Major Cohort Study Assesses Cancer Risk in Celiac Disease

Celiac.com 09/20/2021 - People with celiac disease face an increased risk of death, in part due to cancer. Most studies investigating this cancer risk involved patients diagnosed before widespread increases in celiac disease diagnosis rates and access to gluten-free food. A team of researchers recently conducted a population-based study to assess the risk of cancer for people with celiac disease.

For their study, the team used the Epidemiology Strengthened by histoPathology Reports in a Swedish cohort to gather data from all celiac disease patients in Sweden, with celiac disease defined as duodenal/jejunal villus atrophy. 

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They then matched each patient by age, sex, and county to five or fewer control subjects. Then, following patients from diagnosis until first cancer, or by December 31, 2016, they calculated hazards ratios using the stratified Cox proportional hazards model.

Of nearly 50,000 celiac patients, 64% were diagnosed with celiac disease since 2000. After a median follow-up of 11.5 years, the incidence of cancer was 6.5 and 5.7 per 1000 person-years in celiac disease patients and controls, respectively. 

The risk of cancer rose overall, but it was most sharply elevated in the first year after celiac disease diagnosis, and not later on, although the risks of hematologic, lymphoproliferative, hepatobiliary, and pancreatic cancers remained. 

Risk levels were highest for people diagnosed with celiac disease after age 60 years of age, while those diagnosed before age 40 faced no such increase. Lastly, the cancer risk was similar among those diagnosed with celiac disease before or after the year 2000. The team's data showed an overall rise in cancer risk for celiac disease patients, even in recent years. However, the risk increase is only for those diagnosed with celiac disease after age 40, and then mostly within the first year of diagnosis.

This is one of the first studies to give a solid picture of overall cancer risks for people with celiac disease. Stay tuned for more on this and related stories. 

Read more in Clinical Gastroenterology and Hepatology
 

The research team included Benjamin Lebwohl; Peter H.R. Green; Louise Emilsson; Karl Mårild; Jonas Söderling; Bjorn Roelstraete; and Jonas F. Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; the Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

12/06/2021 - A correction was made to the article "64% were diagnosed with celiac disease since 2000."