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Celiac.com 06/29/2017 - A team of researchers recently set out to document trends in diagnosis of celiac disease among patients from a single centre from 1958–2014, and and to provide data on rates and numbers of cases in those born in Derby city over 4 decades. The team also sought to explore a possible connection between deprivation and prevalence and characteristics of celiac disease in Asians. The research team included Geoffrey K T Holmes, and A Muirhead. They are affiliated with the Royal Derby Hospital, Derby, UK, and the Department of Public Health, Derby City Council, Derby, UK. The team used National Census information to identify 2,410 adult celiac patients diagnosed in Derby area hospitals. To measure changes in disease rates and individual cases over the study period, the team identified 1,077 patients born within Derby city; 191 of whom were Asian. From 2010–2014, 20 times more patients were diagnosed than during 1975–1979. More than one-quarter of patients (27%) were diagnosed at or above 60â€…years of age. The team noted a low number of diagnoses in young men. They noted also that most women were diagnosed 35 and 45 years of age, which is 15â€…years earlier than men. Young women and elderly patients saw the largest increase in diagnosis rates. In 2014, overall prevalence was 1:188. Prevalence in women was 1:138. Nearly 5 percent of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly, although only 5 percent were diagnosed at 60â€…years or older, far lower than for whites. The research team calls for more research into the dramatic increase in celiac cases, and the challenges this increase presents for follow-up and new models of care need. They encourage healthcare workers to be alert to the possibility of undiagnosed celiac disease in young men and elderly Asians. They note that a dedicated celiac clinic is helpful for increasing rates of celiac diagnosis. Source: BMJ Open Gastro 2017; 4:e00013. doi:10.1136/bmjgast-2017-000137
Celiac.com 08/24/2015 - A new study reveals that U.S. Asians experience higher rates of deadlier cases of Enteropathy-associated T-cell lymphoma EATL. Enteropathy-associated T-cell lymphoma is a rare primary intestinal non-Hodgkin lymphoma (NHL) strongly associated with celiac disease. It is an aggressive disease with a median survival of approximately 10 months (Ferreri et al, 2011). Previous studies suggest that EATL may be more common in Europe and among Whites, among whom celiac disease is prevalent (Delabie et al, 2011; Ferreri et al, 2011). However, a second type of EATL (Type II) not associated with celiac disease is increasingly reported in Asia (Lee et al, 2005; Sun et al, 2011; Tan et al, 2013). To date, there have been no comparative epidemiological study in a racially diverse large population. A team of researchers recently set out to conduct such a study. The research team included Pawan K. Karanam, Mohammed Al-Hamadani, and Ronald S. Go. They are variously associated with the Departments of Medical Education and Medical Research at the Gundersen Medical Foundation in La Crosse, USA, and with the Division of Hematology at the Mayo Clinic, and the Mayo Clinic's Robert D, and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA. The team turned to the two largest public cancer databases in the US: the Surveillance, Epidemiology, and End Results (SEER) database (http://www.seer.cancer.gov); and the National Cancer Data Base (NCDB; http://www.facs.org/quality-programs/cancer/ncdb). Using these databases, the research team was able to find and compare the cases of EATL by race. They were also able to describe the clinical features and overall survival (OS) for these cases. The team's study included all patients with an EATL diagnosis according to International Classification of Diseases for Oncology (ICD-O: 9717). The team used SEER-18 registries from 2000 to 2011 to calculate incidence. To describe clinical outcomes, they used the NCDB NHL-PUF with patients diagnosed between 1998 and 2012 for clinical characteristics and those diagnosed between 1998 and 2006 for OS. Because CoC-accredited programs report survival data only once every 5 years, OS analysis was possible only for patients diagnosed between 1998 and 2006. From the data, the team calculated the incidence rate (case/1 000 000), age-adjusted to the 2000 standard US population, according to race (White, Black, Asian/Pacific Islander, American Indian/Alaska native) using seer*stat software version 8.1.5 (National Cancer Institute, Bethesda, MD, USA) and performed risk ratio comparisons using Poisson regression. They analyzed OS using the Kaplan–Meier method and used log-rank tests to compare survival distributions between race cohorts. The prognostic effect of pertinent clinical variables were studied using multivariate Cox proportional hazards models. They found that, for the years 2000–2010, the overall age-adjusted incidence rate of EATL in the US was 0·111 per 1,000,000. Asians/Pacific Islanders had a higher incidence rate (0·236) compared with other races [White (0·101), Black (0·107), American Indian/Alaska native (0·128)]. The risk ratio of Asians/Pacific Islanders compared with non–Asians/Pacific Islanders was 2·32 [95% confidence interval (CI) 1·39–3·69; P = 0·002]. The incidences for Asians and Pacific Islanders were combined in seer*stat, therefore we could not provide separate incidences for Asians and Pacific Islanders. All tests of statistical significance were two-sided and P < 0·05 was considered significant. Source: British Journal of Haematology, Vol. 170 Issue 3. DOI: 10.1111/bjh.13555