PubMed Health⌕ Search

Biomedical subjects

H Tulinius

Publications and source records attributed to H Tulinius.

At least 37 records · Page 2Linked to original sources
PubMed2000

Serum thyroglobulin as a risk factor for thyroid carcinoma.

Samples from a biological serum bank taken up to 23 years prior to diagnosis of thyroid carcinoma were analysed for human thyroglobulin, thyroid-stimulating hormone and thyroxin. After exclusions, the final study material consisted of 59 cases of papillary and follicular carcinomas. These cases were compared with 164 controls, matched for sex, age and time of sample taking. The most interesting finding was that concentrations of thyroglobulin in serum were abnormally elevated in cases compared with controls, equal to or above 30 microg/L, with odds ratio 7.0 (CI 3.1-15.7). This elevation of serum thyroglobulin occurred in 44% of the carcinoma cases. Sensitivity was around 50 for measurements taken up to 15 years prior to diagnosis, but 21 when the interval was over 15 years. Specificity was 89. No differences were found between cases and controls in values for thyroid-stimulating hormone and thyroxin.

Adenocarcinoma, Follicular↗
PubMed2000

Incidence of cancer among commercial airline pilots.

OBJECTIVES: To describe the cancer pattern in a cohort of commercial pilots by follow up through the Icelandic Cancer Registry. METHODS: This is a retrospective cohort study of 458 pilots with emphasis on subcohort working for an airline operating on international routes. A computerised file of the cohort was record linked to the Cancer Registry by making use of personal identification numbers. Expected numbers of cancer cases were calculated on the basis of number of person-years and incidences of cancer at specific sites for men provided by the Cancer Registry. Numbers of separate analyses were made according to different exposure variables. RESULTS: The standardised incidence ratio (SIR) for all cancers was 0.97 (95% confidence interval (95% CI) 0.62 to 1.46) in the total cohort and 1.16 (95% CI 0.70 to 1.81) among those operating on international routes. The SIR for malignant melanoma of the skin was 10.20, 95% CI 3.29 to 23.81 in the total cohort and 15.63, 95% CI 5.04 to 36.46 in the restricted cohort. Analyses according to number of block-hours and radiation dose showed that malignant melanomas were found in the subgroups with highest exposure estimates, the SIRs were 13.04 and 28.57 respectively. The SIR was 25.00 for malignant melanoma among those who had been flying over five time zones. CONCLUSIONS: The study shows a high occurrence of malignant melanoma among pilots. It is open to discussion what role exposure of cosmic radiation, numbers of block-hours flown, or lifestyle factors--such as possible excessive sunbathing--play in the aetiology of cancer among pilots. This calls for further and more powerful studies. The excess of malignant melanoma among those flying over five time zones suggests that the importance of disturbance of the circadian rhythm should be taken into consideration in future studies.

Aerospace Medicine↗
PubMed2000

[Liver metastases of unknown origin.].

OBJECTIVE: Approximately 5% of cancer patients are diagnosed with tumour of unknown origin (3-4% in Iceland). Of those 10-30% have liver metastases. 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.

English Abstract↗
PubMed1999

Breast cancer incidence and familiality in Iceland during 75 years from 1921 to 1995.

Information in the Icelandic Cancer Registry on breast cancer and its collection of breast cancer families has been used to elucidate changes in breast cancer incidence by time period and by age, and the effect of degree of relationship and age on the familial risk of breast cancer. Since 1921 the incidence rates have increased, but the increase is significantly greater (2.06% per year) for ages over 44 years than for ages 20-44 (1.20% per year). It has been shown before that when familial risk is computed, the age of the proband influences the risk for the relatives. However, this study shows that the age of the relative is also important and with increasing age the familial risk decreases.

Age Factors↗
PubMed1998

Population-based study of risk of breast cancer in carriers of BRCA2 mutation.

BACKGROUND: Estimates of an 80-90% risk of breast cancer for carriers of germline mutations in the BRCA1 and BRCA2 genes are based on studies of families at high risk of breast cancer. Risk estimates for a population are possible if the mutation status of a representative sample of that population can be assessed. In Iceland, one common founder BRCA2 mutation occurs in 0.6% of the population. Iceland has a population-based cancer registry and a large collection of pedigrees, and estimation of cancer risk in mutation carriers is therefore possible. METHODS: We studied 575 breast-cancer patients, 541 women and 34 men unselected for family history of breast cancer. Data on cancer in first-degree relatives were available from the cancer registry. Risk of cancer was estimated by comparing the history of cancer in first-degree relatives of carriers and non-carriers. FINDINGS: 56 (10.4%) of the 541 women and 13 (38%) of the 34 men carried the 999del5 mutation. The estimated risk of breast cancer at age 50 for all female carriers of the 999del5 mutation was 17.0% (95% CI 9.1-25.9) and 37.2% (22.4-53.9) at age 70. INTERPRETATION: The results of our population-based study show that the mean risk of breast cancer in carriers of mutation in BRCA2 is lower than previously suggested. Individual risk assessment will, however, have to take account of family history.

Aged↗
PubMed1998

Risk of cancer among offspring of childhood-cancer survivors. Association of the Nordic Cancer Registries and the Nordic Society of Paediatric Haematology and Oncology.

BACKGROUND: Increasing numbers of children with cancer survive and reach reproductive age. However, the risk of cancer (other than retinoblastoma) in the offspring of survivors of childhood and adolescent cancer is uncertain. METHODS: Using data from national cancer and birth registries, we assessed the risk of cancer among 5847 offspring of 14,652 survivors of cancer in childhood or adolescence diagnosed since the 1940s and 1950s in Denmark, Finland, Iceland, Norway, and Sweden. The offspring were followed up for a diagnosis of cancer for 86,780 person-years, and standardized incidence ratios were calculated. RESULTS: Among the 5847 offspring, 44 malignant neoplasms were diagnosed (standardized incidence ratio, 2.6; 95 percent confidence interval, 1.9 to 3.5). There were 17 retinoblastomas, yielding a standardized incidence ratio of 37. There were 27 neoplasms other than retinoblastoma (standardized incidence ratio, 1.6; 95 percent confidence interval, 1.1 to 2.4). The second most common primary site of cancer among the offspring was the brain and nervous system, in which eight tumors were observed (standardized incidence ratio, 2.0; 95 percent confidence interval, 0.9 to 3.9.) There were between zero and four apparently sporadic cases of cancer in other primary sites among the offspring. Excluding 4 likely cases of hereditary cancer and 2 subsequent cancers among the offspring with hereditary retinoblastoma, there were 22 sporadic cancers, for a standardized incidence ratio of 1.3 (95 percent confidence interval, 0.8 to 2.0). CONCLUSIONS: There is no evidence of a significantly increased risk of nonhereditary cancer among the offspring of survivors of cancer in childhood.

Adolescent↗
PubMed1998

High incidence of classical Kaposi's sarcoma in Iceland and the Faroe Islands.

We have examined the incidence of non-AIDS-related Kaposi's sarcoma in Iceland (1955-79) and the Faroe Islands (1974-95). In Iceland, 19 cases, nine in men and ten in women, were identified, and in the Faroe Islands four cases in men and three cases in women were found. This corresponded to surprisingly high incidence rates. In men, world standardized rates (per 100000 person-years) were 0.4 and 0.6 in Iceland and the Faroe Islands, respectively, and for women, the figures were 0.3 (Iceland) and 0.5 (the Faroe Islands). These are among the highest rates ever reported. No explanation for the high rates of Kaposi's sarcoma in these two North Atlantic communities could be identified.

Aged↗
PubMed1998

Relative survival of cancer patients--a comparison between Denmark and the other Nordic countries.

The results of a Nordic collaborative project revealed that Danish cancer patients had a poorer prognosis than patients in the other Nordic countries for some major cancer sites. The present study was undertaken to further explore the differences in survival between Denmark and the other Nordic countries. All cancer cases diagnosed in the Nordic countries during 1958 to 1991/92 were included in the analysis. Relative survival and excess mortality were calculated for intervals in the first five years after diagnosis. Since the 1950s, the prognosis of cancer patients has improved in all the countries, but more moderately in Denmark. For cancers of the stomach, colon, rectum, breast (female), and prostate, the Danish patients had a markedly lower relative survival than the patients in the other countries. They also had the lowest proportion of localized tumours. It appears that Danish cancer patients are diagnosed at a later stage of disease than patients in the other Nordic countries.

Adolescent↗
PubMed1997

Risk of second cancers in classical Kaposi's sarcoma.

An association between Kaposi's sarcoma (KS) and malignant lymphoma has been suspected for many years. Both cancers belong to the group of malignancies associated with immune suppression and have been known to occur in the same individual. Accordingly, a common etiology has been suspected. Through linkage within the Nordic cancer registries, we studied the occurrence of cancers in a population-based cohort of 741 patients with classical KS. The relative risk of subsequent malignancies was expressed as the ratio of the observed numbers of cancer to the numbers expected based on age-, sex-, period- and country-specific incidence rates, i.e., the standardized incidence ratio (SIR). A total of 104 cancers was observed during 5,802 person-years of follow-up, which was close to the expected 98.8 cases (SIR, 1.05). During the first year of follow-up, 3 lymphomas were observed, which is in significant excess of the 0.2 lymphomas expected (SIR, 13.0). In contrast, no lymphomas occurred in the period beyond the first year of follow-up vs. 2.3 expected. Cancers of the buccal cavity and pharynx (SIR, 10.6; n = 4) and of the colon (SIR, 2.7; n = 7) occurred in excess among women but not among men. Accordingly, our results indicate that patients with classical KS are not at increased risk of cancer in general. In particular, the overall risk of lymphomas was not significantly increased. The high relative risk of malignant lymphoma immediately after KS was based on a limited number of cases, and this observation is unlikely to indicate a common etiology.

Age Factors↗
PubMed1997

Oral contraceptive use at a young age and the risk of breast cancer: an Icelandic, population-based cohort study of the effect of birth year.

The possible association between breast cancer and oral contraceptive use before the age of 20 was investigated using Icelandic population-based information from women born after 1944. The design was a nested case-control study within a cohort, using data on duration of oral contraceptive use at young ages. The availability of oral contraceptives before the age of 20 has changed dramatically and is highly dependent on birth years, with 20% and 82% starting before the age of 20 among Icelandic users born in 1945-47 and 1963-67 respectively. The association between total duration of oral contraceptive use and breast cancer was significantly dependent on year of birth. In women born in 1951-67 (based on 81 cases), the relative risk (RR) associated with use for more than 4 years was 2.0 (95% CI 1.1-3.7). The association disappeared when women born in 1945-50 were included (RR 1.1,95% CI 0.8-1.6), adding 123 cases. A significant trend of increased risk with longer duration was present only in the group born after 1950, with RR 0.9, 1.7 and 3.0 for < or = 4 years, >4-8 years and > 8 years of use respectively. The results of this study indicate an association between breast cancer and oral contraceptive use at a young age. They also stress the importance of distinguishing between groups with different opportunities for exposure at young age.

Adolescent↗
PubMed1997

Familial transitional cell carcinoma among the population of Iceland.

PURPOSE: Several case reports have described familial aggregation of transitional cell carcinoma of the urinary tract but to our knowledge only 1 epidemiological study specifically addressed the issue of familial bladder cancer. We evaluated the extent of familial aggregation of transitional cell carcinoma among the population of Iceland. MATERIALS AND METHODS: The first to third degree relatives of 190 patients with bladder, ureter or renal pelvis transitional cell carcinoma diagnosed between 1983 and 1992 in Iceland were identified through the Icelandic Cancer Family Resource. The records of these 12,328 relatives were subsequently linked to the 1965 to 1994 cancer registry. The observed occurrence of transitional cell carcinoma of the urinary tract was compared to the expected occurrence based on age, gender and calendar specific incidence rates. Observed-to-expected ratios and 95% confidence intervals were calculated. RESULTS: In 41 of the 190 pedigrees at least 1 relative had transitional cell carcinoma of the urinary tract. Of the probands 38 had only 1 and 3 had 2 affected relatives. The prevalence of family history of transitional cell carcinoma was 3% in first degree and 10% in first or second degree relatives. The risk of transitional cell carcinoma among all relatives was slightly elevated (observed-to-expected ratio 1.24, 95% confidence interval 0.90 to 1.67). The observed-to-expected ratio was greater among second and third degree relatives than among first degree relatives. CONCLUSIONS: The risk of transitional cell carcinoma among relatives of patients is somewhat increased. However, the greater risk for more distant relatives argues against the existence of a hereditary subtype of bladder transitional cell carcinoma, at least in the founder population of Iceland.

Adult↗
PubMed1997

Study of a single BRCA2 mutation with high carrier frequency in a small population.

Germ-line changes in the cancer-predisposition gene BRCA2 are found in a small proportion of breast cancers. Mutations in the BRCA2 gene have been studied mainly in families with high risk of breast cancer in females, and male breast cancer also has been associated with BRCA2 mutations. The importance of germ-line BRCA2 mutations in individuals without a family history of breast cancer is unknown. The same BRCA2 mutation has been found in 16/21 Icelandic breast cancer families, indicating a founder effect. We determined the frequency of this mutation, 999del5, in 1,182 Icelanders, comprising 520 randomly selected individuals from the population and a series of 632 female breast cancer patients (61.4% of patients diagnosed during the study period) and all male breast cancer patients diagnosed during the past 40 years. We detected the 999del5 germ-line mutation in 0.6% of the population, in 7.7% of female breast cancer patients, and in 40% of males with breast cancer. The mutation was strongly associated with onset of female breast cancer at age <50 years, but its penetrance and expression are varied. A number of cancers other than breast cancer were found to be increased in relatives of mutation carriers, including those with prostate and pancreatic cancer. Furthermore, germ-line BRCA2 mutation can be present without a strong family history of breast cancer. Comparison of the age at onset for mother/daughter pairs with the 999del5 mutation and breast cancer indicates that age at onset is decreasing in the younger generation. Increase in breast cancer incidence and lower age at onset suggest a possible contributing environmental factor.

Adult↗
PubMed1997

Risk factors for malignant diseases: a cohort study on a population of 22,946 Icelanders.

The records of a cohort of 11,580 females and 11,366 males participating in an Icelandic cardiovascular risk factor study were linked with the Icelandic Cancer Registry, identifying 1,785 males and 1,490 females who had been registered with neoplastic diseases from 1968 to 1995. The interval between the time of measurement of the variables and the diagnosis of the malignancy ranged from 4 to 27 years. The variables consisted of answers from a questionnaire on smoking and the use of hypertensive drugs and anthropometric and biochemical measurements. Cox's regression was applied to analyze the predictive power of the variables on the risk of cancer after the first examination at the Heart Preventive Clinic, Reykjavík. Univariate analyses, adjusted for age, were performed for each variable and each major site. Within each major site, multivariate regression analysis was applied for variables that were found significantly (10% level in univariate analysis) positive or negative as risk factors. The results show that smoking is the most important risk factor, negative only for endometrium. For lung cancer, the risk is twice as strong for females as it is for males, whereas for pancreas, males have a relative risk ratio of 4.5, compared with 2.4 for females. Height is a risk factor for all sites for each sex, for breast in females, and for kidney in males. Several anthropometric risk factors were studied. Some of these can describe positive or negative relative risk ratios for cancer, and their use may shed light on cancer pathogenesis. Serum cholesterol is a negative risk factor for breast cancer in females, but triglycerides are a positive risk factor for cervix cancer in females and for colon or rectum and thyroid cancer in males. Serum glucose is a positive risk factor for prostate cancer and a negative risk factor for lymphomas and leukemias.

Adolescent↗
PubMed1996

Male breast cancer in Iceland.

All malignant tumours of the male breast diagnosed in Iceland during the 40-year period 1955-1994 were studied with regard to histological classification, tumour grading and flow cytometric analysis. Of 31 malignant tumours diagnosed, 29 were primary breast carcinomas. Male breast carcinoma constitutes 1% of all breast malignancies in Iceland and 0.25% of all malignant tumours in males. About 80% of the male breast carcinomas were diagnosed during the latter half of the study period. The mean age of the patients was 66.3 years and the left-to-right ratio was 1.9:1.0. Right-sided tumours appeared to be more aggressive. The mean tumour size was 2.6 cm. The vast majority of the carcinomas (79%) were of the infiltrating ductal type. Of these 21.7% were grade I, 43.5% were grade II and 34.8% grade III. Papillary carcinomas made up 17% of the total. These occurred in slightly older patients than the infiltrating ductal carcinomas and were diploid tumours. In this study 57% of the tumours were found to be aneuploid, but nearly 70% of the invasive ductal carcinomas NOS were aneuploid. In general, the aneuploid tumours were larger, of higher average histological grade and had a higher mean S-phase value. The overall mean S-phase fraction was 7.2% which is similar to that found in female breast tumours in Iceland. It is concluded that male-to-female ratio of breast carcinoma in Iceland is similar to that found in other Western countries. The age-standardised incidence has increased considerably in the last 20 years, in contrast to the rates reported from most other countries. Papillary tumours are unusually common in Icelandic males.

Aged↗
PubMed1996

A single BRCA2 mutation in male and female breast cancer families from Iceland with varied cancer phenotypes.

The BRCA2 gene on chromosome 13 has been shown to be associated with familial male and female breast cancer. Here we describe a study on BRCA2 in 21 Icelandic families, including 9 with male breast cancer. We have previously reported linkage to the BRCA2 region in an Icelandic male breast cancer family and subsequently found a strong indication of linkage to BRCA2 and the same BRCA2 haplotype in breast cancer cases from 15 additional families, indicating a common origin. We describe a five base-pair deletion in exon 9 of BRCA2 in an affected male from the male breast cancer family. The same mutation occurs in all the families with the shared BRCA2 haplotype indicating a founder effect. Among mutation carriers there are 12 males with breast cancer, which accounts for 40% of all males diagnosed with breast cancer in Iceland over the past 40 years. Three of them have no family history of breast cancer indicating that this mutation may have variable penetrance. The same BRCA2 mutation appears to be associated with different cancer phenotypes in this population including male and female breast cancer, prostate cancer, pancreas cancer and ovarian cancer.

BRCA2 Protein↗
PubMed1996

Whooping cough and Parkinson's disease. The Europarkinson Preparatory Activity Research Group.

BACKGROUND: We reported high levodopa use and prevalences of Parkinson's Disease (PD) in periodically, time-clustered, icelandic cohorts born after major whooping cough epidemics (MWCE). METHODS: In order to quantify a possible relationship between age at first post-birth MWCE and risk of PD we: 1) calculated cumulative incidences of PD during the period 1954-1963 in one-year Icelandic cohorts born between 1869 and 1927, using raw material from a reported survey; 2) identified MWCE from 1869 onwards in Iceland; 3) estimated cohort ages at onset of incidence period and at first MWCE; and 4) combined the above-mentioned information using log-linear models. In addition, we studied the prevalence of levodopa users in Icelandic birth cohorts during a recent period. RESULTS: The curves of the above-mentioned incidences and prevalences in one-year birth-cohorts showed: 1) a similar, age-related, inverted V profile; and 2) a systematic notchy pattern, with peak values for one or both measurements for cohorts born during or after each of nine MWCE identified during the period 1869-1927. When 13 cohorts born in years with MWCE were excluded from the analysis, the risk of PD rose with age at first defined MWCE, with the linear increase being 8.4% per year (95% CI: -0.1-18.3%). CONCLUSIONS: These results are consistent with reported effects of age at exposure in animal models of toxic parkinsonism, age-related changes in the dopamine receptor-GPT-binding protein-adenylatecyclase system observed in rats treated with pertussis toxin, and some PD epidemiological features. They suggest that pertussis neurotoxicity could be casually treated to PD worldwide.

Adolescent↗
PubMed1996

Risk of subsequent malignant neoplasms among 1,641 Hodgkin's disease patients diagnosed in childhood and adolescence: a population-based cohort study in the five Nordic countries. Association of the Nordic Cancer Registries and the Nordic Society of Pediatric Hematology and Oncology.

PURPOSE: To assess the risk of subsequent malignant neoplasms among Hodgkin's disease patients diagnosed before 20 years of age in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden). PATIENTS AND METHODS: There were 1,641 Hodgkin's disease patients identified through the national cancer registries since the 1940s or 1950s. The patients were monitored for 17,000 person-years until the end of 1991. Expected figures were derived from the age-specific incidence rates in each country and standardized incidence ratios (SIR) were calculated. RESULTS: A total of 62 subsequent neoplasms were diagnosed (SIR, 7.7; 95% confidence interval [CI], 5.9 to 9.9). The overall cumulative risk of subsequent neoplasms was 1.9% at the 10-year follow-up point, 6.9% at 20 years, and 18% at 30 years. There were 26 subsequent neoplasms among males (SIR, 6.5; 95% CI, 4.3 to 9.6) and 36 among females (SIR, 8.9; 95% CI, 6.2 to 12), of which 16 were breast cancers (SIR, 17; 95% CI, 9.9 to 28). High risks were seen for thyroid cancer (SIR, 33; 95% CI, 15 to 62), for secondary leukemia (SIR, 17; 95% CI, 6.9 to 35), and for non-Hodgkin's lymphoma (SIR, 15; 95% CI, 4.9 to 35). The relative risk increased from 3.3 (95% CI, 1.2 to 7.1) for Hodgkin's disease patients diagnosed in the 1940s and 1950s to 15 (95% CI, 7.4 to 27) in the 1980s. The highest risk of secondary leukemia (SIR, 68; 95% CI, 18 to 174) was seen among those diagnosed with Hodgkin's disease in the 1980s. CONCLUSION: Patients who survive Hodgkin's disease at a young age are at very high relative risk of subsequent malignant neoplasms throughout their lives. In particular, the high relative risk of breast cancer following Hodgkin's disease in the teenage years calls for enhanced activity for early diagnosis.

Adolescent↗