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Just How Common Are Malignancies in Celiac Disease?
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Celiac.com 09/22/2014 - The connection between celiac disease and various types of cancer is well supported by scientific evidence. However, to date, there hasn’t been enough data to make accurate predictions of cancer risk in celiac patients. So, we don’t know exactly what the risk levels are for various types of cancer in celiac patients.
Using a large population register of diagnosed celiac patients in Finland, a team of researchers recently set out to establish a realistic projection of the cancer risk for celiac patients.
The researchers included T. Ilus, K. Kaukinen, L.J. Virta, E. Pukkala, and P. Collin. They are variously associated with the Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and University of Tampere in Finland; the Department of Medicine at Seinäjoki Central Hospital in Seinäjoki, Finland; the Research Department at The Social Insurance Institution in Turku, Finland; the Finnish Cancer Registry at the Institute for Statistical and Epidemiological Cancer Research in Helsinki, Finland; and the School of Health Sciences at the University of Tampere in Tampere, Finland.
For the period covering 2002-2011, the register contained 32,439 adult celiac patients. The team paired this data with data from the Finnish Cancer Registry, which includes over 98% of diagnosed malignancies. Using incidence figures for the whole population, the team calculated a standardized incidence ratio (SIR) for the malignancies,
They constructed a time-stratified analysis in 11,991 celiac patients diagnosed after 2004. They did not have information on lifestyle factors, such as smoking habits and obesity.
They found that the overall incidence ratio of malignant diseases did not increase until five or more years from the diagnosis of celiac disease (1.31, 1.04-1.63). The results showed higher SIRs for non-Hodgkin lymphoma (NHL; 1.94; 1.62-2.29), small-intestinal cancer (4.29; 2.83-6.24), colon cancer (1.35; 1.13-1.58), and basal cell carcinoma of the skin (1.13; 1.03-1.22).
However, SIRs for lung cancer (0.60; 0.48-0.74), pancreatic cancer (0.73; 0.53-0.97), bladder cancer (0.53; 0.35-0.77), renal cancer (0.72; 0.51-0.99), and breast cancer (0.70; 0.62-0.79) were lower. SIR for NHL immediately after the diagnosis of celiac disease was 2.56 (1.37-4.38).
Overall, there was no increased SIR of cancer in the whole series, but SIR rose after 5 years from the diagnosis of celiac disease. The overall risk of breast and lung cancers in celiac patients was lower, while the risk of small-intestinal cancer and NHL was higher, but not as high as previous data indicated.
So, patients with celiac disease over five years showed higher rates of non-Hodgkin lymphoma, small-intestinal cancer, colon cancer, and basal cell carcinoma of the skin.
Among other benefits, this study will help clinicians and doctors to better focus their attention toward warning signs for these conditions in people with celiac disease.
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