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Background: Radioactive radon gas is generated from uranium and thorium in underlying rocks and seeps into buildings. The gas and its decay products emit carcinogenic radiation and are regarded as the second most important risk factor for lung cancer after active tobacco smoking. The average radon concentration in Norwegian homes is higher than in most other Western countries. From a health and cost perspective, it is important to be able to quantify the risk of lung cancer posed by radon exposure., Material and Method: We estimated the radon-related risk of lung cancer in Norway based on risk estimates from the largest pooled analysis of European case-control studies, combined with the hitherto largest set of data on radon concentration measurements in Norwegian homes., Results: Based on these estimates, we calculate that radon is a contributory factor in 12 % of all cases of lung cancer annually, assuming an average radon concentration of 88 Bq/m3 in Norwegian homes. For 2015, this accounted for 373 cases of lung cancer, with an approximate 95 % confidence interval of 145 – 682., Interpretation: Radon most likely contributes to a considerable number of cases of lung cancer. Since most cases of radon-associated lung cancer involve smokers or former smokers, a reduction of the radon concentration in homes could be a key measure to reduce the risk, especially for persons who are unable to quit smoking. The uncertainty in the estimated number of radon-associated cases can be reduced through a new national radon mapping study with an improved design.

Background: Patients with epithelial ovarian cancer are often diagnosed with advanced disease; hence they have a generally poor survival rate. The main objective was to assess the clinical effectiveness of the four main treatment options in the primary treatment of epithelial ovarian cancer: i) adjuvant chemotherapy and/or adjuvant radiotherapy, ii) cytoreductive surgery, iii) neoadjuvant chemotherapy in advanced disease, and iv) postoperative chemotherapy in advanced disease., Material and Methods: The scientific literature was identified by searches in Medline, Embase and Cochrane CCTR and by additional manual searches. Using criteria defined by protocol, two reviewers assessed each study according to relevance, quality and validity. Among 2227 publications identified, 635 were read as full-text articles, and 90 studies were critically assessed as relevant publications. All included studies were systematised in three subgroups according to the quality of the study design in question and the validity of the results: high, moderate, or low. A total of 45 studies of high or moderate quality form the documentary basis for this review., Results: Current data are inconclusive regarding the effect of adjuvant chemotherapy. Retrospective data show a survival advantage for patients who have had maximum cytoreductive surgery. The effect of neoadjuvant chemotherapy is uncertain. Several questions remain unanswered despite wide acceptance of paclitaxel-carboplatin as the current standard in first-line treatment., Interpretation: This systematic review demonstrates the need for more clinical studies.

Background: Hypertension represents a risk factor in the development of cardiovascular disease., Material and Methods: The prescription of antihypertensive drugs and the daily doses used were examined in a questionnaire-based survey among 2,586 drug-treated hypertensive patients who attended a general practitioner for clinical control in November 1995., Results: The proportion of patients treated with one antihypertensive drug only was 63%. ACE inhibitors, alpha blockers and angiotensin-II antagonists constituted 22.7%, 6.6% and 4.4%, and betablockers, calcium channel blockers and diuretics 21.7%, 23.7% and 16.3% of the prescriptions respectively. Women were more often prescribed diuretics than men, and older individuals more often than younger persons. No striking difference in the prescription of antihypertensive drugs were observed between the five health regions of Norway. There was no reduction in the prescribed daily doses of antihypertensives used in combination therapy compared with monotherapy. In approximately one quarter of the prescriptions there was a positive correlation between the prescribed daily dose and the patient's weight. The number of antihypertensives prescribed did positively correlate with the patient's weight., Interpretation: This survey shows that antihypertensives without any documented effect on morbidity and mortality were frequently prescribed for hypertension in general practice. Except for the low proportion of diuretic users among elderly patients, our results is in accordance with the Guidelines from the Norwegian Society of General Practitioners.

Incidence of prostate cancer has increased steadily in Norway since the cancer registration started in the 1950s. In Oslo, however, the figures show decreasing incidence since the 1970s, a trend not observed in any other region. These changes have occurred in the groups older than 70 years of age. The most important change is a marked decrease in the number of cases first diagnosed at autopsy, from 12.7% in 1957-61 to 3.8% in 1987-91. However, even after these cases are excluded, a slight downward trend in incidence still exists. The same tendencies are not observed for other forms of cancer. It seems as if the diagnostic intensity has become lower in Oslo than in the rest of the country. This pattern may be explained by a change of priority in diagnostics, owing to scarce resources, but other reasons, such as stabilization of the incidence of prostatic cancer, are also possible.

In a randomized, double blind, parallel-group, multicentre study in Norway, 97 patients with mild to moderate hypertension (mean blood pressure 159/104 mm Hg) were treated with either lisinopril 10-40 mg or nifedipine 20-80 mg and the effects on blood lipids were evaluated. Complete results of laboratory analyses are given for 80 patients. After a 4 week run-in and placebo period, antihypertensive treatment was given for the next 10 weeks. During treatment with lisinopril the changes in lipids were +2.1% for total cholesterol, +0.7% for HDL-cholesterol, +3.8% for triglycerides and -6.1% for ratio HDL/cholesterol-HDL. For nifedipine the corresponding values were -2.4% for cholesterol, -5.8% for HDL-cholesterol, +8.0% for triglycerides and +3.2% for ratio. None of these changes was statistically significant. Both lisinopril and nifedipine lowered the blood pressure significantly, 18.1/12.0 mm Hg with lisonopril (p < 0.01 for both systolic and diastolic pressure) and 8.0/8.5 mm Hg with nifedipine (p < 0.01 for both respectively). Both drugs were well tolerated. In conclusion, neither lisinopril nor nifedipine had any negative impact on lipid levels.

In a randomized, parallel, double-blind study, lisinopril (n = 412) reduced systolic and diastolic blood pressure more than nifedipine did (n = 416) after ten weeks treatment in patients (40-70 years) with mild to moderate essential hypertension. Lisinopril was tolerated better than nifedipine, with fewer withdrawals. Adverse experiences reported after a general question on discomfort were significantly lower for lisinopril than for nifedipine. Questions referring specifically to symptoms revealed higher frequency of coughing with lisinopril, while flushing, edema, palpitations, dizziness, tiredness and rash were reported more frequently with nifedipine. Quality of life was similarly assessed by both patients and spouses. No significant differences in well-being during treatment were found for either drug, except in the case of the highest dose level of nifedipine, which caused a deterioration of well-being.

In a Norwegian, double-blind, double-dummy multicenter study, 828 patients with mild to moderate hypertension were randomized to treatment by either lisinopril or nifedipine. One of the aims of the study was to specifically investigate the frequency of side effects. Spontaneously reported coughing reached 8.5% for lisinopril, as against 3.1% for nifedipine. In two patients coughing led to withdrawal from the study, and in another three it contributed partially to discontinuation of the treatment. A significant sex difference was found for spontaneously reported coughing among patients on lisinopril; 12.6% of the women and 4.4% of the men. A similar difference between the sexes was found for specific questioning about coughing. Use of a visual analogue scale by both patient and spouse revealed similar frequency of coughing as when reported spontaneously. The reason for sex being an important determinant for lisinopril-induced coughing remains obscure.