and obesity