Article

European multi-centre study on coeliac disease and non-Hodgkin lymphoma

Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
European Journal of Gastroenterology & Hepatology (Impact Factor: 2.15). 03/2006; 18(2):187-94. DOI: 10.1097/00042737-200602000-00012
Source: PubMed

ABSTRACT Coeliac disease (CD) is associated with an increased risk of non-Hodgkin lymphoma (NHL), but there is little information about whether this is true for clinically silent CD.
To investigate the frequency of CD in two European populations; one with NHL and another derived from the general population.
A prospective, multi-centre, case-control study in 10 European countries was conducted between May 1998 and April 2001. A total of 1446 consecutive patients with newly diagnosed NHL aged over 18 years was collected. The control group consisted of a population of 9676 individuals who were screened for CD. The number of patients with a previous diagnosis of CD and those with silent CD detected by screening were determined in the two groups.
The patients with CD had a significantly increased risk of developing NHL [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-4.9]. This risk was only present in patients with CD diagnosed clinically before the study (OR 3.3, 95% CI 1.4-7.9), but not in those with silent CD detected by screening (OR 1.3, 95% CI 0.6-2.7).
Patients with CD have an increased risk of developing NHL, although this is lower than previously thought. Clinically silent CD is rare in patients with NHL.

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    • "Their study suggested that the CD-associated population attributable risk of NHL is very low. In contrast, Mearin et al. investigated the frequency of CD in patients that had been diagnosed with NHL compared to the general population, in 10 European countries (38). The study reported finding for 1446 consecutive patients with newly diagnosed NHL. "
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    • "Most studies report an increased risk of non-Hodgkin lymphoma in celiac disease, though the risk for the individual patient is still very low [2]. Some evidence suggests that a gluten-free diet may reduce lymphoma risk [4, 5], though two case-control studies that screened for silent, i.e. untreated, celiac disease in lymphoma patients reported a less clear clinical association than perhaps thought [6, 7]. "
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    • "The risk for malignancies outside the gastrointestinal system has also been reported to be increased [Goldacre et al. 2008; Anderson et al. 2007; Smedby et al. 2005; West et al. 2004]. Although the risk for non-Hodgkin lymphomas has been shown to be increased in some studies, the increased risk was only found in patients who were already diagnosed with celiac disease [Mearin et al. 2006; Farre et al. 2004; Catassi et al. 2002]. "
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