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Celiac.com 04/04/2012 - After numerous studies over several decades showing higher mortality rates in people with celiac disease, including a comprehensive study in 2009, published in Gastroenterology, news of a recent UK study, finding mortality rates for people with untreated celiac disease that are similar to the general population, has raised a few eyebrows. With diverse study data fueling differing opinions, questions regarding long-term mortality in people with celiac disease will likely take time to resolve. In the meantime, a review of scientific literature brought up this small 2007 study. In it, a research team compared long-term mortality rates in people diagnosed with celiac disease as children with rates for those diagnosed as adults. They wanted to find out how those rates might differ and if the rates might be related to the disease and the length of gluten exposure before diagnosis. To find an answer, the team gathered data for 285 children and 340 adults diagnosed with celiac disease. They continued to gather data for each until the end of 2004, excepting those who failed to follow up for other reasons. From their data, the team calculated standardized mortality ratios (SMRs) for the period starting five years after patient diagnosis. They found that adults diagnosed with celiac disease had 38% higher mortality rates (SMR 1.38, 95% CI 1.16-1.63). Children on the other hand, faced rates three-times higher (SMR 3.32, 95% CI 2.05-5.07). This excess mortality in children was mainly due to higher rates of death from accidents, suicide, and violence (seven deaths, SMR 3.22, 95% CI 1.29-6.63), cancer (five deaths, SMR 3.72, 95% CI 1.21-8.67), and cerebrovascular disease (two deaths, SMR 10.03, 95% CI 1.21-36.00). The 2007 study found that adults with celiac disease face a modest increase in mortality rates over the long-term, but that mortality rates for those diagnosed with celiac disease as children were three-times higher starting five years after diagnosis. The team proposed that the increased mortality in children from external causes may be due to behavioral changes associated with living with life-long celiac disease and its treatment. Stay tuned for further developments regarding mortality rates in people with celaic disease. Source: The American Journal of Gastroenterology. 2007;102(4):864-870.
Celiac.com 11/07/2002 - The results of a recent study conducted by researchers in Sweden indicate that the overall cancer risk of people with celiac disease or dermatitis herpetiformis is higher than that of the normal population, but lower than other studies have reported. Further, the overall risk is lower in children and higher in adults, and the risk "declined with time and eventually reached unity," presumably because most of the subjects followed a gluten-free diet. Here is the Medline abstract for the study: Gastroenterology 2002 Nov;123(5):1428-1435 Links Askling J, Linet M, Gridley G, Halstensen TS, Ekstrom K, Ekbom A. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute/Hospital, Stockholm, Sweden; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; Institute of Oral Biology, University of Oslo, Oslo, Norway; and the Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden. BACKGROUND & AIMS: Studies of cancer risk in celiac disease (celiac disease) or dermatitis herpetiformis (DH) indicate increased risks for malignant lymphoma and occasionally other neoplasms, but are characterized by small numbers, lack of systematic cancer assessment, and subjects identified from referral institutions. METHODS: By using Swedish population-based inpatient and cancer registry data, we followed-up 12,000 subjects with celiac disease or DH, and evaluated cancer incidence by using standardized incidence ratios (SIR). RESULTS: Adults (but not children and adolescents) with celiac disease had an elevated overall risk for cancer (SIR = 1.3) that declined with time and eventually reached unity. Elevated risks were found for malignant lymphomas, small-intestinal, oropharyngeal, esophageal, large intestinal, hepatobiliary, and pancreatic carcinomas. The excess occurrence of malignant lymphomas was confined to adults, decreased with time of follow-up evaluation, and decreased over successive calendar periods. Decreased risks were found for breast cancer. Subjects with DH had a slightly increased overall cancer risk (SIR = 1.2) owing to excesses of malignant lymphoma and leukemia, but no increases of gastrointestinal carcinomas. CONCLUSIONS: Albeit increased, the relative risks for lymphomas and gastrointestinal cancers in this study are lower (and declining) than in most previous reports. The overall cancer risk is only moderately increased, and non-elevated during childhood and adolescence. PMID: 12404215 [PubMed - as supplied by publisher]