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. 2007 Jan 7;13(1):146-51.
doi: 10.3748/wjg.v13.i1.146.

Malignancy and mortality in a population-based cohort of patients with coeliac disease or "gluten sensitivity"

L A Anderson  1 , S A McMillan, R G P Watson, P Monaghan, A T Gavin, C Fox, L J Murray
Affiliations

Malignancy and mortality in a population-based cohort of patients with coeliac disease or "gluten sensitivity"

L A Anderson et al. World J Gastroenterol. .

Abstract

Aim: To determine the risk of malignancy and mortality in patients with a positive endomysial or anti-gliadin antibody test in Northern Ireland.

Methods: A population-based retrospective cohort study design was used. Laboratory test results used in the diagnosis of coeliac disease were obtained from the Regional Immunology Laboratory, cancer statistics from the Northern Ireland Cancer Registry and mortality statistics from the General Registrar Office, Northern Ireland. Age standardized incidence ratios of malignant neoplasms and standardized mortality ratios of all-cause and cause-specific mortality were calculated.

Results: A total of 13 338 people had an endomysial antibody and/or an anti-gliadin antibody test in Northern Ireland between 1993 and 1996. There were 490 patients who tested positive for endomysial antibodies and they were assumed to have coeliac disease. There were 1133 patients who tested positive for anti-gliadin antibodies and they were defined as gluten sensitive. Malignant neoplasms were not significantly associated with coeliac disease; however, all-cause mortality was significantly increased following diagnosis. The standardized incidence and mortality ratios for non-Hodgkin's lymphoma were increased in coeliac disease patients but did not reach statistical significance. Lung and breast cancer incidence were significantly lower and all-cause mortality, mortality from malignant neoplasms, non-Hodgkin's lymphoma and digestive system disorders were significantly higher in gluten sensitive patients compared to the Northern Ireland population.

Conclusion: Patients with coeliac disease or gluten sensitivity had higher mortality rates than the Northern Ireland population. This association persists more than one year after diagnosis in patients testing positive for anti-gliadin antibodies. Breast cancer is significantly reduced in the cohort of patients with gluten sensitivity.

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References

    1. Johnston SD, Watson RG, McMillan SA, Sloan J, Love AH. Prevalence of coeliac disease in Northern Ireland. Lancet. 1997;350:1370. - PubMed
    1. Lewis NR, Scott BB. Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests) Aliment Pharmacol Ther. 2006;24:47–54. - PubMed
    1. Holmes GK, Prior P, Lane MR, Pope D, Allan RN. Malignancy in coeliac disease--effect of a gluten free diet. Gut. 1989;30:333–338. - PMC - PubMed
    1. Loftus CG, Loftus EV. Cancer risk in celiac disease. Gastroenterology. 2002;123:1726–1729. - PubMed
    1. Mearin ML, Catassi C, Brousse N, Brand R, Collin P, Fabiani E, Schweizer JJ, Abuzakouk M, Szajewska H, Hallert C, et al. European multi-centre study on coeliac disease and non-Hodgkin lymphoma. Eur J Gastroenterol Hepatol. 2006;18:187–194. - PubMed

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