Incidence of Malignancies in Diagnosed Celiac Patients
Incidence of Malignancies in Diagnosed Celiac Patients
Altogether, 1,626 cancers occurred among celiac disease patients, whereas 1,735 were expected, giving the SIR of 0. 94 (95% CI 0.89–0.98, Table 2). In women, the relative risk was lower (SIR 0.89, 95% 0.83–0.94), and in men it was equal to that in the population at large (SIR 1.00, 95% CI 0.93–1.07). The SIR for the most frequent cancer in women, breast cancer, was 0.70 (95% CI 0.62–0.79), whereas that for the leading cancer in men, prostate cancer, was close to unity (Table 2).
The SIR for NHL in celiac patients was 1.94 (95% CI 1.62–2.29). None of the cases of NHL was diagnosed before the age of 30 years, and 98% were over 45 years old at diagnosis. The risk of Hodgkin lymphoma was decreased, albeit not statistically significantly (SIR 0.53, 95% CI 0.11–1.55).
The SIR for small-intestinal cancer was more than fourfold (Table 2). The risk of colon cancer was increased in celiac patients, whereas the incidence of rectal cancer was slightly lower than in the population in general. The risk of pancreatic cancer was decreased in celiac patients.
The SIR for lung cancer was significantly lower in celiac patients than in the general population. This was also the case for renal and bladder cancers. There were relatively more registered cases of skin basal cell carcinoma among celiac patients than in the average Finnish population (Table 3).
The SIR during the first 5 years of follow-up in patients diagnosed in 2004 or later was not significantly different from that in the longer follow-up in any of the cancer sites (Table 3). The SIR for NHL was increased (2.56) within 2 years from the diagnosis of celiac disease, but not at longer follow-up. The SIR for all cancers was increased after 5 years from the diagnosis. The SIR for colon cancer was 1.79, the risk being highest (3.12) after 5 years from the diagnosis of celiac disease.
Results
Altogether, 1,626 cancers occurred among celiac disease patients, whereas 1,735 were expected, giving the SIR of 0. 94 (95% CI 0.89–0.98, Table 2). In women, the relative risk was lower (SIR 0.89, 95% 0.83–0.94), and in men it was equal to that in the population at large (SIR 1.00, 95% CI 0.93–1.07). The SIR for the most frequent cancer in women, breast cancer, was 0.70 (95% CI 0.62–0.79), whereas that for the leading cancer in men, prostate cancer, was close to unity (Table 2).
The SIR for NHL in celiac patients was 1.94 (95% CI 1.62–2.29). None of the cases of NHL was diagnosed before the age of 30 years, and 98% were over 45 years old at diagnosis. The risk of Hodgkin lymphoma was decreased, albeit not statistically significantly (SIR 0.53, 95% CI 0.11–1.55).
The SIR for small-intestinal cancer was more than fourfold (Table 2). The risk of colon cancer was increased in celiac patients, whereas the incidence of rectal cancer was slightly lower than in the population in general. The risk of pancreatic cancer was decreased in celiac patients.
The SIR for lung cancer was significantly lower in celiac patients than in the general population. This was also the case for renal and bladder cancers. There were relatively more registered cases of skin basal cell carcinoma among celiac patients than in the average Finnish population (Table 3).
The SIR during the first 5 years of follow-up in patients diagnosed in 2004 or later was not significantly different from that in the longer follow-up in any of the cancer sites (Table 3). The SIR for NHL was increased (2.56) within 2 years from the diagnosis of celiac disease, but not at longer follow-up. The SIR for all cancers was increased after 5 years from the diagnosis. The SIR for colon cancer was 1.79, the risk being highest (3.12) after 5 years from the diagnosis of celiac disease.
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