Risk of Dying From Celiac-Related Cancer is Limited Mainly to These Factors

Celiac.com 03/31/2022 - A number of studies have associated celiac disease with increased mortality rates, partly due to celiac-related cancers. 

However, most studies assessing cancer risk used data from celiac patients diagnosed in an era before celiac disease diagnosis rates and access to gluten-free food become more common. What can we learn from a study of celiac patients diagnosed more recently?

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A team of researchers conducted a population-based study to assess cancer risk in celiac disease. The research team included Benjamin Lebwohl; Peter H.R. Green; Louise Emilsson; Karl Mårild;  Jonas Söderling; Bjorn Roelstraete; and Jonas F. Ludvigsson.

Defining celiac disease as duodenal/jejunal villus atrophy, and using the Epidemiology Strengthened by histoPathology Reports in Sweden cohort, the team gathered data on all celiac patients in Sweden. 

The team matched each patient to five or fewer controls by age, sex, and county. They then employed a stratified Cox proportional hazards model, and tracked patients from diagnosis until the first instance of cancer, or to December 31, 2016.

After looking at nearly fifty thousand patients with celiac disease, the team found that nearly sixty-five percent were diagnosed since 2000. After an average follow-up of nearly twelve years, the rate of cancer was 6.5 and 5.7 per 1000 person-years in celiac disease patients and control subjects, respectively. 

The overall risk of cancer rose only in the first year after celiac disease diagnosis and not subsequently, although the risks for hematologic, lymphoproliferative, hepatobiliary, and pancreatic cancers continued. 

People over sixty showed the highest risk, while those diagnosed before age 40 showed no increase in cancer risk. The cancer risk was similar among those diagnosed with celiac disease before or after the year 2000.

Bad news/Good news
The bad news is that the team did find that celiac patients have an elevated risk of developing cancer.

The good news is that the increased risk is found in people diagnosed with celiac disease after age 40, but it is mainly a factor within the first year of celiac diagnosis, and limited to certain gastrointestinal and hematologic cancers.

However, this study is good news for anyone with celiac disease who might be worried about having an overall higher risk of cancer, as that does no seem to be the case, at least going by this data.

Stay tuned for more on this and related stories.

Read more in Clinical Gastroenterology & Hepatology

The researchers are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York; the Department of Epidemiology, Mailman School of Public Health, Columbia University in New York, USA; School of Medical Science, University of Örebro, Örebro, Sweden; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Värmlands Nysäter Health Care Center and Centre for Clinical Research, County Council of Värmland, Sweden; the Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway; the Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; and the Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.