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Reproductive factors and risk for breast cancer in Iceland.

A previous publication has shown that there has been a great increase in the incidence of breast cancer in Iceland. The present study was undertaken to evaluate the importance of known risk factors connected with the reroductive history of the women. In a prospective investigation of a cohort of 31,453 women we confirmed previous findings of the increased risk following higher age at first pregnancy and for nulliparous women. The age at first pregnancy and the proportion of nulliparous women have decreased with time in the Icelandic population so that these factors should have tended to decrease the risk, making the found increase still more important. The effect of parity is that the risk decreases with larger number of children and this effect is independent of the effect of age at first pregnancy. Lower age at menarche increases the breast cancer risk, but the contribution of that factor to the overall risk is negligible.

Adult↗

Familial and sporadic breast cancer cases in Iceland: a comparison related to ABO blood groups and risk of bilateral breast cancer.

This study was aimed at determining whether the familial clustering often observed in breast cancer is associated with genetic factors. We compared familial and sporadic breast cancer cases with respect to ABO blood group distribution and the risk of bilateral disease, using the data from the Icelandic Cancer Registry which contains genealogical information for about 30% of the breast cancer cases diagnosed in Iceland since 1911. Cases were classified as familial if at least one first-degree relative had breast cancer. Using this criterion, we identified 184 familial cases and 572 sporadic cases. The familial cases had a 2-fold higher prevalence of blood group B than did the sporadic cases, and the frequency of this blood group in non-affected relatives of cases was significantly reduced. Familial cases were about 2.7 times more likely to suffer from bilateral breast cancer than were the sporadic patients. These results support the presence of a genetic factor in the etiology of familial breast cancer.

ABO Blood-Group System↗

Refinement of the X-linked cleft palate and ankyloglossia (CPX) localisation by genetic mapping in an Icelandic kindred.

The gene responsible for X-linked cleft palate and ankyloglossia (CPX) has previously been localized to the proximal region of the q arm of the X chromosome in both Icelandic and North American Indian kindreds. In this study, further linkage analysis has been performed on the Icelandic family and has resulted in a significant reduction in the size of the interval containing the mutated gene. A new polymorphism at DXS95, together with DXS1002 and DXS349, defines the proximal boundary of the CPX interval, whereas DXYS1X defines the distal boundary. Multipoint analysis supports this localisation with a peak lod score of 12.7, more than 2 lod score units higher than the next most likely position. In order to assess the physical size of the CPX interval prior to initiating yeast artificial chromosome cloning, metaphase fluorescence in situ hybridisation analysis was performed with the closest flanking markers. The size of the interval between DXS95 and DXYS1X was estimated to be approximately 2-3 Mb.

Chromosome Mapping↗

Techniques for estimating genetic admixture and applications to the problem of the origin of the Icelanders and the Ashkenazi Jews.

A method is introduced for simultaneously using multiple loci to estimate admixture and test goodness of fit of the model of admixture. Deviation of observed frequencies from expectation caused by sources of error such as sampling and/or drift is allowed for all loci in all populations. This allows investigation of the effects of different assumptions about sources of error on the estimates. Admixture is then investigated for Icelanders and Ashkenazi Jews. Results indicate that the Icelanders have a large Norse contribution, and that the Jews may have a small to moderate contribution from the European gene pool. There are some indications that AB0 and G6PD give abnormal estimates of admixture compared to other loci, and that the Jewish gene pool may be derived from additional populations in addition to the populations considered.

ABO Blood-Group System↗

Incidence and prevalence of type 1 (insulin-dependent) diabetes mellitus in Icelandic children 1970-1989.

Through use of primary and secondary data sources for registration and validation, the incidence and prevalence of Type 1 (insulin-dependent) diabetes mellitus in children aged 0-14 years in Iceland has been completely ascertained for the years 1970-1989. The age-adjusted mean annual incidence per 100,000 for the 20-year period was 9.4 (95% confidence interval 7.8-11.3); similar for boys (9.9; 7.7-12.7) and girls (8.8; 6.7-11.5). Between 1970-1979 the incidence was 8.0 (6.0-10.6) and between 1980-1989 it was comparable at 10.8 (8.4-13.8) (p greater than 0.10). By Poisson regression analysis the variation in incidence was related to age at diagnosis (p less than 0.001), while a linear trend for calendar year at diagnosis did not reach statistical significance (p = 0.07). A quadratic curve, however, better described the temporal variation in incidence (p less than 0.05). The total prevalence per 1,000 by the end of 1979 and 1989 was similar, 0.45 (0.30-0.65) and 0.57 (0.40-0.79), respectively. In conclusion, this study confirms that both the incidence and prevalence of childhood Type 1 diabetes in Iceland are low compared to the other Nordic countries. The findings may suggest a causative role for environmental factors that are not related to latitude or ambient temperature.

Adolescent↗

Extremely thermophilic cellulolytic anaerobes from Icelandic hot springs.

Anaerobic enrichment cultures with Avicel as substrate and inoculated with biomat samples from Icelandic hot springs were cultured at 70 degrees C or 78 degrees C and examined for the presence of microorganisms that produce extracellular cellulolytic and xylanolytic enzymes. From four enrichments grown at 78 degrees C eighteen strains were isolated. Five of the strains were screened for their substrate utilization, and on the basis of differences in morphology and substrates used, the two most unique strains were selected for further characterization. All cellulolytic cultures were rod-shaped and non-sporeforming. Motility was not observed. Cells stained gram-negative at various stages of the growth phase. During growth on Avicel, most cultures produced acetate as the major fermentation product, with smaller amounts of lactic acid and ethanol. Carbon dioxide and hydrogen were also produced. The phenotypic characteristics of the enrichment cultures and of isolates are described and assessed in relation to temperature and pH in the hot spring environment. A comparison is made between Icelandic strains isolated in our laboratory and strains isolated from hot springs from other parts of the world. The biotechnological potential of this group of bacteria is briefly discussed.

Acetates↗

Analysis of HPC1, HPCX, and PCaP in Icelandic hereditary prostate cancer.

Putative prostate cancer susceptibility loci have recently been identified by genetic linkage analysis on chromosomes 1q24-25 (HPC1). 1q44.243 (PCaP), and Xq27-28 (HPCX). In order to estimate the genetic linkage in Icelandic prostate cancer families, we genotyped 241 samples from 87 families with eleven markers in the HPC1 region, six markers at PCaP, and eight at HPCX. Concurrently, we assessed allelic imbalance at the HPC1 and PCaP loci in selected tumors from the patients. For each of the candidate regions, the combined parametric and non-parametric LOD scores were strongly negative. Evidence for linkage allowing for genetic heterogeneity was also insignificant for all the regions. The results were negative irrespective of whether calculations were performed for the whole material or for a selected set of early age at onset families. The prevalence of allelic imbalance was relatively low in both the HPC1 (0%-9%) and PCaP (5%-20%) regions and was not elevated in tumors from positively linked families. Our studies indicate that the putative cancer susceptibility genes at chromosomes 1q24-25, 1q44.2-43, and Xq27-28 are unlikely to contribute significantly to hereditary prostate cancer in Iceland and that selective loss of the HPC1 and PCaP loci is a relatively rare somatic event in prostate cancers.

Alleles↗

High incidence of kidney stones in Icelandic children.

All children less than 18 years of age who were diagnosed with a first episode of kidney stones at pediatric referral centers in Iceland during the years 1995-2000 were studied retrospectively. The diagnosis was based on clinical features and results of imaging studies. Patients were invited for evaluation at the end of the study period. Twenty-six patients (15 females, 11 males), median age 9.4 (range 0.2-14.9) years, experienced 34 episodes of kidney stones. The annual incidence was 5.6 and 6.3 per 100,000 children less than 18 and 16 years of age, respectively. Abdominal pain was the most common symptom (N=17; 69%) and urinalysis revealed hematuria in 21 patients (80.8%), sterile pyuria in 17 (65%), and 2,8-dihydroxyadeninuria in two. Six patients (23%) had positive urine cultures at the time of diagnosis and five (20%) had urinary tract anomalies. Family history of kidney stones was positive in one third of patients. Metabolic risk factors for stone formation were identified in 22 of 23 patients (96%) who underwent evaluation. Hypercalciuria, the most common metabolic risk factor, was identified in 18 patients (78%). Stones passed spontaneously in nine patients (35%) and six patients had recurrent stone episodes. The incidence of kidney stones in Icelandic children is high compared with other Western populations, affecting females more than males. Underlying metabolic risk factors were identified in most patients.

Abdominal Pain↗

Search for healthy carriers of scrapie: an assessment of subclinical infection of sheep in an Icelandic scrapie flock by three diagnostic methods and correlation with PrP genotypes.

Subclinical infection in scrapie of sheep, characterized by a long incubation period, may be of importance for the spread of the disease. We screened brain samples from all 65 sheep in a scrapie-affected flock for subclinical infection and correlated with results of PrP genotyping, which is of relevance for the epidemiology and the question, whether by breeding for resistant genotypes one would be breeding for healthy carriers. The sensitivity of three methods was compared, i.e. histopathological examination for vacuoles (HP), immunohistochemical staining (IHC) and Western blotting (WB) for PrP(Sc). Five sheep showed definite clinical signs and histological scrapie lesions, and signs of infection were detected in 25 of 60 asymptomatic sheep, by HP and/or IHC and WB. The IHC was slightly more sensitive than HP and WB. Sheep with subclinical infection were, with one exception, either homo- or heterozygotes for 136-V, as were four of the five sheep with clinical scrapie. The incidence of the VRQ allelic variant in the flock was unusually high compared to the Icelandic sheep population probably contributing to the high prevalence of both clinical and subclinical infection in the flock. Neither sheep with definite scrapie nor detectable subclinical infection, were of the resistant AHQ genotype, indicating that Icelandic AHQ sheep are not healthy carriers of scrapie infection.

Age Factors↗

Prevalence estimates of gambling participation and problem gambling among 16-18-year-old students in Iceland: a comparison of the SOGS-RA and DSM-IV-MR-J.

The aim of this study was to estimate gambling participation and problem gambling among Icelandic adolescents. Participants were 750 16-18-year-old students, 371 girls and 379 boys. The rate of problem gambling was estimated with the SOGS-RA and DSM-IV-MR-J. Results indicated that 96% of adolescents had gambled in their lifetime, 79% at least once in the preceding year and about 10% gamble at least once a week. A psychometric evaluation of the two screening scales revealed satisfactory reliabilities and factor structures for both scales. The DSM-IV-MR-J identified 2% of the participants as problem gamblers while SOGS-RA identified 2.7%, and problem gambling was more common among boys than girls. It was concluded that problem gambling among adolescents is an area of concern for the Icelandic community that needs to be further investigated.

Adolescent↗

Carcinoma of the lung in Iceland: 1931-1974.

During the period 1931-1974, 464 cases of primary lung cancer were diagnosed in Iceland. Only 34 cases were recorded from 1931-1954, but during the next two decades 156 cases and 274 cases were reported, a total of 430 cases which are analyzed in this paper. There is a preponderance of small cell anaplastic carcinoma 33.4% in this series. Epidermoid or squamous cell carcinoma was found in only 24.7% of cases and large cell anaplastic carcinoma in 15.4%. During the period 1955-1974, 143 major surgical procedures were performed for lung cancer in this country, 68 exploratory thoracotomies and 75 resections. Of the resections 58.7% were pneumonectomies. There were 3 surgical deaths in the resected series, for a mortality of 4%. Pneumonectomy carried a mortality of 6.8%, but lobectomies or segmental resections carried no mortality. In the resected series the absolute 5-year survival rate is 29.3%. Patients with epidermoid lesions have the most favorable prognosis. There is a definite correlation between tobacco consumption or cigarette smoking in Iceland and the rising incidence of lung carcinoma.

Adenocarcinoma↗

Organochlorine residues in two seal species from western Iceland.

Harbour seals and grey seals from Faxaflói (Western Iceland) were analyzed for contamination with organochlorines (HCB, PCBs, p,p'-DDT,p,p'-DDE, chlordanes and the enantiomers of alpha-HCH). Although the values strongly varied, both harbour seals and grey seals on averaged showed comparable levels of PCBs, p,p'-DDT, p,p'-DDE and alpha-HCH, as well as chlordanes (sigma CD). Differences were measured in the HCB content of the seal species. The HCB/alpha-HCH ratio in harbour seals was < 1 and in grey seals > 1. The results from seals on Iceland were compared with data derived from seal samples of the Antarctic, the Arctic (Spitzbergen) and the North Sea (Germany) in order to give an insight into the global distribution of pollution with chlorinated organics.

Animals↗

Molecular epidemiology of adenoviruses isolated in Iceland during 1988-1990.

All human adenoviruses isolated in Iceland during 1988-1990 have been subjected to restriction endonuclease analysis. Of 55 isolates altogether, subgenus C (Ad1, Ad2, and Ad5) predominated with 42 isolates followed by subgenus B (Ad3 and Ad7) with 12. Analysis of the 9 Ad1 isolates revealed 6 DNA-variants. Among these the established DNA-variants D4, D7, and D10 were recognized. The remaining 3 DNA-variants were primarily found in Iceland. Among the 22 Ad2 isolates, 7 DNA-variants could be distinguished. D2 predominated with 15 isolates whereas the prototype was isolated only once. The novel 5 DNA-variants of Ad2 were all closely related to D2. Analysis of the 11 Ad5 isolates revealed 6 DNA-variants, 2 of which (D2 and D5) were already established. Ice2 and D3 were the most common occurring DNA-variants of Ad5. Ad5 showed the highest degree of genomic variability within subgenus C, both in terms of the low degree of pair-wise comigration of restriction fragments and the number of principal variants of RE-patterns. Analysis of the 9 Ad3 isolates revealed 3 DNA-variants: D3, D10, and Ice1 (a novel DNA-variant that resembles D10). The DNA-variants D3 and D10 were each represented by 4 isolates. The three Ad7 isolates belonged all to the DNA-variant D5.

Adenovirus Infections, Human↗

Comparison between the Icelandic and Dutch forms of hereditary cerebral amyloid angiopathy.

Hereditary cerebral amyloid angiopathy has been described in Icelandic and Dutch families. Although the clinical manifestations show similarities, biochemical characterization revealed that amyloid in the Icelandic patients consists of cystatin C and in the Dutch patients of beta-protein. Both diseases are caused by a single base mutation leading to the same amino acid (viz. glutamine). Furthermore, both cystatin C and the beta-protein precursor are protease inhibitors. Therefore, the mechanism of amyloidogenesis may be similar in both diseases. A comparison of clinical, pathological, genetic, and biochemical aspects of these two types of hereditary cerebral amyloid angiopathy is presented.

Amyloid beta-Protein Precursor↗

Prevalence of iron deficiency and iron overload in the adult Icelandic population.

The aim of this cross-sectional study was to estimate the prevalence of iron deficiency and overload in the adult population in Iceland, a developed Scandinavian country. The study population consisted of 4240 individuals aged 25-74 years randomly selected from the national roster. Basic hematological, S-iron, S-total iron binding capacity (TIBC), and S-ferritin measurements were obtained on 2588 individuals (61.0%). The results indicated unusually large iron stores in the adult Icelandic population and significantly larger iron stores in the rural compared to the urban population. Iron deficiency was rare except in urban premenopausal women, where 1 in 4 showed evidence of iron deficiency and 3.2% had iron deficiency anemia. Seven patients with hereditary hemochromatosis were identified from a subgroup of 1887 subjects, resulting in a prevalence of 0.37%. Two of the hereditary hemochromatosis patients had been gastrectomized. Measures to improve the iron balance in urban premenopausal women cannot therefore include increased iron fortification of food but must be more directed towards the target group.

Adult↗

Patient-related barriers to pain management: the Icelandic Barriers Questionnaire II.

The Barriers Questionnaire-II (BQ-II) is used to evaluate eight attitudinal barriers to cancer pain management. The purpose of this study was to evaluate the psychometric properties of the Icelandic BQ-II (IBQ-II). Icelandic adults (n=244) completed the IBQ-II, the Brief-Pain-Inventory, and demographic questions. Half the responders were male (52%), and 42.8% had pain on the day of data collection. Participants had a mean (SD) age of 34.73 (11.78) years and education of 15.08 (3.69) years. Factor analysis of the IBQ-II supported three factors. The alpha was 0.90. The mean (SD) IBQ-II total score was 2.32 (0.78), on a scale of 0 to 5, with higher scores indicating stronger barriers. IBQ-II total scores were inversely related to education (r=-0.21; P<0.01), and positively related to least pain (r=0.24; P<0.05), average pain (r=0.23; P<0.05), and pain interference with life activities (r=0.22; P<0.05) for those who had pain. There is support for reliability, validity, and feasibility of the IBQ-II.

Adult↗

The effect of pollution on scope for growth of the mussel (Mytilus edulis L.) in Iceland.

In order to evaluate effects of contaminants at high latitudes, the effects on scope for growth (SFG) were evaluated for both transplanted and resident blue mussel (Mytilus edulis L.) near large and small harbours in Iceland. Low SFG values were found for mussels at the mouth and in the inner part of the large Reykjavík harbour, which could be attributed to elevated levels of organotins and polyaromatic hydrocarbons. Mussels in smaller and/or less polluted harbours and sites off Reykjavík harbour only showed a slight reduction in SFG. No major effects were found at sites >3 km from the large harbour of Reykjavík. SFG provides valuable information on the effects of harbour pollutants in Iceland, in particular in areas of extensive shipping activity. The use of this biomarker on high latitude organisms is highly relevant due to extended oil exploration at higher latitudes.

Animals↗

Risk factors for malignant melanoma in an Icelandic population sample.

OBJECTIVES: To describe the constitutional risk factors for malignant melanoma and exposure to sunlight in a population sample in Iceland. METHODS: Information on various risk factors for malignant melanoma was collected through mailed questionnaires sent to a random sample of the Icelandic population. The information collected was the first phase of a prospective study on malignant melanoma among aircrew members as compared to a population sample. RESULTS: The overall participation rate was about 50%. Seven percent of women and six percent of men had red hair color. Blue or green eye color was reported among 89% of women and 87% of men. Sixteen percent of women aged 20 to 39 had used sun beds more than 100 times during their lifetime, while the corresponding figure was 12% for men of the same age. Younger age groups had more sunny vacations than the older age groups. The frequency of sunburn differed in the groups with reported different skin types according to Fitzpatrick classification. CONCLUSION: The high prevalence of sun bed usage among young women is concurrent with the increased incidence of malignant melanoma among young women registered in the nationwide cancer registry. Young people have more often used sun beds and taken sunny vacation than the older, indicating a changed behavior in the population.

Adult↗