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A new study shows only a modest increase for malignancy and mortality in
celiacs (also a REDUCED risk of breast cancer!)  The full-text in PDF
format is available free.

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BMJ. 2004 Jul 21 [Epub ahead of print]

http://bmj.bmjjournals.com/cgi/reprint/bmj.38169.486701.7Cv1

Malignancy and mortality in people with coeliac disease: population based
cohort study.

West J, Logan RF, Smith CJ, Hubbard RB, Card TR.

Division of Epidemiology and Public Health, University of Nottingham,
Queen's Medical Centre, Nottingham NG7 2UH.

OBJECTIVE: To quantify the risks of malignancy and mortality in people with
coeliac disease compared with the general population. DESIGN: Population
based cohort study. SETTING: General practice research database.
PARTICIPANTS: 4732 people with coeliac disease and 23 620 matched controls.
MAIN OUTCOME MEASURES: Hazard ratios for malignancy and mortality. RESULTS:
Of the 4732 people with coeliac disease, 134 (2.8%) had at least one
malignancy and 237 (5.0%) died. The overall hazard ratios were: for any
malignancy 1.29 (95% confidence interval 1.06 to 1.55), for mortality 1.31
(1.13 to 1.51), for gastrointestinal cancer 1.85 (1.22 to 2.81), for breast
cancer 0.35 (0.17 to 0.72), for lung cancer 0.34 (0.13 to 0.95), and for
lymphoproliferative disease 4.80 (2.71 to 8.50). The increased risk was
primarily in the first year after diagnosis, with the risk for only
lymphoproliferative disease remaining significantly raised thereafter.
After excluding events in the year after diagnosis, the hazard ratio for
malignancy was 1.10 (0.87 to 1.39) and for mortality was 1.17 (0.98 to
1.38), giving absolute excess rates of 6 and 17 per 10 000 person years,
respectively. CONCLUSIONS: People with coeliac disease have modest
increases in overall risks of malignancy and mortality. Most of this excess
risk occurs in the year of follow up after diagnosis. People with coeliac
disease also have a noticeably reduced risk of breast cancer. The mechanism
of this merits further attention as it may provide insights into the cause
of this common malignancy.

PMID: 15269095 [PubMed - as supplied by publisher]

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