Læknablaðið - 01.04.1968, Page 92

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LÆKNABLAÐIÐ
því, að krabbamein í skjaldkirtli væri mjög fátítt hérlendis. Það kom
því á óvart, hve tiltölulega há tíðni þessa sjúkdóms er hér, eða 7.7 á
100.000 í konum. Samanburður á tíðni skjaldkirtilskrabbameins í kon-
um á íslandi og í Svíþjóð leiðir í ljós, að eftir fertugsaldur verður sjúk-
dómur þessi tiltölulega mun tíðari hér á landi en í Svíþjóð.
Til þess að kanna þetta mál nánar hefur verið leitað samvinnu
við prófessor I. Doniach frá Lundúnaháskóla (London Hospital) og dr.
E. D. Williams frá Postgraduate Medical School of London. Gera má
ráð fyrir, að samvinnu þessari verði framhaldið um óákveðinn tíma.
Fy lgiskj al 5
I. Doniach: Endemic Goitre and Thyroid Cancer
Epidemiologic studies in the U.S.A. have shown a lack of correla-
tion between incidence of endemic goitre and thyroid cancer. The in-
troduction of iodized salt in goitre districts led to considerable reduction
in the incidence of goitre but not in thyroid cancer. Histological analysis
of thyroid cancer cases into papillary, follicular, medullary and ana-
plastic types has been reported for a number of large series. The
largest series of over 800 cases is that of Woolner and colleagues from
the Mayo Clinic 1961, They found 61% papillary to 18% follicular. In
other series of adult cases from nongoitre districts the percentage of
papillary carcinomas varied from 41% to 60% and follicular carcinomas
from 23% to 30%. In a series from a region of endemic goitre in
Colombia the finding were 34% papillary and 29% follicular.
The findings suggest that follicular carcinoma of the thyroid might
be more common than papillary in areas of endemic goitre, i. e. associ-
ated with dietary, iodine deficiency. We came to Iceland to try and
analyse the histological types of thyroid cancer in a country w'nere
there is a high dietary iodine content. Professor Ólafur Bjarnason has
demonstrated an unexpectedly high incidence of thyroid carcinoma in
Iceland as compared with Sweden. We agree and also find an unusually
high ratio of over 70% papillary carcinomas to less than 15% follicular
carcinomas.