No increased risk of cancer death with celiac disease

By Kathryn Doyle (Reuters Health) - By 10 years after a diagnosis of celiac disease, people with the condition are no more likely to die from cancer or cardiovascular disease than the general population, according to a new study. People with celiac disease were, in fact, slightly less likely to die of cardiovascular disease than others in the new study. When people with celiac disease, a hereditary condition, eat gluten from rye, wheat and barley, their immune systems respond by damaging the small intestine. As many as two million Americans may have the condition, according to the U.S. Department of Health and Human Services, but most do not know it. Previous studies looking at the influence of celiac disease on risk of dying from various causes have been mixed, the study authors write in the journal Gut. “Overall these results should be reassuring to both patients and their clinicians,” said lead author Alyshah Abdul Sultan of The University of Nottingham in the UK. The researchers used a large UK database of primary care records between 1998 and 2012 to identify nearly 11,000 people with celiac disease, and more than 100,000 similar people without celiac disease as a comparison group. Of the 10,825 patients with celiac disease, 773 died, which was similar to the mortality rate in the comparison group. There was no overall difference in rates of respiratory disease, digestive disease or cancer-related death, according to the results. People with celiac disease were slightly less likely than the general population to die of cardiovascular disease, but they a tenth of a percent more likely to die of non-Hodgkin’s lymphoma, a cancer of the white blood cells. That’s a very small increase in risk, Sultan told Reuters Health. “This study adds to existing modern data that show that celiac disease is not as dangerous as previously thought,” said Dr. Jonas F. Ludvigsson, a pediatrician and epidemiologist at the Karolinska Institutet and Örebro University Hospital in Sweden. “Older studies were often based on celiac individuals with unusually severe celiac disease, malabsorption and associated disorders, the result of which was often rather high relative risks of death,” said Ludvigsson, who was not involved in the new study. “This is a large well-designed study suggesting that celiac patients in England, and likely elsewhere in the Western world, are at no increased risk of death,” he told Reuters Health by email. “That is indeed very good news.” This study did not include people with undiagnozed celiac disease, but if people with the undiagnozed condition do not have symptoms, it may not be that dangerous, he noted. Some diseases, like type 1 diabetes or osteoporosis, might be more common among people with celiac disease, Ludvigsson added. “Some disorders can be tackled by adhering to a gluten-free diet but probably not all,” he said. People with celiac disease tend to have a lower body mass index and are less likely to smoke than the general population, so it makes sense that cardiovascular disease would be less common for them, Sultan pointed out. SOURCE: http://bmj.co/1rA7XWX Gut, online October 24, 2014.