Doctoral Defense in Medical Sciences - Oddur Björnsson

On Friday, June 5, Oddur Björnsson will defend his doctoral dissertation in medical sciences at the Faculty of Medicine of the University of Iceland. The dissertation is titled: Bladder Cancer in Iceland: Epidemiology, Diagnosis, Treatment and Patient Outcomes. Urothelial carcinoma in Iceland: Epidemiology, diagnosis, treatment and patient outcome.

The opponents are Dr. Ulla Nordström Joensen, Clinical Associate Professor at the University of Copenhagen, and Sigurdís Haraldsdóttir, Professor at the University of Iceland.

The supervisor and advisor was Sigurður Guðjónsson. In addition to him, the doctoral committee included Ásgerður Sverrisdóttir, specialist physician (deceased), Eiríkur Orri Guðmundsson, specialist physician, and Tómas Guðbjartsson, professor.

Sædís Sævarsdóttir, Professor and Dean of the Faculty of Medicine, will preside over the ceremony, which will take place in the Ceremonial Hall of the University of Iceland and begin at 1:00 PM.

Abstract
Urothelial carcinoma is among the most common malignancies worldwide, with high incidence rates in the Nordic countries. Bladder cancer represents the majority of urothelial carcinoma cases, whereas upper tract urothelial carcinoma is less common and often associated with poorer outcomes. The aim of this doctoral thesis was to describe the epidemiology, treatment, and outcomes of patients with urothelial carcinoma in Iceland.
This thesis is based on four observational cohort studies. Three were nationwide population-based studies including all patients diagnosed with urothelial carcinoma in Iceland during defined study periods, while one was a single-center study conducted at Landspítali University Hospital. Data were obtained from the Icelandic Cancer Registry, the Icelandic Cause of Death Registry, and patients‘ medical records.
Between 2009 and 2019, 904 patients were diagnosed with urothelial carcinoma in Iceland. Incidence rates remained stable during the study period despite an increase in the absolute number of cases. Most patients presented with non-muscle-invasive bladder cancer, where recurrence was common. The implementation of a standardized TURBT protocol at Landspítali improved adherence to guideline-recommended perioperative management, although its effect on early recurrence was limited. Analyses accounting for repeated recurrences suggested, however, that the cumulative recurrence burden per patient decreased over time in Iceland. Patients undergoing radical cystectomy for bladder cancer or surgery for upper tract urothelial carcinoma had survival outcomes comparable to those reported in other Nordic population-based studies. In advanced and metastatic disease, patient outcome was poor and treatment decisions were strongly influenced by patient age.
In conclusion, urothelial carcinoma in Iceland demonstrates epidemiological patterns and treatment outcomes similar to those observed in other Nordic countries. Disease recurrence remains a major clinical challenge, although the overall burden of recurrence appears to be decreasing over time, possibly reflecting improvements in treatment strategies and follow-up practices.

About the Doctoral Candidate
Oddur Björnsson was born in Reykjavík in 1991. He graduated from the physics department of the Commercial College of Iceland in 2011 and earned his medical degree from the University of Iceland in 2017. After completing his internship year, he worked as a resident physician in the abdominal and urological surgery department at Landspítali University Hospital from 2018 to 2020. Oddur began his doctoral studies at the University of Iceland in November 2020.

In 2021, Oddur moved to Sweden, where he pursued specialist training in urological surgery alongside his doctoral studies. He completed his specialist training in the field at Sahlgrenska University Hospital in Gothenburg, Sweden, in 2025 and now works there as a urological surgeon.

Oddur’s parents are Björn Rúnar Guðmundsson, economist, and Gunnhildur Gísladóttir, chemist. His wife is Rósa Björnsdóttir, clinical psychologist, and their children are Dagur Björn, Hólmar, and Eysteinn.