Tuire Ilus1, Katri Kaukinen2, Lauri J Virta3, Eero Pukkala4, Pekka Collin1. 1. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and University of Tampere, Tampere, Finland. 2. 1] Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and University of Tampere, Tampere, Finland [2] Department of Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. 3. Research Department, The Social Insurance Institution, Turku, Finland. 4. 1] Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland [2] School of Health Sciences, University of Tampere, Tampere, Finland.
Abstract
OBJECTIVES: The association between celiac disease and malignancies is well recognized. In Finland, the prevalence of clinically diagnosed adult celiac disease is 0.6%. In this large, population-based cohort, we aimed at a realistic projection of the cancer risk. METHODS: In the period 2002-2011, the register comprised 32,439 adult celiac patients. This was linked with the Finnish Cancer Registry, which covers over 98% of diagnosed malignancies. The standardized incidence ratio (SIR) was calculated for the malignancies, on the basis of incidence figures for the whole population. A time-stratified analysis was made in celiac patients diagnosed after 2004 (n=11,991). Lifestyle factors, including smoking habits and obesity, were not obtainable. RESULTS: The overall incidence ratio of malignant diseases was not increased (SIR 0.94; 95% confidence intervals 0.89-0.98), but it was ≥5 years from the diagnosis of celiac disease (1.31, 1.04-1.63). The SIRs for non-Hodgkin lymphoma (NHL; 1.94; 1.62-2.29), small-intestinal cancer (4.29; 2.83-6.24), colon cancer (1.35; 1.13-1.58), and basal cell carcinoma of the skin (1.13; 1.03-1.22) were increased, whereas those for lung cancer (0.60; 0.48-0.74), pancreatic cancer (0.73; 0.53-0.97), bladder cancer (0.53; 0.35-0.77), renal cancer (0.72; 0.51-0.99), and breast cancer (0.70; 0.62-0.79) were decreased. SIR for NHL immediately after the diagnosis of celiac disease was 2.56 (1.37-4.38). CONCLUSIONS: There was no increased SIR of cancer in the whole series, but SIR was increased after 5 years from the diagnosis of celiac disease. The risk of breast and lung cancers was decreased. The risk of small-intestinal cancer and NHL was increased, but to a lesser extent than previously described.
OBJECTIVES: The association between celiac disease and malignancies is well recognized. In Finland, the prevalence of clinically diagnosed adult celiac disease is 0.6%. In this large, population-based cohort, we aimed at a realistic projection of the cancer risk. METHODS: In the period 2002-2011, the register comprised 32,439 adult celiac patients. This was linked with the Finnish Cancer Registry, which covers over 98% of diagnosed malignancies. The standardized incidence ratio (SIR) was calculated for the malignancies, on the basis of incidence figures for the whole population. A time-stratified analysis was made in celiac patients diagnosed after 2004 (n=11,991). Lifestyle factors, including smoking habits and obesity, were not obtainable. RESULTS: The overall incidence ratio of malignant diseases was not increased (SIR 0.94; 95% confidence intervals 0.89-0.98), but it was ≥5 years from the diagnosis of celiac disease (1.31, 1.04-1.63). The SIRs for non-Hodgkin lymphoma (NHL; 1.94; 1.62-2.29), small-intestinal cancer (4.29; 2.83-6.24), colon cancer (1.35; 1.13-1.58), and basal cell carcinoma of the skin (1.13; 1.03-1.22) were increased, whereas those for lung cancer (0.60; 0.48-0.74), pancreatic cancer (0.73; 0.53-0.97), bladder cancer (0.53; 0.35-0.77), renal cancer (0.72; 0.51-0.99), and breast cancer (0.70; 0.62-0.79) were decreased. SIR for NHL immediately after the diagnosis of celiac disease was 2.56 (1.37-4.38). CONCLUSIONS: There was no increased SIR of cancer in the whole series, but SIR was increased after 5 years from the diagnosis of celiac disease. The risk of breast and lung cancers was decreased. The risk of small-intestinal cancer and NHL was increased, but to a lesser extent than previously described.
Authors: Fangcheng Yuan; Rayjean J Hung; Naomi Walsh; Han Zhang; Elizabeth A Platz; William Wheeler; Lei Song; Alan A Arslan; Laura E Beane Freeman; Paige Bracci; Federico Canzian; Mengmeng Du; Steven Gallinger; Graham G Giles; Phyllis J Goodman; Charles Kooperberg; Loic Le Marchand; Rachel E Neale; Jonas Rosendahl; Ghislaine Scelo; Xiao-Ou Shu; Kala Visvanathan; Emily White; Wei Zheng; Demetrius Albanes; Pilar Amiano; Gabriella Andreotti; Ana Babic; William R Bamlet; Sonja I Berndt; Paul Brennan; Bas Bueno-de-Mesquita; Julie E Buring; Peter T Campbell; Stephen J Chanock; Charles S Fuchs; J Michael Gaziano; Michael G Goggins; Thilo Hackert; Patricia Hartge; Manal M Hassan; Elizabeth A Holly; Robert N Hoover; Verena Katzke; Holger Kirsten; Robert C Kurtz; I-Min Lee; Nuria Malats; Roger L Milne; Neil Murphy; Kimmie Ng; Ann L Oberg; Miquel Porta; Kari G Rabe; Francisco X Real; Nathaniel Rothman; Howard D Sesso; Debra T Silverman; Ian M Thompson; Jean Wactawski-Wende; Xiaoliang Wang; Nicolas Wentzensen; Lynne R Wilkens; Herbert Yu; Anne Zeleniuch-Jacquotte; Jianxin Shi; Eric J Duell; Laufey T Amundadottir; Donghui Li; Gloria M Petersen; Brian M Wolpin; Harvey A Risch; Kai Yu; Alison P Klein; Rachael Stolzenberg-Solomon Journal: Cancer Res Date: 2020-07-08 Impact factor: 12.701
Authors: Jacalyn A See; Katri Kaukinen; Govind K Makharia; Peter R Gibson; Joseph A Murray Journal: Nat Rev Gastroenterol Hepatol Date: 2015-09-22 Impact factor: 46.802