IBD, several GI cancers join growing list of risks for patients with celiac disease
Key takeaways:
- Celiac patients had higher risks for pancreatic, esophageal, colonic and gastric cancers but not rectal cancer or HCC.
- They also had increased risks for Crohn’s, UC and noninfectious enterocolitis.
A French cohort study confirmed high risks for lymphoma and small bowel cancer in patients with celiac disease but also found elevated risks for pancreatic, esophageal, gastric and colonic cancers, as well as inflammatory digestive diseases.
“Patients with celiac disease (CeD) have increased risk of lymphoma and small bowel cancer,” Anne-Sophie Jannot, PhD, MD, medical director at the National Bank for Rare Diseases in Paris, and colleagues wrote in Clinical Gastroenterology and Hepatology. “Whether risks of other digestive cancers are enhanced remains controversial.”
In a nationwide French cohort study, Jannot and colleagues investigated the association between CeD and the risk for digestive cancers using data from 27,114 patients (mean age, 37.1 years; 72.7% women) hospitalized with CeD from 2011 to 2019. The researchers matched patients 1:1 with nonexposed controls based on age and sex and followed both cohorts for 9 years.
According to study results, there was a significant association between CeD and non-Hodgkin lymphoma (OR = 4.08; 95% CI, 2.76-6.24). For solid tumors, the researchers observed the strongest association between CeD and small bowel cancer (OR = 13.95; 95% CI, 7.52-29.57), followed by pancreatic (OR = 2.41; 95% CI, 1.78-3.31), esophageal (OR = 1.72; 95% CI, 1.08-2.77), colonic (OR = 1.69; 95% CI, 1.39-2.06) and gastric cancers (OR = 1.52; 95% CI, 1.06-2.2).
Conversely, the researchers did not observe associations between CeD and rectal cancer (OR = 1.07; 95% CI, 0.8-1.44), hepatocellular carcinoma (OR = 0.81; 95% CI, 0.54-1.21) or melanoma (OR = 1.11; 95% CI, 0.74-1.68).
Patients with CeD also had a higher risk for pernicious anemia (OR = 11.28; 95% CI, 7.33-18.41), Crohn’s disease (OR = 4.18; 95% CI, 3.44-5.13), ulcerative colitis (OR = 3.27; 95% CI, 2.65-4.06) and noninfectious enterocolitis, which included microscopic colitis (OR = 4.52; 95% CI, 4.1-4.99) as well as nonalcoholic chronic pancreatitis (OR = 1.27; 95% CI, 1.23-2.29). They also demonstrated significantly increased risk for type 1 diabetes (OR = 2.8; 95% CI, 2.57-3.05), thyroiditis (OR = 5.04; 95% CI, 4.05-6.33), rheumatoid arthritis (OR = 1.41; 95% CI, 1.2-1.67) and osteoporosis (OR = 2.16; 95% CI, 1.84-2.56).
“This nationwide cohort study collects the largest number of cancer events in French population affected by CeD, likely due to the long 9-year follow up period and the high number of included patients,” Jannot and colleagues wrote. “Our results confirm high risks of lymphoma and small bowel cancer in celiac patients, but also indicate increased risks of pancreatic, esophageal, gastric and colonic cancers.”
Collapse