Celiac disease: what are the risks for lymphoma and GI carcinoma?

  • van Gils T & al.
  • United European Gastroenterol J
  • 1 Dec 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Newly diagnosed celiac disease (CD) is associated with a 3.5- to 35.8-fold increase in relative risk for 3 types of lymphoma and gastrointestinal (GI) cancer: T-cell lymphoma, small bowel adenocarcinoma, and esophageal squamous cell carcinoma (esophageal SCC).

Why this matters

  • One of the first and largest studies to enumerate relative and absolute risks for lymphoma and GI cancer in CD.
  • Findings suggest that patients diagnosed with CD at age ≥50 years should be screened for T-cell lymphoma and small bowel adenocarcinoma.

Study design

  • Nationwide, population-based case-control study in the Netherlands comparing new, histologically confirmed CD among patients diagnosed with lymphoma or GI carcinoma (n=301,425) vs CD among patients diagnosed with melanoma or basal cell carcinoma (n=576,971; the control group).
  • Funding: None.

Key results

  • T-cell lymphoma (76% of which was intestinal or extraintestinal enteropathy-associated T-cell lymphoma) was associated with CD (relative risk [RR], 35.8; 95% CI, 27.1-47.4).
    • Most T-cell lymphomas diagnosed trend<.001>
  • Small bowel adenocarcinoma (RR, 11.9; 95% CI, 8.2-17.2) and esophageal SCC (RR, 3.5; 95% CI, 2.1-5.8) were also associated with CD.
  • Among these cancers, absolute risk was highest (4.3%) for T-cell lymphoma in men diagnosed with CD at ages 50-80 years.

Limitations

  • Case-control design.

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