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Background: In the mid twentieth century gastric cancer was the most common type of cancer in Iceland. In recent decades, however, the incidence rate of gastric cancer has decreased markedly and currently only represents 2-3% of cancer cases. The Laurén classification system classifies adenocarcinoma into two types, intestinal and diffuse. The main purpose of our study was to describe the epidemiology of the two types of gastric adenocarcinoma in Iceland between the years 1990-2009., Methods: This is a retrospective cohort study. Information on patients diagnosed with gastric cancer in Iceland between 1990 and 2009 was collected from the population based Cancer Registry. Histological descriptions were reviewed and classified according to the Laurén classification system. The records of patients diagnosed with either having intestinal or diffuse adenocarcinomas were reviewed and epidemiological information gathered., Results: Between 1990 and 2009, 730 patients were diagnosed with gastric adenocarcinoma in Iceland, 447 had intestinal adenocarcinoma and 168 diffuse adenocarcinoma. Patients diagnosed with diffuse adenocarcinoma were significantly younger at diagnosis than those diagnosed with intestinal adenocarcinoma. The sex ratio for intestinal adenocarcinoma was 2.3:1 (M:F) and 1.1:1 (M:F) for diffuse adenocarcinoma. The incidence of intestinal adenocarcinoma decreased more rapidly than that of diffuse adenocarcinoma during this period (0.92/100,000 vs. 0.12/100,000). Median survival rates of intestinal and diffuse adenocarcinomas were 23.7 and 20.6 months, respectively. The difference in survival was found to be statistically significant. The hazard ratio between the two groups was 1.31 (CI 1.03-1.67), corrected for age, sex, stage, year of diagnosis and surgical outcome (radical, non-radical or no operation)., Conclusion: The overall incidence rate of gastric cancer has decreased dramatically in the past 20 years. However, the reduction is largely limited to the intestinal adenocarcinoma sub-group. We conclude that the Laurén classification predicts prognosis in gastric adenocarcinoma with diffuse adenocarcinoma having worse prognosis., Key Words: gastric cancer, Laurén classification, survival, incidence. Correspondence: Halla Sif Olafsdottir, hsolafsdottir@gmail.com.

Objective: Allergic or pseudo-allergic reactions to drugs are common complaints. The symptoms vary from mild to life threatening. Although the mechanisms for most drug reactions are unknown or uncertain such reactions are believed to be more common among atopic individuals. Our goal was: 1) To estimate the prevalence of allergic and pseudo-allergic drug reactions in a random urban Icelandic population 20-44 years of age. 2) To search for the characteristics of symptoms and which drugs were involved in such reactions, 3) their association to atopy and atopic diseases and 4) to find possible risk factors., Material and Methods: In the second stage of the European Community Respiratory Health Survey an urban population 20-44 years of age was invited to participate. In Iceland altogether 545 answered an additional question: Have you at any time had allergic reaction to drugs? Those who answered yes to this question were contacted later by telephone and asked further about drug allergy., Results: Altogether 77 (14%) replied yes to the question, more females (19%) than males (9%) (p<0.001). Atopic individuals (with one or more positive prick tests) and those with nasal allergies, eczema, urticaria and illness caused by eating a particular food or foods reported allergic drug reactions more often (p<0.05). IgE geometric mean value was 17.5 kU/L for those who reported allergic drug reaction compared to 12.6 kU/L among the others (p=0.08). The most common symptoms associated with drugs were skin symptoms (urticaria, angioneurotic edema), symptoms from respiratory organs and fever. With further inquiries by telephone 13/64 denied drug allergy. Thus 51/64 (80%) withheld their questionnaire answers. Antibiotics were most often blamed for drug reactions, followed by anaesthetics, NSAID and opiates., Conclusion: There was a correlation between reported drug reactions and atopy and/or atopic diseases. The drug reactions were more than twice as common in women as in men. The only comparable study we know of, shows the prevalence of drug reactions on the same level as in Iceland.