GFD protects against development of malignancies

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Delayed diagnosis of coeliac disease increases cancer risk

Marco Silano et al ..

BMC Gastroenterology 2007

Conclusion
This paper confirms that the gluten-free diet is likely to protect from the development of malignancies in CD patients, since higher is the age at diagnosis of CD, higher is the risk of developing a malignancy, Therefore, the importance of a prompt diagnosis of CD is emphasized. ….

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RESEARCH ON CANCER RISK

20 year follow-up study
A Finnish research study investigated 6849 people without previous diagnosis of coeliac disease. From the 6849 participants, 565 had a positive IgA antibody to coeliac disease. All participants were followed up for a 20 year period (1980- 2001) to determine the risk of cancer (2).
The 20 year follow-up study found that there is no increased risk of overall cancer in untreated coeliac disease in comparison to the general population.

Study on mortality and malignancy
One recent study found that the risk of mortality and malignancy were only modestly increased (3).
This cohort study looked at 4732 people with coeliac disease compared to 23,620 controls. Mortality rates for the groups were 125.3 and 95.7 per 10,000 person years, respectively. Gastrointestinal cancer risk was increased (hazard ratio 1.85) as was lymphoproliferative disease (4.80). A decreased risk of breast cancer and lung cancer was found.

Cancer risk after starting the gluten-free diet
The gluten-free diet is protective and after three to five years of following a gluten-free diet, the risk of malignancy is reduced to that of the general population (4). One study showed that an increased risk was most highly related to the first year following diagnosis (3).

Another study showed that mortality was much higher in patients who presented with malabsorption symptoms, but was no different to a control group when patients with no or minor symptoms were studied (5)....


2 Lohi S, Maki M, Montonen J et al (2009) Malignancies in cases with screening-identified evidence of coeliac disease: a long term population based cohort study. Gut. 58: 643-647.
3 West J, Logan RF, Smith CF, et al (2004) Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ. 329 (7468): 716-9.
4 Holmes GKT, Prior P, Lane MR, et al (1989). Malignancy in coeliac disease - effect of a gluten free diet. Gut. 30: 333-338.
5 Corrao G, Corazza GR, Bagnardi V, et al (2001) Mortality in patients with coeliac ...

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www.ncbi.nlm.nih.gov/pmc/articles/PMC2830645/
www.coeliac.org.uk/healthcare-professionals/associated-conditions-and-complications/mortality-and-malignancy

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EXPERT Q & A
Effective Management of Celiac Disease
By CAROLYN SAYRE

Dr. Ritu Verma is the section chief of gastroenterology, hepatology and nutrition and director of the Children’s Celiac Center at the Children’s Hospital of Philadelphia.

How strictly do patients need to follow the diet if the small intestine and villi will heal after a few months on a gluten-free diet?

A: When you start eating the gluten again, it affects your immune system.
So your intestines will heal, but your immune system gets primed.
It goes haywire and starts sending out these signals to the rest of your body.
Your thyroid and other parts of your body can be affected, and those don’t heal.
So it is not just a matter of healing your intestine; it is also a matter of healing your body and protesting this long-term risk of lymphoma that you can develop years down the line.
The commitment has to be for life. So you can imagine how tough that is for patients, especially when they start feeling better. How many of us finish a course of antibiotics and when we start feeling better say, “O.K., I am done.”

www.nytimes.com/ref/health/healthguide/esn-celiac-expert.html