<<Disclaimer: Verify this information before applying it to your situation.>> The following was posted recently: >I would like to suggest that you check out some of the information on >malignancy and celiac disease, especially lymphoma. One of the studies >established 3 categories: One for those who adhere to the diet strictly; one >for those who follow the diet, but not very strictly; and one for those who >do not follow the diet. > >The first group, after 5 years, shows a significant reduction in risk. In >fact, it is quite close to the risk experienced by members of the general >population. > >The second group does experience some reduction in risk, but it remains >closer to the rate of malignancy in untreated celiac disease. > >The third group has a very high risk of malignancy. I point out that the people in the first group, which supposedly was adhering to a strict gluten-free diet, were likely to have been including foods made with wheat starch in their diet because that was, and is, common in England where the study was carried out. I have asked several celiac researchers in England if I am correct in this assumption. They agreed that I am. Therefore these people in the stricty gluten-free group were likely to be eating a small amount of gluten each day. The amount is unknown because we don't know the amount of gluten in the starch (this varies according to the manufacturer and possibly according to lot) nor how much starch was ingested by which subjects. The apparent small increase in cancer risk for the first group was not statistically significant for those who had been on the diet more than 5 years. In the group with a normal diet, the relative risk of lymphoma was increased 78 fold, but it should be pointed out that the incidence of lymphoma of the gastrointestinal tract in the normal population is rather low. For the 210 patients in the study, the cancer morbidity was expected to be 0.21. For the 46 patients in the normal diet group, 7 cases of lymphoma were observed. For the 108 patients on the strict gluten-free diet, 3 cases of lymphoma were observed. The statistical significance of the numbers is weak because of the relatively small numbers of patients involved. These are extremely valuable and well-done studies. No criticism is intended. To arrange a study with larger numbers will be extremely difficult although a group in Leiden (The Netherlands) is trying to arrange such a study. I have no quarrel with those who wish to play it safe, but I don't think we can say for sure that small amounts of gluten in the range of a milligram to a few milligrams per day are harmful on the basis of any scientific study of which I am aware. They may be, or they may not be. I offer these comments only with the intent of providing as much information to celiac patients as possible so that they can make informed decisions. If anything I have said is incorrect, I hope someone will point out my errors on the net. Don Kasarda, Albany, CA