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Primary Small-Bowel Malignancy and Celiac Disease
In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I foundedÂ The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.View all articles by Scott Adams
QJM, May 1, 2003; 96(5): 345 - 353
Celiac.com 05/29/2003 – A survey was recently conducted by Professor P.D. Howdle, St. Jamess University Hospital (UK), et al, to estimate the frequency in the UK of small bowel malignancy, and its relationship to celiac disease. Data were collected from 1,327 clinicians on a monthly basis between June 1998 and May 2000. The clinicians were asked to report all cases of newly diagnosed primary small bowel malignancy, and whether or not the patients reported also had celiac disease. Normally malignancies of the small intestine are rare, and they only account for less than 2% of all gastrointestinal cancers.
Results: "Clinico-pathological data were ascertained for 395 cases, including 175 adenocarcinomas, 107 lymphomas and 79 carcinoid tumors. In 13% of adenocarcinoma cases and in 39% of lymphomas, there was a diagnosis of celiac disease. Survival rates at 30 months for adenocarcinomas, lymphomas and carcinoid tumors were 58%, 45% and 78%, respectively. Prognosis of all tumors was inversely related to stage at presentation, and lymphomas associated with celiac disease were associated with a poorer prognosis."
This study provides more evidence that those with celiac disease run a greater risk of getting adenocarcinoma of the small bowel, as well as lymphoma. Because of the high rate of metastatic disease in the patients studied, there appears to be a long time from the onset of symptoms to diagnosis, which is a concern.
Unfortunately this study does not address when celiac disease was diagnosed in these patients, and whether or not they were treating it with a gluten-free diet. Other studies have shown that cancer risk decreases to that of the normal population in patients who are on a gluten-free diet for at least five years.
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