{"id":6235,"date":"2026-10-19T09:48:40","date_gmt":"2026-10-19T09:48:40","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-laeknavisindum-jonas-adalsteinn-adalsteinsson\/"},"modified":"2026-10-19T09:48:40","modified_gmt":"2026-10-19T09:48:40","slug":"doktorsvorn-i-laeknavisindum-jonas-adalsteinn-adalsteinsson","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-laeknavisindum-jonas-adalsteinn-adalsteinsson\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed l\u00e6knav\u00edsindum – J\u00f3nas A\u00f0alsteinn A\u00f0alsteinsson"},"content":{"rendered":"
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M\u00e1nudaginn 20. desember ver J\u00f3nas A\u00f0alsteinn A\u00f0alsteinsson doktorsritger\u00f0 s\u00edna \u00ed l\u00e6knav\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: \u00a0Keratinocyte krabbamein \u00e1 \u00cdslandi: Faraldsfr\u00e6\u00f0i og lyfjanotkun. Keratinocyte carcinoma in Iceland: Epidemiology and risk in association with medication.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Hildur Helgad\u00f3ttir, yfirl\u00e6knir vi\u00f0 Karolinska h\u00e1sk\u00f3lasj\u00fakrah\u00fasi\u00f0 \u00ed Stokkh\u00f3lmi, og dr. Kristjana Hr\u00f6nn \u00c1sbj\u00f6rnsd\u00f3ttir, lektor vi\u00f0 H\u00e1sk\u00f3la \u00cdslands.<\/p>\n

Umsj\u00f3narkennari og lei\u00f0beinandi var dr. J\u00f3n Gunnlaugur J\u00f3nasson, pr\u00f3fessor, og lei\u00f0beinandi var dr. Laufey Tryggvad\u00f3ttir, kl\u00edn\u00edskur pr\u00f3fessor. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd dr. \u00de\u00f3runn Rafnar, deildarstj\u00f3ri krabbameinsranns\u00f3kna hj\u00e1 \u00cdE, dr. \u00c1rni Kjalar Kristj\u00e1nsson, s\u00e9rfr\u00e6\u00f0il\u00e6knir, og dr. Desir\u00e9e Ratner, pr\u00f3fessor vi\u00f0 Mount Sinai.<\/p>\n

\u00de\u00f3rarinn Gu\u00f0j\u00f3nsson, pr\u00f3fessor og deildarforseti L\u00e6knadeildar, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00.\u00a0V\u00f6rninni ver\u00f0ur streymt:\u00a0 https:\/\/livestream.com\/hi\/DoktorsvornJonasAdalsteinnAdalsteinsson<\/a> <\/strong><\/p>\n

\u00c1grip<\/strong><\/p>\n

Vita\u00f0 er a\u00f0 mikil aukning hefur veri\u00f0 \u00e1 grunnfrumu- og fl\u00f6gu\u00feekjumeinum \u00ed h\u00fa\u00f0 s\u00ed\u00f0ustu \u00e1r \u00ed vestr\u00e6num l\u00f6ndum en ekki er alveg sk\u00fdrt hvers vegna svo er. Helstu \u00e1h\u00e6ttu\u00fe\u00e6ttir \u00feessara meina eru lj\u00f3s h\u00fa\u00f0 og \u00fatfj\u00f3lubl\u00e1 geislun og einnig hafa sum lyf veri\u00f0 bendlu\u00f0 vi\u00f0 aukna \u00e1h\u00e6ttu me\u00f0 \u00fev\u00ed a\u00f0 valda \u00f3n\u00e6misb\u00e6lingu e\u00f0a auknu n\u00e6mi fyrir \u00fatfj\u00f3lubl\u00e1rri geislun \u00ed h\u00fa\u00f0. Ekki er miki\u00f0 til af ranns\u00f3knum sem sko\u00f0a faraldsfr\u00e6\u00f0i og \u00e1h\u00e6ttu\u00fe\u00e6tti \u00feessara h\u00fa\u00f0meina og \u00fea\u00f0 er \u00f3lj\u00f3st hvort sum \u00feessara lyfja sem auka \u00feessa \u00e1h\u00e6ttu myndu gera \u00fea\u00f0 \u00e1 \u00cdslandi \u00fear sem \u00fatfj\u00f3lubl\u00e1 geislun er l\u00edtil mi\u00f0a\u00f0 vi\u00f0 flest \u00f6nnur l\u00f6nd. Helstu markmi\u00f0 \u00feessarar ranns\u00f3knar var a\u00f0 athuga s\u00e9rstaklega t\u00ed\u00f0ni \u00feessara meina \u00e1 \u00cdslandi og einnig a\u00f0 sko\u00f0a hva\u00f0a \u00e1hrif \u00e1kve\u00f0in lyf g\u00e6tu haft \u00e1 \u00e1h\u00e6ttu \u00cdslendinga a\u00f0 f\u00e1 \u00feessi mein. Sko\u00f0u\u00f0 voru s\u00e9rstaklega hydrochlorothiazide (HCTZ), TNF-alpha hindra og stat\u00edn, sem hafa \u00ed sumum ranns\u00f3knum veri\u00f0 bendlu\u00f0 vi\u00f0 aukna \u00e1h\u00e6ttu \u00e1 h\u00fa\u00f0meinum. Einnig voru sko\u00f0u\u00f0 hugsanleg tengsl metform\u00edns vi\u00f0 h\u00fa\u00f0mein, en metform\u00edn hefur s\u00fdnt a\u00f0 \u00fea\u00f0 hefur tengsl vi\u00f0 l\u00e6gri \u00e1h\u00e6ttu \u00e1 krabbameinum \u00ed sumum ranns\u00f3knum. Gagnagrunnur hj\u00e1 krabbameinsskr\u00e1 var nota\u00f0ur til \u00feess a\u00f0 reikna t\u00ed\u00f0nit\u00f6lur og var lyfjagrunnur landl\u00e6knisemb\u00e6ttis nota\u00f0ur til \u00feess a\u00f0 sko\u00f0a tengsl vi\u00f0 lyf. Ni\u00f0urst\u00f6\u00f0ur s\u00fdndu a\u00f0 jafnvel \u00fe\u00f3 a\u00f0 \u00fatfj\u00f3lubl\u00e1 geislun \u00e1 \u00cdslandi s\u00e9 l\u00e1g hefur t\u00ed\u00f0ni grunn- og fl\u00f6gu\u00feekjumeina aukist til muna, og \u00cdsland er eina landi\u00f0 \u00fear sem t\u00ed\u00f0ni grunnfrumumeins og grunns fl\u00f6gu\u00feekjumeins er h\u00e6rra \u00ed konum en k\u00f6rlum. \u00deetta kann a\u00f0 sk\u00fdrast af \u00fev\u00ed konur vir\u00f0ast vera l\u00edklegri til \u00feess a\u00f0 nota lj\u00f3sabekki og stunda s\u00f3lb\u00f6\u00f0 \u00feegar \u00fe\u00e6r eru erlendis heldur en karlmenn. Karlmenn vinna oftar \u00fati en konur en erlendis eru \u00feeir \u00fev\u00ed \u00ed h\u00e1rri \u00e1h\u00e6ttu a\u00f0 f\u00e1 h\u00fa\u00f0krabbamein vegna mikillar geislunar. \u00c1 \u00cdslandi er \u00feessi geislun heldur minni. Einnig s\u00e1st a\u00f0 \u00feessi aukning \u00e1 h\u00fa\u00f0meinum er mest \u00e1 b\u00fak og f\u00f3tleggjum kvenna, sem bendir enn frekar til lj\u00f3sabekkja e\u00f0a s\u00f3larlandafer\u00f0a sem ors\u00f6k. Var\u00f0andi lyf var HCTZ tengt vi\u00f0 aukna \u00e1h\u00e6ttu \u00e1 b\u00e6\u00f0i grunn- og fl\u00f6gu\u00feekju\u00e6xlum. HCTZ eykur n\u00e6mi fyrir \u00fatfj\u00f3lubl\u00e1um geislum og \u00fev\u00ed var ekki endilega b\u00faist vi\u00f0 a\u00f0 lyfi\u00f0 auki \u00e1h\u00e6ttu \u00ed landi me\u00f0 svo litla bakgrunnsgeislun. TNF-alpha hindrar og stat\u00edn voru b\u00e6\u00f0i tengd vi\u00f0 aukna \u00e1h\u00e6ttu \u00e1 fl\u00f6gu\u00feekjumeinum, en ekki grunnfrumukrabbameini. L\u00e6knar sem skrifa \u00fat \u00feessi lyf \u00feurfa a\u00f0 vera me\u00f0vita\u00f0ir um \u00feessa tengingu. Metform\u00edn var tengt vi\u00f0 l\u00e6gri \u00e1h\u00e6ttu \u00e1 grunnfrumukrabbameini en ekki fl\u00f6gu\u00feekjukrabbameini, en \u00fe\u00f6rf er \u00e1 frekari ranns\u00f3knum til \u00feess a\u00f0 sta\u00f0festa \u00feessa tengingu.<\/p>\n

English abstract<\/strong><\/p>\n

An epidemic of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) has led to a significant healthcare burden in white populations. The incidence of both cancers is on the rise, the reasons for which are unclear. While the principal risk factors for these cancers are fair skin and ultraviolet radiation (UVR) exposure, certain medications have also been implicated in increased skin cancer risk through immunosuppression, immunomodulation, or UVR sensitization. Whole population studies assessing the epidemiology of and risk factors for BCC and SCC are lacking, and it is unclear whether medications significantly increase the risk of BCC and SCC development in the low UV radiation environment that Iceland provides. The primary objective this study was to establish incidence rates and tumor burden in an unselected, geographically isolated population that is exposed to low levels of UVR. The secondary objective was to delineate the relationship between SCC\/BCC and hydrochlorothiazide (HCTZ), TNF-alpha inhibitors (TNFi), and statins. These medications have, in some studies, been associated with increased risk of BCC and SCC development through UV sensitization, immunosuppression, and immunomodulation, respectively. Lastly, the relationship between metformin, which has been shown in some studies to cancer risk, and BCC and SCC development was investigated. \u00a0<\/strong>To accomplish our goals, we undertook a whole-population study based on the Icelandic cancer registry. To assess the relationship between medication and skin cancer, we used a population-based case-control study design. During the study period, the incidence for all subtypes of KC increased, despite Iceland\u2019s low background UVR. This increase was most prominent in women on sites not generally exposed to UV radiation in Iceland: the trunk and legs. Men are more likely than women to develop invasive SCCs, which occur almost exclusively in the head and neck. HCTZ was associated with all subtypes of KC. TNFis and statins were associated with SCC but not BCC. Metformin was associated with decreased risk of BCC. Cutaneous KC is becoming a significant public health problem worldwide. Iceland is the only reported population, to our knowledge, in which the incidence of BCC and SCCis is significantly higher in women than in men. While in most countries, men have a higher incidence of BCC and SCC, Iceland’s low UV radiation environment might protect men, as women may be more likely to engage in high-risk tanning behaviors. Despite the low background UV radiation in Iceland, high cumulative exposure to the UV sensitizing medication HCTZ was associated with the development of BCC, SCCis, and invasive SCC, suggesting that sun-protective behaviors alone may not eliminate the carcinogenic potential of HCTZ in high UV countries. TNFis and statins increased individual risk for SCC, but not BCC, a phenomenon also seen in organ transplant recipients and patients on immunosuppressive medications such as cyclosporine. Metformin might be beneficial in reducing BCC risk. These associations require further study.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

J\u00f3nas A\u00f0alsteinn A\u00f0alsteinsson er f\u00e6ddur \u00ed Reykjav\u00edk 24. apr\u00edl 1990. Hann lauk st\u00fadentspr\u00f3fi af n\u00e1tt\u00farufr\u00e6\u00f0ibraut fr\u00e1 Menntask\u00f3lanum \u00ed Reykjav\u00edk 2010, BSc-gr\u00e1\u00f0u \u00ed l\u00e6knisfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands 2013 og emb\u00e6ttispr\u00f3fi \u00ed l\u00e6knisfr\u00e6\u00f0i 2016. A\u00f0 loknu kand\u00eddats\u00e1ri vann hann vi\u00f0 ranns\u00f3knir \u00ed h\u00fa\u00f0l\u00e6kningum \u00e1 Mount Sinai sj\u00fakrah\u00fasinu \u00ed New York og h\u00f3f svo s\u00e9rn\u00e1m \u00ed h\u00fa\u00f0l\u00e6kningum vi\u00f0 University of Connecticut. Hann \u00fatskrifast sem s\u00e9rfr\u00e6\u00f0ingur \u00ed h\u00fa\u00f0l\u00e6kningum \u00ed j\u00fan\u00ed 2022. Foreldrar J\u00f3nasar eru A\u00f0alsteinn Egill J\u00f3nasson og \u00c1sd\u00eds Halla Bragad\u00f3ttir. Eiginkona J\u00f3nasar er N\u00edna Gu\u00f0r\u00fan Geirsd\u00f3ttir og eiga \u00feau eina d\u00f3ttur, Matthildi Eddu.<\/p>\n<\/div><\/div>","protected":false},"featured_media":5003,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2021-12-20T13:00:00+00:00","_phd_date_end":"2021-12-20T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"Keratinocyte krabbamein \u00e1 \u00cdslandi: Faraldsfr\u00e6\u00f0i og lyfjanotkun. 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