title: [Hepatocellular carcinoma in Iceland.].
abstract: BACKGROUND
  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.
  
  
  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.
authors.affiliation: Department of Medicine, Landspitali University Hospital, Fossvogi, 108 Reykjavík, Iceland. sigurdol@landspitali.is.
authors.forename: B
authors.initials: B
authors.lastname: Ragnarsdóttir
authors.forename: J G
authors.initials: JG
authors.lastname: Jónasson
authors.forename: H
authors.initials: H
authors.lastname: Tulinius
authors.forename: S
authors.initials: S
authors.lastname: Olafsson