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No Higher Cancer Risk for Silent Celiac Disease

Celiac.com 05/13/2009 - People with silent celiac disease, those who test positive for celiac disease antibodies, yet show no clinical signs of the disease itself, do not face a higher risk for developing malignant cancers, according to results of a recent Finnish study.

Previous studies done in the 1970s and 1980s indicated that patients with clinically recognized celiac disease face a higher risk for developing malignancies, Dr. Katri Kaukinen, of the University of Tampere, Finland, told reporters from Reuters Health. However, she explained, "it has not been known whether apparently clinically silent unrecognized cases also carry an increased risk of celiac disease-related complications, and thus whether the healthcare system should recognize and treat."

In an effort to answer that question, Dr. Kaukinen led team of researchers in assessing whether adults with previously unrecognized screening-identified evidence of celiac disease have an increased risk of malignancies.

Recent screening figures put the prevalence of celiac disease somewhere between 1% and 2% of the population, which means from 7 to 14 million Europeans with gluten intolerance. 75% to 90% of all the celiac disease remains undiagnosed due to absent or atypical symptoms.

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The team examined data from a Finnish population-based adult-representative cohort of 8000 subjects compiled from 1978 to 1980. In 2001, the researchers screened blood samples of people with no history of celiac disease or any malignancy (n = 6849) for immunoglobulin A (IgA) class tissue transglutaminase antibodies. They further screened
positive samples for IgA class tissue transglutaminase antibodies (Celikey tTG) and for IgA endomysial antibodies (EMA).

The team analyzed a total of 6849 blood samples. 565 samples showed positive Eu-tTG results. 202 of these subjects showed positive Celikey tTG results ((2.9%) while 73 showed positive EMA screens (1.1%).

Just over 10% of the study subjects, a total of 694 participants, developed malignancies during the period of the study. Overall malignancy risk was no higher for celiac autoantibody-positive subjects. Adjusted for age and sex, the results showed that the relative risks were 0.91 for those who were Celikey tTG positive, and 0.67 and for those who were EMA positive.

According to Dr. Kaukinen, the results seem to support the current clinical approach, and suggests that "earlier diagnosis of the disease through serological mass screening would not be beneficial in improving the prognosis of celiac disease as regards malignancies."

However, before completely ruling out mass screening, Dr Kaukinen noted that it is important to pursue "further prognostic studies [on] mortality and fractures among earlier unrecognized celiac disease cases," as "[t]hese issues should be also addressed" before any official decisions are made regarding the use of mass blood screening for celiac disease.


Gut 2009; 58:643-647.

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3 Responses:

 
Andrés
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said this on
03 Jun 2009 7:14:10 AM PST
So is there a higher risk of cancer if we don't follow the gluten-free diet or not? I wouldn't mind getting the occasional diarrhea abdominal pains if I could lead a normal life again.

 
Nancy
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said this on
07 Jun 2009 3:30:08 PM PST
My celiac was found by my doctor investigating liver disease. I didn't have IBS until I started the gluten-free diet 6 months ago. If there's no risk of cancer, why am I on this horrible diet? My favorite foods are pasta and bread and I don't like the substitutes made with corn.

 
claire
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said this on
23 Sep 2009 5:37:32 AM PST
"No higher risk for silent disease" is not through any more! There was a new research about risk of mortality for silent disease and silent disease got the highest risk.
Gluten sensitivity raises death risk (75% more), it is half for celiac (33% more); it is once again the proof that gluten is toxic and we just start to understand how much with research like this one. In France, I fight to obtain less gluten for everyone in food from agro-business but there is even more gluten in American food and I don't know if American celiacs act to make this danger well known by every consumer?
Friendly yours!




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