Sometimes, innovation that can change the world pops up in the most unimaginable places. That's the case in cancer research. A group of renown medical researchers are front-running a project in Iceland backed by the IMF that aims to decipher the genetic codes for most of the population of the tiny island nation through screening to determine who is predisposed for multiple myeloma, a form of blood cancer that develops in the bone marrow, typically in older adults. The immediate goal: to learn what genetic factors can cause the disease and spur it to progress.
"All this from a simple blood test that can see if a person has a precursor for the disease, " explains project leader Dr. Sigurdur Kristinsson, a professor of hematology at the University of Iceland.
Myeloma is a test ground for other cancers because it is so easily tracked. The hope is that treatments that are proved effective for this disease may be effective in other cancers as well.
Establishing a database from which to draw general conclusions on the behavior of such diseases like cancer requires massive amounts of data collecting and analysis. It is no small feat.
Why Iceland, the land of the Vikings, that's known more for its live volcanoes and the Blue Lagoon than anything else?
"It's the country's insular and homogeneous population of some 329,000 people that make it a great sample for genealogists and scientists to trace genetic mutations that can increase the risk of cancer," said Dr. Brian Durie, chairman and co-founder of the International Myeloma Foundation who is overseeing the so-called iStopMM project in Iceland. Today 93 percent of all citizens are ethnically Icelandic, the government reports. Lineage comes from a small number of founders, making it easier to trace genealogies and pedigrees.
Icelanders also have a strong social conscience and are committed to advances in science, according to former president of Iceland Vigdís Finnbogadóttir. "We are a compassionate people, and we care about the well-being of others," she said. "We hope this study will help in the prognosis of those who have this cancer condition."
For more than 18 years the country has been doing genetic sequencing for one-third of its population through the National Human Genome Research Institute. It's a genetic treasure chest that has already led to important breakthroughs.
A biopharmaceutical company, deCODE Genetics in Reykjavik, Iceland, has led the charge, and the findings from its research have been dazzling. It's led to insights into cancer epidemiology and biomarker discovery. For example, the discovery of a mutation in a gene called BRCA2 was found in 2,000 Iceland men and women. Those that carry it have a 4.6-fold increase in the lifetime risk of carrying cancer. For men, at least 360 of the carriers of the mutation will develop prostate cancer. For women who carry this mutation they have an 86 percent probability of developing either breast or ovarian cancer.
The country has also made all medical records electronic as it's been building its genetic database. This has allowed for Iceland to build a good infrastructure to track all citizens that have cancer and other diseases.
The hub of innovation is taking place at the University of Iceland in Reykjavic, where Dr. Durie and nine other scientists are leading the initiative. As part of the study, 140,000 Icelanders over the age of 40 will have their blood samples tested for the precursor to multiple myeloma. If they have it, they will have the option to participate in a clinical trial to treat or prevent progression of the disease.
Already 75,000 have signed up to participate in the project since its launch last October.
"I am hoping this research project can improve the quality of life of multiple myeloma patients and improve drug treatments," said Linda Huguelet, a multiple myeloma patient in Chattanooga, Tennessee. "Even more important, help scientists collaborate from around the world to help find a cure."
A tissue bank has been established to store the samples at the deCODE facility at the University of Iceland, allowing researchers to learn from this study for decades to come.
Once all Icelanders that have the precursor for multiple myeloma are identified, they will be tracked to see how the disease is progressing, so doctors can offer treatment at the earliest possible time to achieve a cure.
"Our ultimate goal is to be the first country in the world to offer a cancer cure for its entire population," Dr. Durie said.
The world is watching.