Colorectal cancer in the Faroe Islands--a setting for the study of the role of diet.

BACKGROUND: The Faroe Islands are a group of small islands in the north Atlantic. The population is well-defined and is therefore very suitable for epidemiological research, including dietary studies in relation to carcinogenesis. With the establishment of a cancer registry on January 1, 1994, with data from 1960, inspection of incidence rates and trends in cancer may give clues to areas for etiologic research. METHODS: We identified retrospectively all incident cases of colorectal cancer in the period 1979-1993, by reviewing all case reports and death certificates in the Faroe Islands. RESULTS: We found 242 cases of colorectal cancer: 166 colon cancers and 76 rectal cancer, of which 93% and 96% (respectively) were histologically confirmed. Colorectal cancer incidence was significantly lower than in Denmark, with standardised incidence ratios (SIRs) for colon cancer at 0.8 (95% CI = 0.7-1.0) in men and 0.7 (95% CI = 0.6-0.9) in women. For rectal cancer SIRs were 0.6 (95% CI = 0.5-0.9) in males and 0.6 (95% CI = 0.4-0.9) in females. CONCLUSIONS: This paper presents for the first time incidence rates of colorectal cancer in the Faroe Islands. For both cancer types the most recent standardised incidence rates, 1989-1993, were among the lowest in north western Europe and North America. This relatively low risk of colorectal cancer occurs in spite of a low intake of vegetables and a high intake of total fat. However, the Faroese diet is high in fish, calcium and vitamin D and the possibility therefore exist that the low rates are due to a protective effect of these nutrients and micronutrients.

Recurrent familial intrahepatic cholestasis in the Faeroe Islands. Phenotypic heterogeneity but genetic homogeneity.

Recurrent familial intrahepatic cholestasis is an autosomal recessive disorder characterized by episodes of severe pruritus and jaundice lasting for weeks to months without extrahepatic bile duct obstruction. Symptom-free intervals may last for months to years, and chronic liver damage does not develop. We recently studied four of the five patients from the Faeroe Islands described by us 30 years ago (one had recently died) and an additional five patients that were identified after the initial report. The episodes of cholestasis were more frequent and severe in patients with early onset, but tended to reduce in frequency with age. The youngest patient, aged 25 years, who had had 16 episodes each lasting about 6 months, had a liver transplant after which no further episodes were recorded (1 year after surgery). Signs of chronic liver disease were absent in all patients. The FIC1 gene was investigated for mutations in the surviving patients. A single mutation (I661T) was found on both chromosomes in all nine patients, indicating that they are genetically identical for the disease-causing defect. Nevertheless, considerable differences among patients were observed clinically.

[Recurrent familial intrahepatic cholestasis in the Faroe Islands]. / Recidiverende familiaer intrahepatisk kolestase på Faerøerne.

Recurrent familial intrahepatic cholestasis is an autosomal recessive disorder characterized by episodes of severe pruritus and jaundice lasting for weeks to months without extrahepatic bile duct obstruction. Symptom-free intervals may last for months to years, and chronic liver damage does not develop. We recently studied four of the five patients from the Faeroe Islands described by us 30 years ago (one had recently died), and a further five patients who were identified after the initial report. The episodes of cholestasis were more frequent and severe in patients with early onset, but tended to reduce in frequency with age. The youngest patient, aged 25 years, who had had 16 episodes, each lasting about six months, had a liver transplant after which no further episodes were recorded (one year after surgery). Signs of chronic liver disease were absent in all patients. The FIC1 gene was investigated for mutations in the surviving patients. A single mutation (I661T) was found on both chromosomes in all 9 patients, indicating that they are genetically identical for the disease causing defect. Nevertheless, considerable differences between patients were observed clinically.