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Low risk of gastrointestinal cancer among patients with celiac disease, inflammation, or latent celiac disease.
Clin Gastroenterol Hepatol 2012; 10(1):30-6CG

Abstract

BACKGROUND & AIMS

Celiac disease has been associated with gastrointestinal (GI) cancers in small studies; risks have not been estimated from large populations or based on histopathology analyses.

METHODS

We examined the risk of GI cancers by using data from cohorts of patients with celiac disease (villous atrophy, Marsh score of 3; n = 28,882) or inflammation (Marsh score of 1-2; n = 12,860); biopsy samples were evaluated at 28 pathology centers. A third cohort included 3705 individuals with latent celiac disease (normal mucosa, but positive serology results). Data were compared with those from an age- and sex-matched population.

RESULTS

Of patients with celiac disease, 372 developed incident GI cancers; 347 patients with inflammation and 38 with latent celiac disease developed GI cancers. In the first year after diagnosis and initial biopsy, celiac disease was associated with 5.95-fold increase in risk of incident GI cancer (95% confidence interval [CI], 4.64-7.64); the hazard ratio [HR] for inflammation was 9.13 (95% CI, 7.19-11.6) and for latent celiac disease was 8.10 (95% CI, 4.69-14.0). After the first year, patients were at no significant increase in risk for GI cancers; the HR for celiac disease was 1.07 (95% CI, 0.93-1.23), for inflammation it was 1.16 (95% CI, 0.98-1.37), and for latent celiac disease it was 0.96 (95% CI, 0.56-1.66). The absolute risk for any GI cancer in patients with celiac disease was 101/100,000 person-years, with an excess risk of 2/100,000 person-years.

CONCLUSIONS

Although celiac disease, inflammation, and latent disease all increase risk for GI cancers in the first year after diagnosis, there is no increase in risk thereafter.

Authors+Show Affiliations

Department of Neonatology, Astrid Lindgren Children's Hospital-Danderyd, Karolinska University Hospital, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21723236

Citation

Elfström, Peter, et al. "Low Risk of Gastrointestinal Cancer Among Patients With Celiac Disease, Inflammation, or Latent Celiac Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 10, no. 1, 2012, pp. 30-6.
Elfström P, Granath F, Ye W, et al. Low risk of gastrointestinal cancer among patients with celiac disease, inflammation, or latent celiac disease. Clin Gastroenterol Hepatol. 2012;10(1):30-6.
Elfström, P., Granath, F., Ye, W., & Ludvigsson, J. F. (2012). Low risk of gastrointestinal cancer among patients with celiac disease, inflammation, or latent celiac disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 10(1), pp. 30-6. doi:10.1016/j.cgh.2011.06.029.
Elfström P, et al. Low Risk of Gastrointestinal Cancer Among Patients With Celiac Disease, Inflammation, or Latent Celiac Disease. Clin Gastroenterol Hepatol. 2012;10(1):30-6. PubMed PMID: 21723236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low risk of gastrointestinal cancer among patients with celiac disease, inflammation, or latent celiac disease. AU - Elfström,Peter, AU - Granath,Fredrik, AU - Ye,Weimin, AU - Ludvigsson,Jonas F, Y1 - 2011/06/30/ PY - 2011/05/05/received PY - 2011/06/09/accepted PY - 2011/7/5/entrez PY - 2011/7/5/pubmed PY - 2012/4/12/medline SP - 30 EP - 6 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 10 IS - 1 N2 - BACKGROUND & AIMS: Celiac disease has been associated with gastrointestinal (GI) cancers in small studies; risks have not been estimated from large populations or based on histopathology analyses. METHODS: We examined the risk of GI cancers by using data from cohorts of patients with celiac disease (villous atrophy, Marsh score of 3; n = 28,882) or inflammation (Marsh score of 1-2; n = 12,860); biopsy samples were evaluated at 28 pathology centers. A third cohort included 3705 individuals with latent celiac disease (normal mucosa, but positive serology results). Data were compared with those from an age- and sex-matched population. RESULTS: Of patients with celiac disease, 372 developed incident GI cancers; 347 patients with inflammation and 38 with latent celiac disease developed GI cancers. In the first year after diagnosis and initial biopsy, celiac disease was associated with 5.95-fold increase in risk of incident GI cancer (95% confidence interval [CI], 4.64-7.64); the hazard ratio [HR] for inflammation was 9.13 (95% CI, 7.19-11.6) and for latent celiac disease was 8.10 (95% CI, 4.69-14.0). After the first year, patients were at no significant increase in risk for GI cancers; the HR for celiac disease was 1.07 (95% CI, 0.93-1.23), for inflammation it was 1.16 (95% CI, 0.98-1.37), and for latent celiac disease it was 0.96 (95% CI, 0.56-1.66). The absolute risk for any GI cancer in patients with celiac disease was 101/100,000 person-years, with an excess risk of 2/100,000 person-years. CONCLUSIONS: Although celiac disease, inflammation, and latent disease all increase risk for GI cancers in the first year after diagnosis, there is no increase in risk thereafter. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/21723236/Low_risk_of_gastrointestinal_cancer_among_patients_with_celiac_disease_inflammation_or_latent_celiac_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(11)00670-7 DB - PRIME DP - Unbound Medicine ER -