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    Scott Adams

    Primary Small-Bowel Malignancy and Celiac Disease

    Scott Adams
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    Reviewed and edited by a celiac disease expert.

    QJM, May 1, 2003; 96(5): 345 - 353



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    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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  • About Me

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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