Patients with celiac disease at increased risk of cancer, study finds

Sweden: In a study, it was found out that, even in recent years, there has been an increase in the risk of cancer in Celiac disease (CD), although this risk rise is limited to individuals diagnosed with CD after the age of 40 and is predominantly apparent within the first year of diagnosis. This nationwide study was conducted by Benjamin Lebwohl and his team, the findings were published in the journal Clinical Gastroenterology and Hepatology on 21st May 2021.

Celiac disease (CD) is connected with an increased risk of death, owing in part to malignancy. The majority of research looking at this cancer risk involved individuals who were diagnosed prior to substantial increases in CD diagnosis rates and access to gluten-free diets. The aim of this study was to assess the risk of cancer-related to CD.

The personal identifying number was used to link participant data on CD to verified Swedish health records in order to determine absolute and relative cancer risks when compared to reference persons from the general population. Gastrointestinal histology report data on 2.1 million Swedish people biopsied between 1965 and 2016 were collected between 2015 and 2017. The data were obtained from Sweden's 28 pathology departments as part of the Epidemiology Strengthened by histopathology Reports in Sweden cohort.

Key Findings:

o This cohort research of 47,241 people with celiac disease identified by small intestine biopsy discovered a 1.11-fold higher risk of cancer, with gastrointestinal and hematologic/lymphoproliferative cancers accounting for the majority of the extra risk.

o Cancer incidence in celiac disease was 6.5 per 1000 person-years compared to 5.7 per 1000 person-years in the general population.

o The overall risk of cancer increased only in the first year following celiac disease diagnosis, but sustained increases in hematologic, hepatobiliary, and pancreatic malignancies were observed beyond 1 year.

o Despite the fact that cancer is a danger, was no longer statistically significant above 1 year following CD diagnosis, a long-term risk remained. This has been seen in some cancer subtypes.

o The sex-stratified analysis indicated that the cancer risk in CD was raised in males but not in women and that this was only partially attributable to the lower breast cancer risk identified in this cohort.

o It was also shown that the risk of cancer in CD varied by cancer subtype, with gastrointestinal malignancies having a higher risk but breast and lung malignancy having a lower risk.

In conclusion, as it was seen that people diagnosed with celiac disease found that the risk of cancer increased slightly during the first year of celiac diagnosis but decline afterward. The co-author added, "It appears that the increased risk of cancer in people with celiac disease decreased over time, and this may be related to the beneficial effect of the gluten-free diet in the long term,".

Reference:

Lebwohl, B., Green, P. H. R., Emilsson, L., Mårild, K., Söderling, J., Roelstraete, B., & Ludvigsson, J. F. (2021). Cancer Risk in 47,241 Individuals With Celiac Disease: A Nationwide Cohort Study. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2021.05.034