The effect of pregnancy on the survival of women diagnosed with breast cancer

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: To answer the question whether the prognosis of women with breast cancer is affected by pregnancy after diagnosis. Material and methods: We used information from the Icelandic Cancer Registry, the Birth Registry and the Genetic Committee. We identified all women who were diagnosed with breast cancer in the years 1927-1992 and who later became pregnant. Controls were women without a history of childbirth after diagnosis of breast cancer. They were matched on tumour size, axillary lymph node status and years of birth and diagnosis, with four year deviation. Results: In the years 1927-1992, 838 women at ages below 50 were diagnosed with breast cancer in Iceland. Of those, 29 gave birth to a child after the diagnosis. Fourteen cases and 33 matched controls fulfilled the inclusion criteria of the study. Survival was better in the group of women who became pregnant after diagnosis, but the difference was not statistically significant (P=0.06). Discussion: Our results do not indicate that the prognosis of women who become pregnant after the diagnosis of breast cancer is worse than of those who do not become pregnant. The group was too small to make definite conclusions. However, the results are in concordance with results from other studies.Tilgangur: Að leita svara við þeirri spurningu hvort horfur kvenna með brjóstakrabbamein versni við að eignast börn eftir greiningu. Efniviður og aðferðir: Notaðar voru upplýsingar frá Krabbameinsskrá, Fæðingaskráningu og Erfðafræðinefnd. Í rannsóknarhópnum voru konur sem greindust yngri en 50 ára með brjóstakrabbamein á árunum 1927-1992 og eignuðust síðar börn. Fundin voru viðmið sem einnig höfðu greinst með brjóstakrabbamein en höfðu ekki eignast börn eftir greiningu. Þessi viðmið voru sambærileg við sjúklingana varðandi stærð æxlis og eitlaíferð auk greiningar- og fæðingarára með fjögurra ára fráviki. Niðurstöður: Á árunum 1927-1992 greindust 838 konur yngri en 50 ára með brjóstakrabbamein, þar af eignuðust 29 konur börn í kjölfarið. Fjórtán þessara kvenna uppfylltu aðgangsskilyrði rannsóknarinnar. Fyrir þær fundust 33 viðmið. Lífshorfur reyndust vera betri í hópi þeirra kvenna sem áttu börn eftir greiningu brjóstakrabbameinsins, en munurinn var ekki tölfræðilega marktækur (P=0,06). Umræður: Niðurstöður okkar gefa ekki til kynna að barnsfæðing í kjölfar greiningar brjóstakrabbameins hafi slæm áhrif á horfur. Hópurinn er of lítill til þess að draga megi almennar ályktanir á grundvelli hans, en niðurstöðurnar eru í samræmi við erlendar rannsóknir

Hepatocellular carcinoma in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: The incidence of hepatocellular carcinoma (HCC) varies throughout the world, being relatively low in Northern Europe (less than five per 100,000 population) where the majority of the patients have cirrhosis. In Iceland the prevalence of viral hepatitis and cirrhosis, the main risk factors for HCC, is lower than reported in many other countries. The aim of our study was to investigate the incidence and etiology of HCC in Iceland. Material and methods: All patients diagnosed with HCC in Iceland in 1984-1998 were included in the study. Histologic diagnosis was required for inclusion. Patients were identified from the Icelandic Cancer Registry and by reviewing autopsy and histopathology reports. Further information was obtained from medical records. Results: A total of 71 cases of HCC were identified, 51 males and 20 females. The mean age for males was 69.3 years (18-95) and 73 years (52-89) for females. The age-standardized annual incidence rate of HCC was 1.08/100,000 (males 2.10, females 0.67). The incidence did not increase significantly during the study period. Alcohol abuse (15.5%) and hemochromatosis (11%) were the most common risk factors. Twenty-three (32%) had cirrhosis but 39 (55%) had no known risk factors. Of 55 cases where non-neoplastic tissue was available for examination, 27 had liver disease. Conclusions: 1) The incidence of HCC in Iceland is lower than reported in other countries. 2) Alcohol abuse and hemochromatosis are the most common risk factors. 3) The ratio of patients with cirrhosis is low

Liver metastases of unknown origin

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Approximately 5% of cancer patients are diagnosed with tumour of unknown origin (3-4% in Iceland). Of those 10-30% have . Liver metastases of unknown origin is thus not an uncommon problem. In the present study information about the origin and histology of liver metastases of unknown origin was compiled. Material and methods: Records of all biopsies from liver metastases performed in the years 1987-1996 were retrieved from the medical database of the Department of Pathology at the University of Iceland. The biopsies came from a group of 176 patients. Ninety-two cases, in which the origin of the primary tumour was suspected or known, were excluded from the study, leaving 84 cases where the primary was completely unknown. The database of the Icelandic Cancer Society was used to gather data about the final tissue diagnosis and the location of the primary tumour when known. Results: The Cancer Society data revealed the location of the primary tumour in 55 of the 84 cases of liver metastases of unknown origin. The most prevalent (75%) primary tumours were cancers of the pancreas (15), lung (13) and colon/rectum (12). The tissue diagnosis was adenocarcinoma in 33 of the 55 cases. In the male patients 83% of the adenocarcinoma metastases came from the colon/rectum or pancreas. The corresponding figure for the female patients was 67%, while 20% of the tumours in females originated in the gallbladder and biliary tree. Conclusions: In two thirds of the cases of liver metastases of unknown origin the primary tumour was later discovered. The most prevalent tumours were cancers in the pancreas, lung and colon/rectum. Adenocarcinoma was the tissue diagnosis in 60% of cases.Tilgangur: Um 5% krabbameinssjúklinga greinast með æxli af óþekktum uppruna (3-4% á Íslandi). Af þeim hafa 10-30% meinvörp í lifur. Lifrarmeinvörp af óþekktum uppruna er því ekki sjaldgæft vandamál. Meinafræðingar eru oft beðnir um að skoða sýni frá lifrarmeinvörpum og koma með tillögur um staðsetningu frumæxlis. Í þessari rannsókn eru teknar saman upplýsingar um uppruna og vefjagerð lifrarmeinvarpa af óþekktum uppruna. Efniviður og aðferðir: Leitað var í skrám Rannsóknastofu Háskólans í meinafræði að öllum skráðum grófnálarsýnum frá meinvörpum í lifur frá árunum 1987-1996. Alls fundust sýni frá 176 sjúklingum. Útilokaðir voru 92 sjúklingar sem höfðu þekkt frumæxli eða vísbendingu um upprunastað. Þeir 84 sjúklingar sem eftir voru töldust hafa meinvörp af óþekktum uppruna. Könnuð var niðurstaða vefjagreiningar í gögnum Rannsóknastofunnar. Leitað var í Krabbameinsskrá Krabbameinsfélags Íslands að upplýsingum um endanlega vefjagreiningu og staðsetningu frumæxlis. Niðurstöður: Krabbameinsskrá gaf upplýsingar um staðsetningu frumæxlis hjá 55 sjúklingum af 84 sem greindust með lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin (75%) voru krabbamein í brisi (15), lunga (13) og ristli/endaþarmi (12). Hjá 33 sjúklingum af 55 var vefjagerðin kirtlakrabbamein (adenocarcinoma). Hjá körlum voru 83% kirtlakrabbameinsmeinvarpa upprunnin í ristli eða brisi, en 67% hjá konum, þar sem 20% komu frá gallblöðru/gallvegum. Ályktanir: Í tveimur þriðju tilfella kom upprunastaður að lokum í ljós fyrir lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin voru krabbamein í brisi, lungum og ristli/endaþarmi. Kirtlakrabbamein var vefjagreiningin í 60% tilfella

BRCA2 mutation carriers, reproductive factors and breast cancer risk

BACKGROUND: Germline mutations in the BRCA genes dramatically increase the risk of breast cancer. In the general population, breast cancer risk is affected by age at menarche, by age at first birth, by the number of births and by the duration of breast feeding. Whether this is true for mutation carriers is not clear. METHODS: In a case–control study, nested in a population-based cohort of the Icelandic Cancer Detection Clinic, two groups of cases were defined, matched on year of birth, on age at diagnosis and on age when giving information on reproductive factors: 100 carriers of the Icelandic founder BRCA2 mutation 999del5, and 361 BRCA2-negative cases. The mean age at diagnosis was 48 years. There were 1000 women in a matched group of unaffected controls. Conditional logistic regression was used for the analysis. RESULTS: An increased number of births was associated with a decreased risk of breast cancer in BRCA2-negative cases but not in BRCA2-positive cases. A negative association between risk and duration of breast feeding was observed only in the mutation carriers. These associations were not statistically significant, but the effects of the two variables differed significantly according to mutation status (P = 0.007 and P = 0.045 for interaction with number of births and with duration of breast feeding, respectively). This was maintained when limiting the analysis to women diagnosed older than the age of 40 years. CONCLUSION: The association between breast cancer and the number of pregnancies and between breast cancer and the duration of breast feeding was not the same for carriers and noncarriers of a detrimental BRCA2 mutation. In the context of other epidemiological and laboratory studies, this may indicate that the product of the BRCA2 gene has a function relating to the differentiation of epithelial tissue in the breast

Consumption of Fish Products across the Lifespan and Prostate Cancer Risk

Objective: To examine whether fish and fish oil consumption across the lifespan is associated with a lower risk of prostate cancer. Design: The study was nested among 2268 men aged 67–96 years in the AGES-Reykjavik cohort study. In 2002 to 2006, dietary habits were assessed, for early life, midlife and later life using a validated food frequency questionnaire. Participants were followed for prostate cancer diagnosis and mortality through 2009 via linkage to nationwide cancer- and mortality registers. Adjusting for potential confounders, we used regression models to estimate odds ratios (ORs) and hazard ratios (HRs) for prostate cancer according to fish and fish oil consumption. Results: Among the 2268 men, we ascertained 214 prevalent and 133 incident prostate cancer cases, of which 63 had advanced disease. High fish consumption in early- and midlife was not associated with overall or advanced prostate cancer. High intake of salted or smoked fish was associated with a 2-fold increased risk of advanced prostate cancer both in early life (95% CI: 1.08, 3.62) and in later life (95% CI: 1.04, 5.00). Men consuming fish oil in later life had a lower risk of advanced prostate cancer [HR (95%CI): 0.43 (0.19, 0.95)], no association was found for early life or midlife consumption. Conclusions: Salted or smoked fish may increase risk of advanced prostate cancer, whereas fish oil consumption may be protective against progression of prostate cancer in elderly men. In a setting with very high fish consumption, no association was found between overall fish consumption in early or midlife and prostate cancer risk

Íslenskar rannsóknir á krabbameinum í brjóstum [ritstjórnargrein]

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenÁ síðari helmingi þessarar aldar hafa verið gerðar gróskumiklar rannsóknir í faraldsfræði brjóstakrabbameina á Íslandi. Þetta má að nokkru rekja til aukins skilnings lækna og annarra fræðimanna á mikilvægi faraldsfræðinnar. Áður voru rannsóknir á orsökum sjúkdóma stundaðar í mörgum greinum læknisfræðinnar, en þó kannski mest af meinafræðingum sem í daglegum störfum sínum fengust við leit að orsökum sjúkdóma í einstaklingum. Með tilkomu faraldsfræðinnar hefur áhuginn beinst að orsökum sjúkdóma í hópum fólks. Nokkrar vörður á þessari leið má benda á. Krabbameinsfélögin stofnuðu Krabbameinsskrána árið 1954 og hefur hún verið grundvöllur þessara rannsókna. Leitarstöð krabbameinsfélaganna tók til starfa áratugi síðar, en hún hefur safnað markverðum upplýsingum um ýmsa áhættuþætti brjóstakrabbameina. Af þeim toga eru greinar um áhættuþætti tengda tíðablæðingum kvenna. Í þeim flokki eru allmargar greinar sem voru meðal þeirra fyrstu sem sýndu fram á að aukinn barnafjöldi minnkar líkur á krabbameinum í brjóstum, en áður hafði verið sýnt fram á að hár aldur við upphaf blæðinga væri áhættuþáttur. Nýlega er komin út grein um það umdeilda atriði hvort notkun getnaðarvarnalyfja auki hættu á krabbameinum í brjóstum í litlum vel skilgreindum hópum

Íslenskar rannsóknir á krabbameinum í brjóstum [ritstjórnargrein]

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenÁ síðari helmingi þessarar aldar hafa verið gerðar gróskumiklar rannsóknir í faraldsfræði brjóstakrabbameina á Íslandi. Þetta má að nokkru rekja til aukins skilnings lækna og annarra fræðimanna á mikilvægi faraldsfræðinnar. Áður voru rannsóknir á orsökum sjúkdóma stundaðar í mörgum greinum læknisfræðinnar, en þó kannski mest af meinafræðingum sem í daglegum störfum sínum fengust við leit að orsökum sjúkdóma í einstaklingum. Með tilkomu faraldsfræðinnar hefur áhuginn beinst að orsökum sjúkdóma í hópum fólks. Nokkrar vörður á þessari leið má benda á. Krabbameinsfélögin stofnuðu Krabbameinsskrána árið 1954 og hefur hún verið grundvöllur þessara rannsókna. Leitarstöð krabbameinsfélaganna tók til starfa áratugi síðar, en hún hefur safnað markverðum upplýsingum um ýmsa áhættuþætti brjóstakrabbameina. Af þeim toga eru greinar um áhættuþætti tengda tíðablæðingum kvenna. Í þeim flokki eru allmargar greinar sem voru meðal þeirra fyrstu sem sýndu fram á að aukinn barnafjöldi minnkar líkur á krabbameinum í brjóstum, en áður hafði verið sýnt fram á að hár aldur við upphaf blæðinga væri áhættuþáttur. Nýlega er komin út grein um það umdeilda atriði hvort notkun getnaðarvarnalyfja auki hættu á krabbameinum í brjóstum í litlum vel skilgreindum hópum

Nýgengi krabbameina og dánartíðni krabbameinssjúklinga á Íslandi síðustu 35 árin

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe objective was to investigate the changes in incidence and mortality from malignant diseases over the period from 1955 to 1989 in Iceland. The results are presented as number of cases and incidence rates in five age groups and seven time periods, males and females. The same is presented for mortality. There was an increase in incidence rates in all age groups except the youngest (0-19 years). Overall there was a decrease in mortality rate, ten per cent for females and five per cent for males. In the youngest age group this decrease in mortality was more than fifty per cent for both sexes.Í þessari grein er lýst breytingum á nýgengihlutfalli og dánartíðni illkynja sjúkdóma á Íslandi 1955-1989. Niðurstöðurnar eru sýndar sem nýgengihlutfall í fimm aldurshópum og sjö fimm ára tímabilum fyrir karla og konur. Sömu upplýsingar eru um dánartíðni. Nýgengihlutfall hækkaði í öllum aldurshópum nema þeim yngstu (10-19 ára). Dánartíðni lækkaði um 10% hjá konum og um 5% hjá körlum. í yngsta aldurshópnum var lækkun á dánartíðni meira en 50% hjá báðum kynjum

Nýgengi krabbameina og dánartíðni krabbameinssjúklinga á Íslandi síðustu 35 árin

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe objective was to investigate the changes in incidence and mortality from malignant diseases over the period from 1955 to 1989 in Iceland. The results are presented as number of cases and incidence rates in five age groups and seven time periods, males and females. The same is presented for mortality. There was an increase in incidence rates in all age groups except the youngest (0-19 years). Overall there was a decrease in mortality rate, ten per cent for females and five per cent for males. In the youngest age group this decrease in mortality was more than fifty per cent for both sexes.Í þessari grein er lýst breytingum á nýgengihlutfalli og dánartíðni illkynja sjúkdóma á Íslandi 1955-1989. Niðurstöðurnar eru sýndar sem nýgengihlutfall í fimm aldurshópum og sjö fimm ára tímabilum fyrir karla og konur. Sömu upplýsingar eru um dánartíðni. Nýgengihlutfall hækkaði í öllum aldurshópum nema þeim yngstu (10-19 ára). Dánartíðni lækkaði um 10% hjá konum og um 5% hjá körlum. í yngsta aldurshópnum var lækkun á dánartíðni meira en 50% hjá báðum kynjum