<<Disclaimer: Verify this information before applying it to your situation.>>

In a follow-up article to the one I cited just the other day,

"Risk of malignancy in patients with celiac disease.
Am J Med. 2003 Aug 15;115(3):191-5.
Green PH, Fleischauer AT, Bhagat G, Goyal R, Jabri B, Neugut AI.
Departments of Medicine (PHRG, RG, AIN), College of Physicians and
Surgeons, New York, New York, USA"

the authors now point out that in endoscopic screenings, adenomacarcinoma
is found less often than statistics from studies suggest it should be,
implying that routine endoscopic examinations are not adequate.

----------
Scand J Gastroenterol. 2003 Aug;38(8):831-3.

Risk of duodenal adenoma in celiac disease.

Rampertab SD, Fleischauer A, Neugut AI, Green PH.

Dept. of Medicine and Herbert Irving Comprehensive Cancer Center, Columbia
University College of Physicians and Surgeons, New York, USA.

BACKGROUND: There is a 60- to 80-fold increased risk of small-bowel
adenocarcinoma in patients with celiac disease. While the adenoma-carcinoma
sequence appears to operate in the small bowel as in the large bowel, the
risk of duodenal adenomas in celiac patients is unknown. METHODS: The
records of 381 patients (245 F, 136 M) with biopsy-proven celiac disease
were reviewed to determine the prevalence of duodenal adenoma found during
esophagogastroduodenoscopy (EGD). We conducted an extensive literature
review to find data for estimates of the prevalence of duodenal adenoma in
a comparable general population; we used data from a study at another New
York City medical center of 7346 EGDs conducted between 1976 and 1982
(Ghazi et al., 1984). We estimated the relative risk, expressed as a
standard morbidity ratio (SMR), by calculating the observed to expected
(O/E) ratio. RESULTS: Duodenal adenomas were found in 3 celiac patients
(0.78%), with 24 adenomas (0.33%) in the reference population, giving an
SMR of 2.39 (95% CI 0.67-8.48). CONCLUSION: We did not find a significantly
increased risk of duodenal adenoma in celiac patients compared to a non-
celiac endoscoped population. Thus, despite the previously described
elevated risk of small-bowel adenocarcinoma in these patients, routine
endoscopic examination of the duodenum may not be adequate for screening.

* * *

*Support summarization of posts, reply to the SENDER not the CELIAC List*