No Higher Risk of Colorectal Neoplasia in Celiac Disease

Celiac.com 09/17/2010 - People with celiac disease have higher risk for developing lymphoma and small bowel malignancy, though most studies have found no higher risk of colorectal cancer.

To compare rates of colorectal cancer in celiac disease patients with rates for non-celiac disease control subjects, Dr. Peter Greene and colleagues at Columbia University Medical Center conducted a study. The research team included B. Lebwohl, E. Stavsky, and A. I. Neugut.

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For the study, the team reviewed case data for all celiac disease patients who underwent colonoscopy at Columbia Medical Center during a 44-month period. They matched each patient with non-coeliac disease controls according to age, gender and presiding endoscopist.

They then compared rates of colorectal adenoma between the groups, and used multivariate analysis to rate any independent association between celiac disease and cancers (adenomas).

The team found 180 patients with celiac disease and 346 controls. Thirteen percent of celiac patients and seventeen percent of control subjects showed at least one adenoma (P = 0.20).

Multivariate analysis showed that age and male gender were associated with adenomas in both groups, but showed no connection between celiac disease and adenomas.

More specifically, relative adenoma risk rose by 4% with each additional year of age, with men facing a 2.33-fold increased risk compared with women.

Their data showed clearly that celiac disease is not associated with an increased risk of colorectal neoplasia. They also note that the lack of increased risk of colorectal cancer seen in population studies reflects a genuine average risk of colorectal neoplasia, rather than an increase in colonoscopies and associated polypectomies in people with celiac disease.

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