Research Environment

During the past decade, there has been a remarkable increase in expenditure on research and development work. Icelanders spent 3% of their gross domestic product on research and development undertakings in 2001, compared to 1.1% in 1990, thereby reaching the goal that the European Union has set for itself to achieve by 2010. The benefits of this investment may be measured, for instance, by the favorable outcome of Icelandic scientists in international cooperation and through added innovation, which has led to growth in employment and in the export of goods and services based mainly on knowledge (the Icelandic Centre for Research, 2005). In 2005, Iceland ranked second in the world by measuring the degree of preparation of a nation or community to participate in and benefit from information and communication technologies (the Global Information Technology Report, 2004-2005).

Because of Iceland's small size and scale of resources, the majority of Icelandic physicians and many other disciplines seek their postgraduate training abroad, either in Europe or North America. This has benefited healthcare and research in Iceland as the majority repatriates, bringing back the connections, ambitions, and initiative, that allow them to achieve success on an international scale. Although the smallness of the country limits resources, it is balanced by advantages of short routes of communication among individuals, institutions, and businesses.

Through health registries, which may date back a century or more, Iceland offers rich resources for health-related research, which cover the entire population, including cancer prevalence, cardiovascular health, and mortality. Linking the Icelandic health registries to the extensive genealogy database is beginning to underscore the importance of genetic predisposition for an entire population (Jonsson et al., 2004).

A national cancer registry was started in 1954. It contains information on around 30,000 individual cases of cancer diagnosed since then. It is one of few such registries in the world containing information on an entire nation. Currently, about 1000 cases of cancer are diagnosed annually in Iceland. The most commonly affected organs are the prostate for men and the breast for women, closely followed by the lung for both sexes. Research in cancer epidemiology has been one of the main functions of the Icelandic Cancer Society since the cancer registry was started (the Icelandic Cancer Society). Data from the Icelandic population was also important in identifying both the BRCA1 and BRCA2 genes for breast cancer, but a founder mutation in each gene is present in the Icelandic population (Bergthorsson et al., 1998; Thorlacius et al., 1998).

The public is generally supportive of medical research, and the high public participation rate is a distinctive advantage of locating such research in Iceland (see Table 61.1). Furthermore, the population has lived through and been exposed to relatively similar

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