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  • Jefferson Adams
    Jefferson Adams

    Just How Common Are Malignancies in Celiac Disease?

    Reviewed and edited by a celiac disease expert.

    Caption: Photo: Wikimedia Commons--Pinni_b_01

    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.

    Photo: Wikimedia Commons--Pinni_b_01Using 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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    I have had basal cell skin cancer six times ( squamous once, melanoma once) before being diagnosed with celiac disease. These happened in my 40-54 age range. I attributed this to the high inflammation in my body and am hoping my skin cancers stop occurring since I'm gluten free. Fingers crossed!

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    I had a DNA (saliva test) that showed my risks of different diseases, ranked from highest to lowest. At the top were the diseases (mostly autoimmune--like celiac, Sjogrins, arthritis which I have) It showed I was at high risk for stomach and esophageal cancer, melanoma. It helps to have this testing done so that you can keep an eye out for these diseases. I've been gluten free for 9 years.

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    Having had one sister die due to small bowel lymphoma (undiagnosed type-cause), and the rest of my siblings suffering from various serious autoimmune disorders, I wake up everyday wondering if this would be the day I find blood in the toilet like she did. And hoping that I did not pass this genetic time bomb to my daughter and my young grandsons. I don't sleep very well anymore.

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    So interesting. I haven't had any basal cells for 20 years, but had numerous prior to that. I've been gluten free for 10 years, since I found out I have severe osteoporosis. My father died of non-hodgkins lymphoma. My brother has chronic lucacite lymphoma, I have 3 cousins on my mother's side with colon cancer. It makes you wonder what would happen if everyone gave up gluten.

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    Guest Phyllis Galante

    Posted

    I had non hodgkins in 2007, in 2009 I had Large B cell lymphoma. I was diagnosed with celiac in 2013. I have been gluten free for 2 years and am cancer free.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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