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ABSTRACT: Both genetic and environmental factors play a role in the development of Crohn's disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel disease (IBD). The aim of this study was to estimate the genetic component in IBD in Iceland.
A population-based sample, representing everyone diagnosed with IBD in Iceland from 1950 to 1996, was studied using a computerized population-wide genealogic database. The relationships among the patients were analyzed by calculating the kinship coefficient and the relative risk.
The kinship coefficients for the patients were significantly greater than the mean kinship coefficient for the controls ( P < 10 -6 ). The risk ratio for siblings of IBD, UC, and CD patients was 5.0 ( P < 0.001), 5.9 ( P < 0.001), and 4.1 ( P = 0.033), respectively. The cross-risk ratio for siblings of UC patients developing CD (or vice versa) was 2.6 ( P = 0.015).
The results indicate that the IBD patients are more closely related than the controls, which strongly supports the involvement of a genetic component in the development of IBD in Icelandic patients. We find that the increase in risk for relatives of UC probands to develop UC, or relatives of CD probands to develop CD, is greater than the increase in risk for relatives of UC probands to develop CD, or relatives of CD probands to develop UC.
Clinical Gastroenterology and Hepatology 09/2004; 2(9):806-12. · 5.63 Impact Factor
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ABSTRACT: The aim of this study was to determine the nationwide incidence of collagenous and lymphocytic colitis in Iceland and the location of histopathological changes in the large bowel. All pathology reports of patients diagnosed with or suspected of having collagenous colitis or lymphocytic colitis in the period 1995-1999 were identified. All pathology samples were reevaluated using strict diagnostic criteria. After reevaluation 125 patients fulfilled our diagnostic criteria, 71 as collagenous colitis and 54 as lymphocytic colitis. The mean annual incidence for collagenous colitis was 5.2/100,000 inhabitants, and the mean age at diagnosis was 66.1 years. The mean annual incidence for lymphocytic colitis was 4.0/100,000 inhabitants, the mean age at diagnosis was 68.7 years. Both diseases more commonly involved the colon than the rectum. The incidence of collagenous colitis and lymphocytic colitis is high in Iceland. The mean annual incidence of collagenous colitis is much higher in Iceland than hitherto reported elsewhere.
Digestive Diseases and Sciences 06/2002; 47(5):1122-8. · 2.12 Impact Factor
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ABSTRACT: Objective: To find the incidence of ulcerative colitis in Iceland during the past decade for comparison with previous study and incidence figures from neighbouring countries. Methods: This was a nationwide retrospective study of the period 1980-1989. Cases were retrieved by reviewing all reports on tissue specimens from the large and small intestine with any type of inflammation referred to the two departments of pathology in Iceland. All possible cases of ulcerative colitis were then followed by a review of the clinical information. Only those cases fulfilling accepted diagnostic criteria were included in the study. Results: Thus 282 cases of ulcerative colitis were found, 166 men and 116 women, M/F ratio 1.43. The mean annual incidence for the 10 year period was 11.7/100,000. The highest age specific incidence was found in the group 30-39 years, 21/100,000/year. Most frequently the inflammation was limited to the rectum (proctitis), found in 53.9% of the patients. Proctosigmoiditis was seen in 29.8%, left-sided col notitis in 5.3% and extensive colitis in 11%. Approximately 63% of the patients had been symptomatic for less than six months before diagnosis. Information on familial cases of inflammatory bowel disease was obtained from 8.9% of the patients. Conclusion: There has been a steady and significant increase in the incidence of ulcerative colitis in Iceland in the past four decades and the mean annual incidence has almost doubled from the last decade 1970-1979. This increase in incidence is considered real, i.e. not due to better methods of detection or a change in diagnostic criteria.
Laeknabladid 11/1996; 82(11):771-777. · 0.23 Impact Factor
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ABSTRACT: Objective: To find the incidence of Crohn's disease in Iceland during the past decade for comparison with previous study and incidence figures from neighbouring countries. Methods: A nationwide retrospective study of the incidence of Crohn's disease in Iceland for the 10-year period 1980-1989 was conducted. New cases were retrieved by review of all small and large intestinal tissue specimens with any type of inflammation submitted to the two departments of pathology in Iceland. All cases with the slightest possibility of Crohn's disease were followed clinically by examining their hospital, outpatient and x-ray records. In addition all small intestinal x-rays with the diagnosis of Crohn's disease were screened. The criteria of Lennard-Jones were used to confirm or exclude Crohn's disease. Results: Thus 75 patients were found, 36 men and 39 women, M/F ratio 0.9. The mean annual incidence was 3.1/100,000, which is a three fold increase compared to the period 1970-1979. The incidence of Crohn's disease in Iceland is still the lowest among the neighbouring countries. The highest age specific incidence was in the age group 60-69 years, 8.9/ 100,000, which is unusual. The most frequent localization of the intestinal inflammation at diagnosis was colon only (54.7%). The second most common localization was ileum only (25.3%), but in 18.7% of the patients the disease involved both ileum and colon. Inflammation limited to the colon was significantly more frequent in the older age groups. There was a family history of inflammatory bowel disease (IBD) in 8% of the cases. Conclusion: The incidence of Crohn's disease in Iceland, while still low compared to that of the neighbouring countries, is rising. The reason for this increase is unknown.
Laeknabladid 82(6):436-442. · 0.23 Impact Factor
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ABSTRACT: It is widely agreed that the presence or absence of axillary lymph-node involvement (N) is the most reliable predictor of relapse or survival in breast cancer, together with tumor size (T) and the presence or absence of distant metastasis (M). These prognostic factors are the cornerstones of the TNM staging system. The aim of the present study was to ascertain, in all patients diagnosed with invasive primary breast cancer in Iceland during the years 1981-84 (n=347), whether flow cytometric DNA analysis of ploidy status and fraction of cells in the S-phase contribute prognostic information, addi nottional to that obtained with TNM staging variables. Paraffin fixed tumor material was available from 340 patients (98%) and DNA ploidy and S-phase fraction was assessed with flow cytometry. DNA ploidy could be analysed in 98% of tumor samples (n=334), of which 114 (34%) were diploid and 220 (66%) non-diploid. S-phase fraction could be analysed in 97% of the tumor samples (n=329), the median S-phase value was 7.0%, and was higher in non-diploid than diploid tumors (p<0.0001, 9.3% vs. 2.7%). Median duration of patient follow-up was 7.5 years. The disease-free survival at that point of time was 15% higher in patients with diploid tumors than non-diploid ones (p=0.004, 69% vs 54%). Similar survival comparison in relation to S-phase fraction was 30% when the median S-phase value was used as cut-off point (p<0.0001, S-phase<7.0% being 74% vs. S-phase ;7.0% being 44%). Multivariate analyses with regard to breast cancer survival and disease-free survival, which included both ploidy status and S-phase categories adjusting for age, tumor size and lymph node involvement, showed the S-phase value categories to be independent prognostic variables (p<0.0001). Patients with high S-phase tumors had a three-fold higher risk of recurrence than patients with low S-phase tumors. Ploidy status was not an independent prognostic variable, if however the S-phase categories were excluded from analysis, ploidy status was on the borderline of being an independent variable (p=0.09). In node-negative patients the S-phase fraction was the only useful variable in determining prognosis. We conclude that the S-phase value is a useful prognostic guide for the clinician and will be used for this purpose in the treatment of breast cancer in Iceland.
Laeknabladid 82(2):138-147. · 0.23 Impact Factor
