Malignancy in Celiac Disease -- Effect of a Gluten-Free Diet

Holmes GK, Prior P, Lane MR, Pope D, Allan RN
Gut 1989 Mar;30(3):333-8
Gastroenterology Unit, General Hospital, Birmingham.
PMID: 2707633, UI: 89212172

Celiac.com Sponsor (A12):
Two hundred and ten patients with coeliac disease previously reported from this unit were reviewed at the end of 1985 after a further 11 years of follow up. The initial review at the end of 1974 could not demonstrate that a gluten free diet (GFD) prevented these complications, probably because the time on diet was relatively short. The same series has therefore been kept under surveillance with the particular aim of assessing the effects of diet on malignancy after a further prolonged follow up period. Twelve new cancers have occurred: of which one was a carcinoma of the esophagus and two lymphomas. Thirty nine cancers developed in 38 patients and of 69 deaths, 33 were the result of malignancy. A two-fold relative risk (RR) of cancer was found and was because of an increased risk of cancer of the mouth and pharynx (RR = 9.7, p less than 0.01, 95% confidence interval (CI) = 2.0-28.3), esophagus (RR = 12.3, p less than 0.01, CI = 2.5-36.5), and of non-Hodgkins lymphoma (RR = 42.7, p less than 0.001, CI = 19.6-81.4). The results indicate that for coeliac patients who have taken a GFD for five years or more the risk of developing cancer over all sites is not increased when compared with the general population.