[Cancer risk in coeliac disease]

Abstract

Background: Coeliac disease is a common disease which seems to be considered less harmful now than previously. An association between coeliac disease and some types of cancer is well known. It is thus important to evaluate the seriousness of the condition and give patients advice and proper follow-up.

Material and methods: The article is based upon literature retrieved through a non-systematic search of PubMed. There are no Norwegian, but several European studies on the topic. Study design and patient selection varies.

Results: Most studies show increased cancer risk and mortality, especially for B-and T-cell lymphoma also outside the gut. The risk of breast and lung cancer is decreased. The studies show that the risk of mortality and cancer development is most pronounced the first three years after coeliac disease is diagnosed. The mortality of patients with coeliac disease during this period is nearly doubled in relation to a control population. There does not seem to be an increased cancer risk when the disease is diagnosed during childhood. Adherance to a gluten-free diet is at least partly protective.

Interpretation: Coeliac disease causes a certain increased risk of cancer and early death. It is not an innocent condition. This strengthens the arguments for coeliac patients to adhere to a gluten free diet.