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Open Access Highly Accessed Research article

Delayed diagnosis of coeliac disease increases cancer risk

Marco Silano1*, Umberto Volta2, Anna Maria Mecchia1, Mariarita Dessì3, Rita Di Benedetto1, Massimo De Vincenzi1 and the collaborating centers of the Italian registry of the complications of coeliac disease

Author Affiliations

1 Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy

2 Department of Internal Medicine, S. Orsola-Malpighi Hospital, Viale Massarenti 9, Bologna, Italy

3 Department of Laboratory Medicine, University Hospital Tor Vergata, Viale Oxford 81, Rome, Italy

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BMC Gastroenterology 2007, 7:8  doi:10.1186/1471-230X-7-8

Published: 9 March 2007

Abstract

Background

The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease.

Methods

The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005.

Results

The SIR for all cancers resulted to be 1.3; 95% CI = 1.0–1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9–7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5–51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7–25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3–4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not.

Conclusion

Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.